Year 1 update The Gambia Olimatou Kolley SMC Focal Person 18th January 2016

2015 Round Summary Key Accomplishments Upcoming Outstanding Activities Apr 2015 May 2015 Jun 2015 Jul 2015 Aug 2015 Sep 2015 Oct 2015 Nov 2015 Dec 2015 Jan 2016 Planned 7 1 2 4 5 6 8 3 9 10 11 Actual 1 2 3 4 5 6 7 8 9 10 11 Training of health workers Training of distributors 7-10. SMC cycles 11. Lessons learned Dakar meeting Official kickoff in-country Micro-planning ToT Key Accomplishments Upcoming Outstanding Activities Number of trainers trained: 13 Number of health staff trained: 49 Number of volunteers trained: 148 in CRR & 143 in URR Peak number of children reached: 84,298 TBD Key Milestones Legend Grey Originally planned Green Completed as planned Yellow Acceptable delay Red Excessive delay

Delivery methods & approaches Door-to-door strategy 143 distribution teams in URR and 148 in CRR Distribution team consist of two: Data collector and drug distributor (CHW) CHNs, PHOs and OICs were used for the different levels of supervision

Training and materials (I) There were four levels of training: 13 National Trainers 91 Supervisors (team, district & regional) 49 Health Facility Workers 148 in CRR and 143 in URR CHWs and data collectors (on SMC as well as the use of the iPad) Campaign materials distributed: 91000 Job aid for mothers 350 Job aid for CHWs 500 Q&A Key messages 1000 Posters ( for health centres and distribution sites) 2 Banners (for the launching) 91000 Distribution cards 1000 T-Shirts

Training and materials (II) Training manuals developed by MC for the different levels of training were used for the SMC training Training materials: Pens Notepads Flip chart and Markers supervisory forms End of cycle health facility reporting forms

Admin Coverage Summary (I)

Admin Coverage Summary

Stock Summary

Pharmacovigilance Summary

Pharmacovigilance (II) PV guideline yet developed All Health facilities received PV forms 400 PV forms were distributed to health facilities and 50 forms were filled and sent back (12.5% ) There was one case of severe adverse reactions (involuntary muscle movement of the face and neck, blinking of eyes and finger spasms) Child was hospitalized and later recovered There was no death

IEC/BCC approaches 300 community members sensitized 100 religious and influential leaders sensitized 65 CHNs and 291 CHWs sensitized 2112 radio spots were aired and TV spots aired twice a week Using all approaches mentioned above was found to be very effective The same approaches will be used for 2016

3 Key Success The use of the iPad for on spot data collection at community level Use of pill crusher was found to be relatively cheap, simple to use, fast in crushing, requiring minimal energy to crush, light to carry from door to door and protects against wastage during crushing Strong political commitment and good collaboration between CRS & MOH&SW enhanced implementation and acceptance of SMC

Key Issues Heavy rains and flooding resulting in damaged and impassable roads in both implementing regions. Inadequate allocation of days for first cycle (both registration and distribution took place in first cycle) Over estimation of the targeted number of children in some districts. This made it impossible to meet the target in those districts Unavailability of some community members due to farming activities.

Support by other partners SMC in the Gambia was not supported by other partners

Role of NMCP / MoH SMC was adopted as a strategy in 2012 and included as part of the national policy in 2013 A task force has been set up and a meeting is planned to discuss resource mobilization for SMC Funding for SMC is not currently coming from the national health budget