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Roadmap to Achieve 2010,31st December RBM
Targets
September 2009 – December 2010
Country Summary
Intervention Units used Need to 2010
Already covered
Funded and expected to be distributed before end 2010
Gap
LLINs (Universal Access – avg 1 net for 2 pp)
Nets 7,367,600 2,343,100 (2008 -
2009)
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*
Population at risk (Projected): 12,900,000 (2009), 13,200,000 (2010), Ref: CSO Projection Reports, 2003
(*) 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 Need to 2010 Already covered
Funded and expected to be distributed before end 2010
Gap
M&E Financial / USD
2,554,000
2,054,000 500,000
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 $)
SOURCE COMMENT
1,383,8051,334,413
GFATM R4
Yr 4Yr 5
567, 446 LLINs procured and ready to be distributed to households (MOH) – R1 & R4 Y3
215,000 MOH negotiating Emergency procurement (UNICEF)208,000 for 2010 MOH procurement (UNICEF)
140,000 LLINs expected by October 2009 (CHAZ)
2,933,1315,120,0006,820,000
GFATM R7Yr 1Yr 2Yr 3
MOH R7 funds not yet disbursed – 2010 procurement454,815 LLINs - MOH800,000 LLINs - MOH1,000,000 LLINs – MOH
190,000 LLINs expected by October 2009 (CHAZ)Distribution costs are included
10,400,000
800,000
PMI
PMI
900,000 LLINs for the MIP 2010
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 2009Direct 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 2010Quantities 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 $)
SOURCE COMMENT
2,250,000 World Bank/Russian Trust Fund
US$ 1,000,000 for 2009 IRS actual implementation US$ 1,250,000 for 2010
120,000 GRZ US $ 100,000 for 2009US $ 20,000 for 2010
6,751,000 PMI US$ 501,000 for 2009US$ 6,250,000 for 2010
901,000 GFATM R4 400,000 for chemicals in 2009501,000 for cascade training in 2009GFR9 proposal submitted – IRS main intervention
Indoor Residual Spraying 2010Total 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 2010Lambdacyhalothrin 10% CS (550,000 sachets) for 2010
Procurement schedules DDT and part of pyrethroids delivered in-countryExpected 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 4th 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 targetsFUNDS
AVAILABLE (US $)SOURCE COMMENT
1,868,086
1,227,4461,265,5181,258,480
GFATM R1 Y3
GFATM R4 Y3GFATM R4 Y4GFATM R4 Y5
R1 balance from earlier ACT procurement (2,490,000 treatment courses)950,000 ACT treatment courses1,052,650 ACT treatment courses1,052,650 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 RDTsUNITAID supplies from 2011
164,400166,000
1,286,9161,430,537
690,0003,679,000
GFATM R4 Y3GFATM R4 Y5
GFATM R7Y1GFATM R7 Y2
World BankPMI
RDTs164,400 RDT kits166,000 RDT kits
1,286,916 RDT kits1,430,537 RDT kits(R7 not disbursed but due)690,000 RDT kits1,200,000 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
ACTs
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
Intermittent Preventive TherapyNumber 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
Performance review, HMIS data review
Other core interventions to be delivered by the end of 2010
Intervention DatesHome 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 to create/increase malaria awareness and utilization of malaria interventions.
Sept- Dec 2009 and Jan-Dec 2010
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 2011-2015 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 SolutionsFunding gap for commodities
- prompt diagnosis (RDTs),
- key interventions (LLINs and IRS) - - Support programmes (Operations Research, advocacy activities, M&E).
Resource mobilization and effective utilization of available resources
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 PartnerProgramme Performance Review and Development of Malaria Control Strategic Plan; 2011-2015
WHO, MACEPA, UNICEF,
PMI, WB
Capacity building on PSMUSAID Deliver, WHO, PMI, GF
Revision of policy guidelines/documentsWHO, UNICEF, PMI, MACEPA
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
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