1 Roadmap to Achieve RBM Targets Liberia January 2011 – December 2011 Liberia

2 Country Summary (Interventions & Services) Population at Risk: 3,703,430 Interventi on Operational objectives/targets for 2011 Need to end 2011Already 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 31 st 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 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 Distribution cost: $666,552

3 Country Summary (Interventions & Services) Population at Risk: 3,703,430 Interventi on Operational objectives/targets for 2011 Need to end 2011Already 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 31 st 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 ,572 Total nets already distributed =2,580,060 Total nets where financing is already pledged 1,049,496 Total gap =0)0

4 Country Summary (Interventions & Services) Interventi on Operational objectives/targets for 2011 Need to end 2011Already covered Funded and expected to be distributed before end of 2011 Commodity Gap (Quantity) Financial Gap (USD) ACTsTo sustain Universal coverage* of malaria treatment with ACTs To increase access to prompt and effective ACT treatment for 80% of the population by 31 st 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

5 Country Summary (Interventions &Services) (Cont'd ) InterventionOperational 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 3,256,500 Total 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

6 Country Summary (Interventions &Services) (Cont'd ) InterventionOperational 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) IRSTo 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. $ ,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

7 Country Summary (Interventions &Services) (Cont'd ) InterventionOperational 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 31 st 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, 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

8 Country Summary (Cross cutting issues) Intervention Operational targets/Objectives for 2011 Strategies/ActionsResource 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, ,325 50,000 35,000 1,500,000 49,357 (GF) 80, (PMI) 0 500, , ,000

9 Country Summary (Cross cutting issues) Intervention Operational targets/Objectives for 2011 Strategies/ActionsResource requirement (USD) Available budget (USD) Budget Gap (USD) M&E Conduct health facility based survey $65,000065,000

10 Country Summary (Cross cutting issues) Intervention Operational targets/Objectives for 2011 Strategies/ActionsResource requirement (USD) Available budget (USD) Budget Gap (USD) BCC/IECImprove 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/advoca cy, child-to-child communication, mass media, peer education etc. $532, ,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 (PMI)

11 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 12 Assumptions Used to Calculate ACTs & RDTs 2.1% growth rate3,703,430 Population of pregnant 5%185,172 Population of under 17.7 %655,507 Population of 5 to 14 years 29.50%1,092,512 Population of Adults 47.8%1,770,240 Episodes Episodes for under 54 Episodes for 5 to 14 years4 Episodes for Pregnant women2 Episodes for others1 RDT Impact Factor of RDT of treatment2 Planned National Coverage85%

13 Implementation Plan - LLINs Major action / Output / Milestone TIMEFRAME JFMAMJJASOND Procure sufficient LLINs to allow door-to-door distribution with “hang-up”, “keep up” and follow up campaignsXXXXX Conduct Post distribution surveysXX Quarterly routine monitoring of LLINsXXX

14 LLIN resources available to achieve the 2011 targets (including timing of disbursements) Funds available (USD)Source of fundingCommentTIMEFRAME JFMAMJJASOND Funds [$2,100,000] to procure [350,000] of LLINs PMIOrder has been placed for PMI LLINs for XXXX Funds [$1,465,000] to procure [368,415] of LLINs Global FundGlobal Fund phase II R7 approved grant not sign yet Funds ($437,500) to deliver (350,000) of LLINs PMIXXXX Funds ($460,518.75) to deliver (368,415) of LLINs Global Fund

15 Implementation Plan - IRS Major action / Output / Milestone TIMEFRAME JFMAMJJASOND Environment AssessmentXX Mapping and Geographical ReconnaissanceXX Procurement and supply managementxXX Training and Capacity buildingxX Conducting Indoor Residual Spraying In targeted communitiesxXX Conduct community feed back meetings to obtain lessons learned and best practices for inclusion in future IRS interventionsX

16 IRS resources available to achieve the 2011 targets Funds available (USD)Source of fundingCommentTIMEFRAME JFMAMJJASOND Funds [4,000,000] to spray [80,000] of structures PMI XXXXXXX

17 Implementation Plan – Case Mgt Major action / Output / Milestone TIMEFRAME JFMAMJJASOND  Train facility and community-level health workers, caregivers, and pharmacy owners and staff in case management and referral according to the MOH&SW guidelines; Xxxx  Train additional cadres, general Community Health Volunteers (gCHVs) and staff of community IMCI programs in malaria case management with ACTs; xxxx  Ensure that all health training institutions include malaria case management in their curriculum; XX  Engage the private sector on mechanisms of ACT rollout including social marketing; xxx  Train staff of all facilities in improved diagnosis of malaria by RDT and/or microscopy and monitor the quality of the microscopic diagnosis; xxxx  Improve the procurement, distribution, and monitoring of usage of antimalarial drugs and diagnostics to prevent stock-outs at all levels; xxx

18 Case Management resources available to achieve the 2011 targets Funds available (USD)Source of funding CommentTIMEFRAME JFMAMJJASOND Funds to procure [1,000,000] of ACTs PMIFunds already committed by PMI in MOP 2010 xX Funds [$706,904,40] to procure [589,087] of ACTs Global FundFunds already committed in GF Round 7 Phase II Funds to deliver (2,950,000) of ACTs PMIFunds provided for logistics under SPS Funds to deliver (1,000,000) of ACTs Global FundInformation not available Funds to procure [[2,950,000] of RDTs PMIInformation not available Xx Funds to procure [1,00,000] of RDTs Global Fund Information not available Funds to deliver [2,950,000] of RDTs PMIInformation not available Funds to deliver [1,000,000] of RDTs Global Fund Information not available

19 Implementation Plan – IPTp Major action / Output / Milestone TIMEFRAME JFMAMJJASOND  Train health workers for management or referral of malaria in pregnancy including administration of IPT according to MOH&SW guidelines; Xxxx  Include training in MIP in all pre-service health professionals training programs (physician, nursing, midwifery, physician assistants, pharmacy, et al); xxxX  Train the TTMs in the management of malaria in pregnancy; Xxxx  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; xxxX

20 IPTp resources available to achieve the 2011 targets Funds available (USD)Source of fundingCommentTIMEFRAME JFMAMJJASOND 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 xx Funds to distribute [570,000] of IPTp doses Global FundGlobal fund Round 7 Phase II not yet sign

21 Implementation Plan – Cross cutting Major action / Output / Milestone TIMEFRAME JFMAMJJASOND Effective management of malaria control activities and the use of evidence-based information for policy planning by the National Malaria interventions XX Improve knowledge, attitude and practice on malaria control and prevention X Strengthen the Health System XX

22 Cross-cutting resources available to achieve the 2011 targets Funds available (USD)Source of fundingCommentTIMEFRAME JFMAMJJASOND $1,500,000.00PMI Partial amount for LMIS in ,000 outstanding $532,000.00PMI Amount to support NMCP IEC/BCC activities $80,000.00PMI Amount to cover the cost of End Use Verification activities $98,600.00GF Amount to cover the cost of quarterly monitoring to health facilities and mini surveys

23 Summary of technical assistance needs to end 2011 Area of NeedType of support required Resources available Source of funding TIMEFRAME JFMAMJJASOND LLINs IRSIntegration of IRS to private sector and roll out to the entire population 0RBM, PMI ACTPrivate sector and community Case Management roll out 0RBM, PMIxxx RDTs/microscopyParasitological diagnosis and IMCI integration 0WHOXXX Cross cuttingReview, revised IEC/BCC Strategy. Finalization of National M&E Plan 0PMIXXX Program Management / Partnerships GF Grant Implementation

24 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