1. 1 RESULTS OF THE 1ST YEAR OF SMC, 2015 GUINEA ACCESS-SMC TEAM GUINEA  Dr Souleymane DIAKITE, Focal Point, ACCESS-SMC  Dr Eugène Kaman LAMA, Acting Project Manager/MEAL Officer Kampala 18 January 2016

2. 2 SMC Campaign Summary, 2015 Jan 2015Mar 2015April 2015June 2015July 2015Aug 2015Sept 2015Oct 2015Nov 2015Dec 2015Jan 2016 1234578 9 10 11 6 1 2 4 5678 Planned Actual 1.Official Country Launch (January 2015) 2.Dakar Meeting 3.Macro-planning 4-5 : Training of trainers 6. Training of Health Workers and Distributors 6-9. SMC Cycles 10-11. Lessons Learned Achievements Number of trainers trained : 5 Number of Health workers trained : 205 ( 2 NMCP, 2 pediatricians, 9 regions, 36 HD, 52 HC, 104 supervisors; Approx. ) Number of Community workers trained : 1261 Maximum number of children treated :210.448 Legend of Key stepsGreyInitial PlanningGreenCompleted on timeYellowAcceptable DelayRedExcessive Delay Remaining and upcoming activities 3109

3. 3 Distribution Methods and Approaches (1/3) DOOR TO DOOR Number of teams 634 teams (8-12 teams per health centre for 52 HC) Composition of Distribution teams (by type of approach) 2 Distributors 1 Tally man The teams consist of community health workers and are supervised by Professional Health Workers

4. 4 NMCP RHD Boké PCG CRS ACCESS SMC HD/Koubi a HD/Mali HD KoundaraHD /Gaoual RHD Labé RHD Faranah UNITAID HD/Dinguiray e HD/Tougué Health Centre LSHTM SYNERGY SMC Implementation Space Figure 1 ; Operational framework of ACCESS SMC IN Guinea, 2015 Distribution Methods and Approaches (2/3) Speak Up Africa : CHW ……… Return CHW to the HC for conciliation SP/AQ and replenishment ____ Itinerary CHW/Distributor SP/AQ Legend MSH/SIAPS MC

5. 5 Distribution Methods and Approaches (3/3) Table N°1: Target distribution status for CHW Teams and health centres, SMC Guinea 2015 Health centres SMC target CHW Teams Ratio of Targets /CHW Teams / cycles / day Planned5221010763133383 Achieved5220128363131980

6. Guinea Health Districts 2015 New Health Districts 2016

7. 7 POPULATIONS OF DISTRICTS COVERED Table N°2: Distribution of the SMC target population by age groups of 3 to 11 months and 12 to 59 months, Guinea, 2015 (N=210 107) Districts SMC Anticipated targets in 2015, Guinea Total PopChildren 3-59 months3- 11 months12- 59 months Gaoual 198 51039 7027 94031 762 Koundara 133 07026 6145 32321 291 Mali 296 70059 34011 86847 472 Tougué 118 90023 7804 75619 024 Koubia 103 39020 6784 13616 542 Dinguiraye 199 96739 9937 99931 995 Total1 050 537210 10742 021168 086

8. 8 Table N°3: Status of the targets and HC by SMC District, Guinea, 2015 RegionsBoké FaranahLabéTotal DistrictsGaoual Koundar a DinguirayeKoubiaMali Tougu é Target Pop. 3-59 months 397022661439993206785934023780 6631639993103798210107 Number of Health Centres covered 87861310 1582952

9. 9 *2 supervisors per health centre and the health centre manager acting during the distribution Table N° 4: Training situation for SMC actors in cycle 1, Guinea 2015 TRAINING AND TOOLS (1/2) Master Trainer s Pediatricia ns University Hospital Regional Supervisors District Supervisors Local Supervisors CHW Distributor s Social Mobilisers Gaoual 5 2 3 6 24 19916 Koundara 6 21 13414 Koubia 3 6 18 15312 Mali 6 39 35026 Tougué 6 30 19420 Dinguiraye 36 24 23116 Total 52936 156* 1261104 Training Date June 2015July 2015 Number of training days 5 days3 days 2 days1 day

10. 10 TRAINING AND TOOLS (2/2)  SMC Trainer’s Guide,  Textbooks used: Trainer’s Practical Manual, Community Health Worker’s Manual; CHW job-aid. o CHW: job-aid is used as a summary of training given to CHWs; o Health professionals: Trainer’s Technical Guide, Trainer’s Practical Manual

11. Table N°5: Using the Main SMC management tools, Guinea, 2015 Form TypesWhat is the data collected?Frequency Who is Responsible for completion How many distributed How many used Distribution Map Child's name, mother(guardian)'s name, Child's address, total dose of SP / AQPer cycle Community Health Worker (CHW)240000211997 Tally Sheet (CHW + HW) CHW/Supervisor Competency Checklists) Name (Region, District, Health Centre, Village, CHW, local supervisor, Tel. No. CHW and Health Center Manager, number of children who received SP / AQ), SP / AQ (receipts, losses, distributed and remaining). Day of cycle and each month CHW6000 Evaluation of distributors competencies Every 2 months Local Supervisor24961261 All level supervision forms All information on the ACCESS-SMC campaign: Beneficiaries, resources, data, Adverse Reactions associated with SP / AQ Each day of the cycle at community, health centre, District, Region and National levels National, regional and district supervisors 32111560 Training (pre / post test) Knowledge, procedures, resource management tools, Distribution Strategies, side effects management Before the distribution of SP / AQ National & District Trainers 29281561 PV Form Management of adverse reactions to SP/AQ Throughout the SP/AQ distribution programme SMC District Committee 8000 (Yellow PV Form) 39 Health centre end of cycle report Data distribution (Children and SP/AQ) End of each cycle District Supervisor 416208 SMC Reference Form Circumstances of Sick Children Each day of the cycle CHW, Health Centre Manager 50003458 Campaign Summary Form Data Distribution (children and drugs) Throughout the distribution campaign Health Centre Manager, National, regional and district supervisors 1963 11

12. 12 Administrative Coverage summary (1/2) Table N° 6: SMC Coverage measured by Health District, Guinea 2015 HEALTH REGIONS HEALTH DISTRICTS TARGET 1st Cycle2 nd Cycle3rd Cycle4th Cycle Children Covered Coverage (%) Children Covered Coverage (%) Children Covered Coverage (%) Children Covered Coverage (%) BOKE Gaoual39 70236 9459437 0089638 4819740 331102 Koundara26 61423 1838726 60610026 82510126 19798 LABE Mali59 34045 8188359 6109958 9559959 235100 Koubia20 67815 9177720 5619920 1549720 40699 Tougué23 78018 4447724 64710024 461510424 205102 FARANAHDinguiraye39 99334 1418943 56510939 2089840 074100 TOTAL210 107174 44885211 997101208 23899210448100

13. 13 SMC Administrative Coverage Summary 2015 (2/2)

14. Stock Summary Table N° 7: SP/AQ Management by Health District, Guinea 2015 HEALTH REGION HEALTH DISTRICT Received 3-11 months Received 12-59 months Distributed 3-11 months Distribute d 12-59 months LossesRemaining 3-11 months 12-59 months 3-11 months 12-59 months BOKE Gaoual39 200156 95033 593120 8131 0948645 21434 153 Koundara26 350105 25018 92981 1835398226 88218 095 FARANAHDinguiraye39 500158 10034 216118 2176704823 77535 675 LABE Koubia39 50081 75014 85262 1543625175 23619 133 Mali58 650234 60049 428162 4901 1431,2639 60844 219 Tougué23 50094 00016 59173 1983264356 67521 357 TOTAL226 700830 650167 609618 0554 1344 38337 390172 632

15. 15 Activities Undertaken for PV (1/2)  PV guidelines available in the health districts;  Production / delivery: 8000 PV yellow Forms  Integrated training on PV  33 PV forms filled in by the HW and collated at the Health District and the NMCP / LSHTM with a copy to CRS.  Zero cases of severe adverse reactions reported.

16. 16 Pharmacovigilance Summary (2/2) Table N°8 : Management of Undesirable Side Effects linked to SP/AQ by health district, Guinea2015 District Vomiting Skin Reactions Drowsiness Abdominal Pain EP Syndrome JaundiceTotal AR Gaoual 06150012 Koundara 1400005 Mali 0000000 Koubia 0402006 Tougué 3000014 Dinguiraye 020100012 Total4161170139

17. Support from Other Partners  MSH-SIAPS: Withdrawal of AS+AQ and AL made available in SMC areas;  Central Pharmacy of Guinea: Supplying and stocking the health centres with SP/AQ;  Partners on the ground: StopPalu, WHO, CNFRSR de Maférinyah, Fond de Développement Social et de la Solidarité (FDSS) de Koundara, Comité préfectoral d’appui à la vaccination (CPAV) à Koundara, supervision and / or community mobilisation in SMC areas.

18. Role of NMCP / Min. of Health  SMC integration in the National Policy and National Strategy Plan NMCP (NSP 2013-2017);  Advocacy for SMC at all national levels  Establishing contacts with other partners, including research institutions;  Support for the supervision of SMC campaigns  Mobilizing resources for the sustainability of SMC  Other funding sources: State  logistics support to RHD (3 vehicles), HDs (6 Vehicles and 52 Motorcycles) and NMCP

19. Key Successes  Existence of a strong demand for SMC at community level;  Strong social mobilization and integration of all stakeholders (In the Context of Ebola Virus Disease / new programme with no pilot);  Adaptive strategy (number of days; additional distributors; training and retraining, provision of equipment - umbrellas);  Renewed Community confidence in health services (Distribution coverage rate increased following the visits of the vaccination workers and of SMC health workers; review of SMC cards at the Urban Centre of Koubia).

20. Key Issues  Difficulty in crushing the SP/AQ tablets  Difficulty in accessing populations in remote areas due to river flooding, bad roads, population movements and farm work.  Difficulties related to the management of fever cases referred by the CHWs in health facilities (health posts and centers);  Difficulties related to the management of adverse side effects (SAEs) due to SP / AQ.

21. 21 Thank you, together for a Guinea free of Malaria!