Transcript Roadmap in PPT format

Roadmap to Achieve 2010,
31st December RBM
Targets
September 2009 – December 2010
Country Summary
Population at risk (Projected):
12,900,000 (2009), 13,200,000 (2010), Ref: CSO Projection Reports, 2003
Intervention Units used Need to
2010
Already
covered
2,343,100
(2008 2009)
Funded and
expected to be
distributed
before end 2010
Gap
LLINs
Nets
(Universal
Access –
avg 1 net for
2 pp)
7,367,600
3,657,000 1,367,500 gap for
universal coverage of
LLINs if all funds are
received, otherwise
minus R7, gap is
5,02,500;
ACTs
Treatments
4,406,335
5,546,000 No gap,
To negotiate extra funds
to procure RDTs
RDTs
Number of
tests
5,300,000
4,937,453 362,547
IPTp
Women to
be treated
3,708,979
2,000,000 1,708,979
IRS
Financial /
USD
10,850,000
10,022,000 828,000*
(*) PMI funding may be less as it includes other overheads and not the actual available hence IRS gap may
have been under estimated
Country Summary
Intervention
Units used
M&E
Financial / USD
Need to 2010 Already
covered
Funded and
expected to be
distributed
before end 2010
Gap
2,054,000
500,000
2,554,000
BCC/IEC
Financial / USD
450,000
250,000
200,000
Human Resources
(including Capacity
Building)
Financial / USD
??
??
??
Other
LLIN resources available to achieve the 2010 targets
FUNDS AVAILABLE
(In US $)
1,383,805
1,334,413
SOURCE
COMMENT
GFATM R4
567, 446 LLINs procured and ready to be distributed to
households (MOH) – R1 & R4 Y3
Yr 4
Yr 5
215,000 MOH negotiating Emergency procurement (UNICEF)
208,000 for 2010 MOH procurement (UNICEF)
140,000 LLINs expected by October 2009 (CHAZ)
2,933,131
5,120,000
6,820,000
GFATM R7
Yr 1
Yr 2
Yr 3
MOH R7 funds not yet disbursed – 2010 procurement
454,815 LLINs - MOH
800,000 LLINs - MOH
1,000,000 LLINs – MOH
190,000 LLINs expected by October 2009 (CHAZ)
Distribution costs are included
10,400,000
PMI
900,000 LLINs for the MIP 2010
800,000
PMI
These are funds for distribution costs for MIP to be given to
implementation partner (SFH)
*No GFATM R7 disbursed and may not receive these funds
LLIN resources available to achieve the 2010 targets (2)
FUNDS AVAILABLE
(US $)
SOURCE
COMMENT
1,520,000
WORLD
BANK
300,000 LLINs procured and delivered in country - Sep 2009
Direct delivery to districts for mass distribution (door to door)
139,000
MACEPA
26,800 LLINs - expected by October, 2009 and immediate
mass distribution (door to door)
1,516,750
RAPIDS
303,350 LLINs - procured (133,350 in the country and balance
expected before end of 2009 (door to door campaign)
LLINs Ordering & Distribution to end of 2010
Quantities
GFATM (MOH and CHAZ) – 3,657,000 LLINs
World Bank 300,000 LLINs
MACEPA
26,800 LLINs
PMI
900,000 LLINs
RAPIDS
–
303,350 LLINs
Procurement dates
GF procurements (UNICEF - Sept 2009; UNICEF/VPP? - Jan 2010)
Expected delivery
9 months from date tender is floated
September 2009, November 2009; The rest, June 2010, August 2010
Planned Campaign Date
September to November 2009; July to October 2010
MIP (ANC) September 2009 to December 2010
BCC /IEC
September 2009 to December 2010 – On going
Community radio stations, drama, Mobile Video units, National media, religious
leaders announcements, door-to-door, training Malaria Focal Persons
Community mobilization
September 2009 to December 2010,
Community malaria booster (COMBOR), Radio Listening Groups, Community health
workers including use of CHW
Distribution
Sept 2009 – Dec 2010
Nation wide priority given to non IRS areas and districts with high incidence rates
Distribution mechanisms
Door-to-door mass campaigns, MIP routine distribution through ANC at health
facilities
Monitoring and evaluation
Sept 2009 – Dec 2010 – Routine Support Supervision, Routine HMIS data
October 2009 – Health facility survey
April-May 2010 – Malaria indicator survey
IRS resources available to achieve the 2010 targets
FUNDS
AVAILABLE (US $)
SOURCE
2,250,000 World
Bank/Russian
Trust Fund
120,000 GRZ
6,751,000 PMI
901,000 GFATM R4
COMMENT
US$ 1,000,000 for 2009 IRS actual implementation
US$ 1,250,000 for 2010
US $ 100,000 for 2009
US $ 20,000 for 2010
US$ 501,000 for 2009
US$ 6,250,000 for 2010
400,000 for chemicals in 2009
501,000 for cascade training in 2009
GFR9 proposal submitted – IRS main intervention
Indoor Residual Spraying 2010
Total Households targeted
1,280,000 (structures) for 2009
1,800,000 (structures) for 2010
DDT required
DDT 75% WP (40,000 sachets) for 2009 and DDT 75% WP (40,000 sachets) for
2010
Pyrethroids required
K-othrine 25% WG and Lambdacyhalothrin 10% CS (735,200 sachets) for 2009
K-othrine 25% WG (700,000 sachets) for 2010
Lambdacyhalothrin 10% CS (550,000 sachets) for 2010
Procurement schedules
DDT and part of pyrethroids delivered in-country
Expected procurement of 350,000 sachets of pyrethroids at a cost of $ 1,500,000 in the
fourth quarter (for 2009)
2010 Procurements - chemicals, pumps and PPEs at a cost of $ 4,500,000; Tendering by
first Quarter 2010 (Feb); No objection from donors by first quarter 2010 (March);
Delivery/receipt of goods in country by Second Quarter (June) for 2010
Distribution
First consignment of commodities delivered in August; Delivery of Insecticides in 4 th
quarter at $ 10,000 for 2009 and delivery of Equipment,
Insecticides and Personal Protective Equipment in 3rd quarter at $50,000 (in
2010)
Training
Completion of Cascade training of 1,890 spray operators in September at a cost of
$ 620,000 (2009)
2010 Training of Trainers (180 personnel) in July at a cost of $ 250,000
2010 Cascade training of 2,400 spray operators in August at a cost of $400,000
BCC/IEC
Community mobilization Sep – Dec 2009
Provision of IEC/BCC all quarters at a cost of $ 250,000 in 2010
Indoor Residual Spraying to 2010
Spraying
Implementing IRS in 36 districts in 4th quarter at
US$ 1,650,000 by 2009
Implementing IRS in 54 districts in 4th quarter
US$ 3,000,000 by 2010
Monitoring and
evaluation (bioassays,
insecticide resistance
etc)
Conducting pre IRS entomological and Parasitological
surveys in October at a cost of $50,000;
Supervision and Monitoring in 3rd and 4th quarters at
$50,000 by 2009
Conducting pre and post IRS entomological &
Parasitological to be done in all quarters at a cost of
$250,000 by 2010 and
Supervision and Monitoring in third and fourth quarters
at a cost of $50,000 in 2010
•Conduct insecticide susceptibility studies – Sep 2009,
Aug 2010
Enumeration of
households/structures in
18 districts
•To be done in all quarters at a cost of $300,000 in 2010
ACT resources available to achieve the 2010 targets
FUNDS
AVAILABLE (US $)
SOURCE
COMMENT
1,868,086
GFATM R1 Y3
1,227,446
1,265,518
1,258,480
GFATM R4 Y3
GFATM R4 Y4
GFATM R4 Y5
R1 balance from earlier ACT procurement
(2,490,000 treatment courses)
950,000 ACT treatment courses
1,052,650 ACT treatment courses
1,052,650 ACT treatment courses
(total of 3,056,210 up to 2010 for R4)
4,406,335 treatment need (1,556,335 -2009 &
2,850,000 - 2010 ).
To negotiate extra GF conversion to procure RDTs
UNITAID supplies from 2011
164,400
166,000
GFATM R4 Y3
GFATM R4 Y5
1,286,916
1,430,537
GFATM R7Y1
GFATM R7 Y2
690,000
3,679,000
World Bank
PMI
RDTs
164,400 RDT kits
166,000 RDT kits
1,286,916 RDT kits
1,430,537 RDT kits
(R7 not disbursed but due)
690,000 RDT kits
1,200,000 RDT kits (650,000 received; expecting
650,000) – Converted ACTs to procure RDTs
Case management (1)
ACTs
required
National Target : 100% public sector; Based on public sector
consumption trends in past 6 months, plus 2008 HMIS data on
malaria cases
1,556,335 ACTs treatment courses are required up to Dec 2009;
2,850,000 ACTs needed for 2010
No gap for ACTs in the public sector - May need to convert ACT funds
to RDTs procurement
Reprogrammed PMI ACTs to RDTs
RDTs
required
3,737,853 RDTs available from Sep 2009 to December 2010
5,451,316 RDTs required from Sep 2009 to December 2010
1,713,463 RDT gap
Procurement
schedules
GF procurements through UNICEF
All ACTs for 2009 expected in country by October 2009
1,3 million RDTs ordered; Expected delivery November, 2009;
4 million RDTs to be ordered in 2010.
BCC/IEC
Continuously Sept 2009 and 2010 December, by CHWs Sensitization
and Mass media (TV/Community Radio) sensitizations on health
seeking behaviours, early recognition of symptoms ; Orientation on
Dispersible Coartem
Case management (2)
Distribution
Mechanisms
Distribution through the Central Medical Stores to all public
health facilities (HFs) through PULL system to district level and
the district re-distributes to local facilities based on consumption
data and district need. This includes community health worker
supplies for Home management of malaria
Drug Efficacy
Monitoring
Annually 2009 and 2010 – Six (6) sites for drug efficacy trials on
Monitoring and
Evaluation
2009 Health facility Survey (October 2009)
Private sector ACTs Studies (Sept-Dec 2009)
2010 Malaria Indicator Survey
Essential Drug pilot Evaluation (2009, 2010)
Data reviews
Performance assessment
ACTs
Intermittent Preventive Therapy
Number of Pregnant women
targeted
2009; 690,454 Pregnant women
2010; 710,447 pregnant women
SP doses required
2009: IPT3; 724,977 Sep – Dec 2009 (2,899,906 for
2009); 2010; IPT3; 2,984,003
Procurement schedules
Procure by GRZ and PMI in Sep - Oct 2009
Delivery - GRZ Sep 2009; PMI Dec 2009
Distribution modalities
Medical Store Ltd (MSL) will store and distribute
monthly to various districts integrated with other
essential drug supply
Implementation through ANC at health facilities
through DOT (3 courses after first trimester, a month
apart)
Training
Training reproductive health unit of MOH supported by
the malaria control programme
BCC / IEC
2009; Sept-Dec and continue 2010; Update advocacy
plan & community mobilization, mass media
Monitoring and evaluation
HF Survey Oct 2009; 2010 MIS in May-July
Other core interventions to be delivered by the end of 2010
Intervention
Dates
Home management of malaria (HMM) – training community health
workers to strengthen skills in testing (confirm diagnosis) and
treatment, health information
HMM- Sept-Oct;
Jul ,Nov 2010
IEC/ Advocacy - mobilize partnership, resources, increase advocacy Sept- Dec 2009 and JanDec 2010
to create/increase malaria awareness and utilization of malaria
interventions.
Quality control (QC), Quality assurance (QA) and reporting
Sept2009-Dec 2010
Epidemic Preparedness and Response – Thresholds, capacity
building, strengthen emergency drugs and commodity stocks,
conduct assessments for preparedness, build capacities
(training, community, mobilization).
Sept- Dec 2009
Jan-Feb 2010
May-Aug 2010
M&E, Operations research, surveillance - strengthen operations
research and surveillance system
Sept-Dec 2009; Jan-Dec
2010
Other core interventions to be delivered by the end of 2010
Intervention
Dates
Comprehensive Programme review, needs assessment and 20112015 Strategic plan
March – September 2010
Human Resources: Strengthen NMCP; Provincial focal persons and
District focal persons
Oct 2009
Feb – March 2010
June to July 2010
Cross Border Initiatives – Support SARN and SADC in resource
mobilization and implementation
Sept-Oct 2009;Jan-Apr 2010
Summary of rate-limiting factors ( Over the next 17 months)
Problems
Solutions
Funding gap for commodities
- prompt diagnosis (RDTs),
Resource mobilization and effective utilization of available
resources
- key interventions (LLINs and IRS) - Support programmes (Operations
Research, advocacy activities, M&E).
Low utilization of preventive
interventions especially LLINs
Innovative messaging (IEC), mass media including
Community radio stations, drama, Mobile Video
units, National media, religious leaders involvement,
household door-to-door activities and training
Malaria Focal Persons, community empowerment to
participate
Procurement bottleneck - Long
processes coupled with delays in funds
disbursement
Capacity building on PSM, holding of Technical
meetings on commodity forecasting and
quantification in the NMCP for malaria partners and
financial management support
Human Resource; Staff shortage, high
staff attrition at service delivery and
retention of staff
Regular capacity building for staff on key
interventions (case management, LLINs, IRS, M&E)
and Programme management)
Integration of activities
Summary of technical assistance needs
over the next 17 months
Needs & Dates
Partner
Programme Performance Review and Development of Malaria
Control Strategic Plan; 2011-2015
WHO, MACEPA, UNICEF,
PMI, WB
USAID Deliver, WHO, PMI, GF
Capacity building on PSM
WHO, UNICEF, PMI, MACEPA
Revision of policy guidelines/documents
Management Systems - National Malaria Surveillance, Data
base, drug efficacy trial
WHO, MACEPA, UNICEF, WB
PMI
Cross Border Initiatives to support SADC in resource mobilization
WHO/RBM/ MACEPA
Financial Management Support
GF, PMI, WB, MACEPA
Partnership Coordination
All Partners, RBM