Year 1 update Nigeria 1 Dr Jamilu Ibrahim Nikau SMC Focal Person, NMEP [Date]

2 Planned Actual 2015 Round Summary Key AccomplishmentsUpcoming Outstanding Activities Number of trainers trained: Number of health staff trained: Number of volunteers trained: Peak number of children reached: TBD 1.Dakar meeting 2.Official kickoff in-country 3.Micro-planning 4.ToT 5.Training of health workers 6.Training of distributors SMC cycles 11. Lessons learned 11 Key Milestones LegendGreyOriginally plannedGreenCompleted as plannedYellowAcceptable delayRedExcessive delay Mar 2015Apr 2015May 2015Jun 2015Jul 2015Aug 2015Sep 2015Oct 2015Nov 2015Dec 2015Jan

Delivery methods & approaches Door-to-door and fixed points approaches are used for the drugs distribution. There are Number of fixed teams = 667, House to House teams =1,827, Health facilities = 371 Composition of distributors’ teams (per type of approach) Fixed post = 3/team House to House = 2/team Health facilities = 3/team Health workers working in HF were trained and engaged during the distribution, and HF served points for managing ADR

4 Name of State Numb er of LGA Superv isors Team Ward supervi sor Health Faciliti es Qualifi ed as Fixed Point Numb er of CHWs Numb er of CHWs for Fixed Point Numb er of CHWs for HH Numb er of Comm unity Mobili zers Numb er of Town Annou ncers Numb er of CHWs Team Numb er of HH team Sokoto Zamfara Total

5 Training and materials (I) Training People trained [list by category] Master trainers 25 4 days LGA Supervisory team days Ward Supervisors days HF Staff days CHWs days Community Mobilizers day Town Announcers day Materials distributed (job aids, training manuals, flyers & posters, etc.) [list by category] Job aids, dsds National TRAINERS TRAINING REPORT TEMPLATE RMC TRAINING EVALUATION SUMMARY TEMPLATE TOT WORKBOOK FOR National TRAINERS National TRAINER TOT CERTIFICATE RMC TRAINER GUIDE SMC

6 Training and materials (II) Training were conducted using developed training manuals, job aids and other materials at the National, state and the step down trainings. Job aids are particularly useful to CHW and the health workers. It was not effectively used by all the CHWs because they felt they know it all. The recommendation is that all the fixed post should be converted to house-to-house and the number of supervisors should be increased, also more female supervisors should be engaged and health worker should be used as supervisors.

Admin Coverage Summary (I)

Admin Coverage Summary (II) 8

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Stock Summary

Pharmacovigilance Summary

Pharmacovigilance (II) Health Facilities workers were trained on how to identify, manage and refer adverse reaction from SMC drugs. PV guidelines were produced and shared to all HF during the training. but the reporting rate was low. Though there was reported of hospitalization or death related to SMC drugs, but the mild cases were not adequately reported and documented. The system is weak as regards reporting and documentation of PV cases, this is noticed in other adverse events. As a result of poor reporting of adverse reaction, a meeting was held with NMEP, National Drug Law Enforcement Agency((NAFDAC), Malaria Consortium and Dr Paul Milligan to look at ways of improving PV. The following was agreed as way forward:  HF staff to be encourage to be reporting to NAFDAC using a designated toll free number  SMS remainders to be sent regularly to HF staff to encourage them to be vigilant and report all suspected cases  The toll free number would also be printed on the children card in local languages along with message to encourage parents to report reaction

IEC/BCC approaches Sseveral approaches were employed for community and HH mobilization, these included: mass media (radio talk shows), Town Announcers, religious and traditional leaders and organizations, community mobilizers, posters and fliers and mobile announcement vehicles. Be prepared to answer questions about what worked, worked better where and worse where, Town announcers proved to be the most effective in disseminating SMC information based on reponses from the lesson learnt meeting held in the states. Engagement of more town announcers and community mobilizers (based on feel back from the LLM) use of radio and television announcements, mobile announcement vehicles

3 Key Successes Strong acceptance of the intervention by political, religious and religious leaders Successful planning and training of relevant personnel Strong acceptance of the intervention by the communities which progressively increased following reduction in malaria episodes after cycles of drugs distribution. But there was a drop in cycle 4 which is due to -- Hitch free distribution of the drugs in the 4 cycles to eligible children as planned, with some modification where necessary, such as during the heavy down pour of rain, increase or decrease of coverage in different settlements

3 Key Issues There is need to do a comparative analysis of allowances paid to volunteers and LGA teams with other NGOs implementing health programs in the sates. Need to engage more hands preferably women as supervise to ensure drugs are administered correctly and right information are given to parents by CHWs The drugs should be sweetened and easily dispersible for effective administration Engagement of more staff either as adhoc or permanent

Support by other partners No funders/implementers of other programs in the two states where ACCES-SMC Project is being implemented supported SMC. MSH supported with TA on supply chain But some partners supported some states in other SMC projects in Nigeria; Bill and Melinda Gates Foundation in Katsina state and SUNMaPs in Jigawa state CHAI pledged to support some state in 2016, the states are yet to be determined.

The 2015 National Guidelines for Diagnosis and Treatment of Malaria has included SMC as a major intervention in the Sahelian region of the country The Guideline has also opened up the possibility of a SMC+ to allow for other intervention that may ride on the back of the intervention Though there is no other funding for SMC in the national budget, the FMoH is engaging others NGOs and state/ regional government to buy in to SMC. Katsina state has pledged to fund SMC In 2016 Role of NMCP / MoH