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Roadmap to Achieve 31.12.2011 RBM Targets
Liberia
January 2011 – December 2011Liberia
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Country Summary (Interventions & Services)Population at Risk: 3,703,430
Intervention
Operational objectives/targets
for
2011
Need to end 2011 Already covered in 2010
Funded and expected to be
distributed before end of
2011
Commodity Gap (Quantity)
Financial Gap (USD)
LLINs (Universal Access)
To increase the use of Insecticide Treated Nets (LLIN) among the whole population, especially vulnerable groups such as pregnant women and children under five, to 80% by 31st December 2010 and sustain this use through 2015
* Define how universal coverage target was
calculated e.g. 1 net for 1.8 persons
Mass Campaign:
Total number of nets required to reach the
operational target
741,400
Mass Campaign:Active nets
already in the community#
2,520,060
Procurement on-
going for 80,000
nets from Malaria
no more/UNICEF
to be distributed
before Dec. 2010
Mass Campaign:
Total number of nets for which
financing is already pledged
257,162 (PMI)
+
607,162 (GF)
=
864,324
Mass Campaign:
Number of nets for which financing has
to be mobilized to achieve the
operational target within
2011
0
Distribution cost:
$666,552
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Country Summary (Interventions & Services)Population at Risk: 3,703,430
Intervention
Operational objectives/targets
for
2011
Need to end 2011 Already covered in 2010
Funded and expected to be
distributed before end of
2011
Commodity Gap (Quantity)
Financial Gap (USD)
LLINs (Universal Access)
To increase the use of Insecticide Treated Nets (LLIN) among the whole population, especially vulnerable groups such as pregnant women and children under five, to 80% by 31st December 2010 and sustain this use through 2015
* Define how universal coverage target was
calculated e.g. 1 net for 1.8 persons
Routine distribution:
Total number of nets required to reach the
operational target (state what target
group is e.g. pregnant women
through ANC)
Total=185,172
GF= 92,586
+
PMI=92,586
Routine distribution:
Active nets already in the community#
# based on number of
nets already distributed
in last three years
60,000
Routine distribution:
Total number of nets for which
financing is already pledged
Total=185,172
GF= 92,586
+
PMI=92,586
Routine distribution:
Total number of nets for
which financing is
already pledged
0
0
Total nets needed in 2011
926,572
Total nets already
distributed =2,580,060
Total nets where financing is
already pledged
1,049,496
Total gap =0) 0
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Country Summary (Interventions & Services)
Intervention Operational
objectives/targets for
2011
Need to end 2011 Already covered
Funded and expected to be
distributed before end of
2011
Commodity Gap (Quantity)
Financial Gap (USD)
ACTs To sustain Universal coverage* of malaria treatment with ACTs
To increase access to prompt and effective ACT treatment for 80% of the population by 31st December 2010 and sustain this reduction through 2015
*define universal coverage target e.g. whole population, population treated
through the public health services and private sector etc)
Total number of doses to be made available during
the year
5,905,490
Public sector & Community (54%)=3,188,965
+
Services by private sector (46%)=2,716,525
Doses already in stock
1,900,000
Number of doses for which financing is already pledged or committed
1,00,000(PMI)
+
589,087 (GF)
=
1,589,087
Number of doses for which additional financing has to be mobilized to achieve the planned operational target
4,839,087
$3,112, 984
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Country Summary (Interventions &Services) (Cont'd )Intervention Operational objectives/targets
for
2011
Need to end 2011
Already covered
Funded and expected to be distributed before end of 2011
Commodity Gap (Quantity)
Financial Gap (USD)
RDTs and microscopy
To expand coverage of parasitological diagnosis to a
given level (if Universal coverage is not feasible within 2011)
At least 80% of patients with uncomplicated malaria receive early diagnosis and are provided with prompt and effective treatment according to MOH&SW guidelines.
At least 65% of patients with complicated or severe malaria are diagnosed in a timely manner and receive correct treatment according to MOH&SW guidelines.
Total number of RDTs to be
made available during the year
8,960,000
RDTs already in
stock
325,000
No. of RDTs for which financing is already pledged
or committed
1,000,000 (GF)
+
2,950,000 (PMI)
Total=3,950,000
No. of RDTs for which additional financing has to be mobilized to achieve the planned operational target
5,010,000
3,256,500Total number of
microscopy tests to be
made available during the year
1,181,098 (20% of total cases will be microscopic
tested)
Microscopy tests
already in stock
Number of microscopy tests
for which financing is
already pledged or committed
No. of microscopy tests
for which additional
financing has to be mobilized to
achieve the planned
operational target
Total diagnosis target
N/A
total diagnostics already in
stock
N/A
Total diagnostics already pledged
N/A
Total gap in diagnostics
N/A
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Country Summary (Interventions &Services) (Cont'd )
Intervention Operational objectives/targets for
2011
Need to end 2011
Already covered
Funded and expected to be distributed before end of 2011
Commodity Gap (Quantity)
Financial Gap (USD)
IRS To expand coverage to a given level of X% of the population through spraying of X structures
To increase the population protected by indoor residual spraying (IRS) from 5% in 2009 to 40% in 2010 and 2011 and scale up to full coverage by 2015 after evaluation of the first three years of use.
Total number of structures to be sprayed protecting Y% of the population
80,000 (11% of the population)
Cost per structure sprayed.
$32.00
52,647 which is 420,532 pop. protected
Total number of structures for which financing is already pledged or committed
80,000
Number of structures for which additional financing has to be mobilized to achieve the planned operational target
Negotiation with private sector companies on-going to spray additional structures
Not available
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Country Summary (Interventions &Services) (Cont'd )
Intervention Operational objectives/targets for
2011
Need to end 2011
Already covered in 2010
Funded and expected to be distributed before end of 2011
Commodity Gap (Quantity)
Financial Gap (USD)
IPTp To sustain Universal coverage (if Universal coverage already achieved by 2010)
To increase the use of Intermittent Preventive Treatment (IPT) among pregnant women in Liberia to 80% by 31st December 2010 and sustain this use through 2015
Total number of doses to be
made available during the
year to cover X% of
pregnant women
1,133250 for 85% of
pregnant women
(157,000)
Doses already in
stock
127,800
Number of doses for which
financing is already pledged
or committed
570,000
Number of doses for
which additional
financing has to be
mobilized to achieve the
planned operational
target
563,250
$11,265.00
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Country Summary (Cross cutting issues)
Intervention Operational targets/Objectives for
2011
Strategies/Actions Resource requirement
(USD)
Available budget
(USD)
Budget Gap
(USD)
M&E Malaria Indicator Survey
Provide the information data for the biannual and annual review of program activities and the Annual NMCP Malaria Report.
Trained at least 30 county M&E officers in data management and will have trained at least one M&E officer for each County Hospital (In Country training)
Post-distribution surveys for LLINs
Costing & validation of National M&E Plan
Conduct MIS
Quarterly Monitoring,
conducting mini surveys, End Use Verification (EUV)
Conduct in country training for 30 M&E
officers
Determine ownership and utilization
2,000,000
98,600.00
9,325
50,000
35,000
1,500,000
49,357 (GF)
80,000.00 (PMI)
0
0
0
500,000
00
9,325
0
35,000
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Country Summary (Cross cutting issues)
Intervention Operational targets/Objectives for
2011
Strategies/Actions Resource requirement
(USD)
Available budget
(USD)
Budget Gap
(USD)
M&E Conduct health facility based survey
$65,000 0 65,000
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Country Summary (Cross cutting issues)
Intervention Operational targets/Objectives for
2011
Strategies/Actions Resource requirement
(USD)
Available budget
(USD)
Budget Gap
(USD)
BCC/IEC Improve knowledge and behaviourr regarding prevention and treatment of malaria among the general population to at least 80% by December 2013 and to sustain this level thought 2015
Carry on awareness and
behaviour change(social
mobilization/advocacy, child-to-child communication,
mass media, peer education etc.
$532,000.00 1,400,000 (PMI) 0
Human Resources (Cap Bldg)
Insert others as required e.g. CSS, HSS, OR
Contribute to the ten year plan for an efficient and effective public health supply chain in Liberia
$2,000,000.00 750,000 (PMI)
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Assumptions for calculating the needs (Quantity and Funding) to achieve 2011 Targets
Justify the assumptions used for calculating the targets
LLINs
• Universal Coverage for LLINs is planned at the end of (2010) therefore net coverage calculated based on 3 nets per household of 5 persons; routine nets based on 85% of pregnant women accessing ANC and 1 nets per pregnant woman.
IRS
• IRS Household coverage in targeted districts based on LMIS 2009 malaria prevalence;
• Based on the NMCP strategic plan for IVM “To increase the population protected by indoor residual spraying (IRS) from 5% in 2009 to 40% in 2010 and 2011 and scale up to full coverage by 2015 after evaluation of the first three years of use”.
•
Assumptions for calculating the needs (Quantity and Funding) to achieve 2011 Targets
ACT & RDTs/microscopy
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Assumptions Used to Calculate ACTs & RDTs
Population @ 2.1% growth rate 3,703,430
Population of pregnant women @ 5% 185,172
Population of under 5 @ 17.7 % 655,507
Population of 5 to 14 years 29.50% 1,092,512
Population of Adults (others) @ 47.8% 1,770,240
Episodes
Episodes for under 5 4
Episodes for 5 to 14 years 4
Episodes for Pregnant women 2
Episodes for others 1
RDT
Impact Factor of RDT of treatment 2
Planned National Coverage 85%
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Implementation Plan - LLINs
Major action / Output / Milestone
TIMEFRAME
J F M A M J J A S O N D
Procure sufficient LLINs to allow door-to-door distribution with“hang-up”, “keep up” and follow up campaigns X X X X X
Conduct Post distribution surveys X X
Quarterly routine monitoring of LLINs X X X
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LLIN resources available to achieve the 2011 targets (including timing of disbursements)
Funds available (USD) Source of funding Comment TIMEFRAME
J F M A M J J A S O N D
Funds [$2,100,000] to procure [350,000] of LLINs
PMI Order has been placed for PMI LLINs for 2010.
X X X X
Funds [$1,465,000] to procure [368,415] of LLINs
Global Fund Global Fund phase II R7 approved grant not sign yet
Funds ($437,500) to deliver (350,000) of LLINs
PMI X X X X
Funds ($460,518.75) to deliver (368,415) of LLINs
Global Fund
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Implementation Plan - IRS
Major action / Output / Milestone
TIMEFRAME
J F M A M J J A S O N D
Environment Assessment X X
Mapping and Geographical Reconnaissance X X
Procurement and supply management x X X
Training and Capacity building x X
Conducting Indoor Residual Spraying In targeted communities x X X
Conduct community feed back meetings to obtain lessons learned and best practices for inclusion in future IRS interventions X
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IRS resources available to achieve the 2011 targets
Funds available (USD) Source of funding Comment TIMEFRAME
J F M A M J J A S O N D
Funds [4,000,000] to spray [80,000] of structures
PMI X X X X X X X
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Implementation Plan – Case Mgt
Major action / Output / Milestone
TIMEFRAME
J F M A M J J A S O N D
Train facility and community-level health workers, caregivers, and pharmacy owners and staff in case management and referral according to the MOH&SW guidelines;
X x x x
Train additional cadres, general Community Health Volunteers (gCHVs) and staff of community IMCI programs in malaria case management with ACTs;
x x x x
Ensure that all health training institutions include malaria case management in their curriculum;
X X
Engage the private sector on mechanisms of ACT rollout including social marketing;
x x x
Train staff of all facilities in improved diagnosis of malaria by RDT and/or microscopy and monitor the quality of the microscopic diagnosis;
x x x x
Improve the procurement, distribution, and monitoring of usage of antimalarial drugs and diagnostics to prevent stock-outs at all levels;
x x x
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Case Management resources available to achieve the 2011 targets
Funds available (USD) Source of funding
Comment TIMEFRAME
J F M A M J J A S O N D
Funds to procure [1,000,000] of ACTs
PMI Funds already committed by PMI in MOP 2010 x X
Funds [$706,904,40]
to procure [589,087] of ACTs
Global Fund Funds already committed in GF Round 7 Phase II
Funds to deliver (2,950,000) of ACTs
PMI Funds provided for logistics under SPS
Funds to deliver (1,000,000) of ACTs
Global Fund Information not available
Funds to procure [[2,950,000] of RDTs
PMI Information not available X x
Funds to procure [1,00,000] of RDTs
Global Fund Information not available
Funds to deliver [2,950,000] of RDTs
PMI Information not available
Funds to deliver [1,000,000] of RDTs
Global Fund Information not available
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Implementation Plan – IPTp
Major action / Output / Milestone
TIMEFRAME
J F M A M J J A S O N D
Train health workers for management or referral of malaria in pregnancy including administration of IPT according to MOH&SW guidelines;
X x x x
Include training in MIP in all pre-service health professionals training programs (physician, nursing, midwifery, physician assistants, pharmacy, et al);
x x x X
Train the TTMs in the management of malaria in pregnancy;
X x x x
Train TTMs and gCHV on BCC strategies to promote the regular use of LLINs by pregnant women and early care seeking from appropriate providers for case management;
x x x X
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IPTp resources available to achieve the 2011 targets
Funds available (USD) Source of funding Comment TIMEFRAME
J F M A M J J A S O N D
Funds [$11,400.00] to procure [570,000] of IPTp doses for 85% pw
Global Fund Global fund Round 7 Phase II not yet sign
x x
Funds to distribute [570,000] of IPTp doses
Global Fund Global fund Round 7 Phase II not yet sign
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Implementation Plan – Cross cutting
Major action / Output / Milestone
TIMEFRAME
J F M A M J J A S O N D
Effective management of malaria control activities and the use of evidence-based information for policy planning by the National Malaria interventions
X X
Improve knowledge, attitude and practice on malaria control and prevention
X
Strengthen the Health System X X
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Cross-cutting resources available to achieve the 2011 targets
Funds available (USD) Source of funding Comment TIMEFRAME
J F M A M J J A S O N D
$1,500,000.00 PMI Partial amount for LMIS in 2011. 500,000 outstanding
$532,000.00 PMI Amount to support NMCP IEC/BCC activities
$80,000.00 PMI Amount to cover the cost of End Use Verification activities
$98,600.00 GF Amount to cover the cost of quarterly monitoring to health facilities and mini surveys
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Summary of technical assistance needs to end 2011
Area of Need Type of support required
Resources available
Source of funding
TIMEFRAME
J F M A M J J A S O N D
LLINs
IRS Integration of IRS to private sector and roll out to the entire population
0 RBM, PMI
ACT Private sector and community Case Management roll out
0 RBM, PMI x x x
RDTs/microscopy Parasitological diagnosis and IMCI integration
0 WHO X X X
Cross cutting Review, revised IEC/BCC Strategy.
Finalization of National M&E Plan
0 PMI X X X
Program Management / Partnerships
GF Grant Implementation
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Summary of rate-limiting factors/solutions over the next 12 months - threats
Potential threats to achieving targets
Supply Chain System not fully functional
Delay in the implementation of Private Sector rollout of ACTs
Inadequate Funding for BCC and M&E