1. Livesy Abokyi Kintampo Health Research Centre 9 th INDEPTH AGM 26-29 th October,2009 Pune, INDIA

2.  Main stakeholders meeting held 15 th July, 2009 – Representatives from both public and private Heath Facilities, District Health Administration and Regional Health Directorate  Community meetings  Radio discussions on local radio station in the local languages.  Media briefing with presenters on the local radio stations

3.  Redemarcation of field worker areas from 14 to 18 to make up for additional workload  More field workers and supervisors have been recruited  Field workers and field supervisors have been trained on: fever form, HH access and costing survey and Assessment of population parasite prevalence  Listings for HH access and costing generated for 2 nd half of HDSS round– 25% (4226 HHs).  Listings have also been generated for the assessment of population parasite prevalence

4.  Population monitoring for fever burden – Eleven weeks of data collection – 1384 forms completed – 478 Households with fever  Household Access and Costing survey – Four weeks of data collection

5.  Spontaneous Adverse Event Reporting System (SAERS)  Cohort Event Monitoring (CEM)  Situational analysis on SAERS done - Coordinators from the two major hospitals have received training but not implementing -Some staff in the peripheral health facilities know about the form but have never reported - There were no forms at the periphery

6.  Challenges from the perspective of health workers - Inadequate forms -Inadequate knowledge about the system of reporting Response to situational analysis  INESS safety team meeting held in Oct – discussed findings and the way forward – -discussed terms of reference of the safety team and frequency( monthly at district level and two safety teams to meet quarterly)

7.  Training for reporters on 21 st and 23 rd Oct. organized with the FDB Health workers and chemical sellers -Plan to do radio discussion to increase community awareness -Supply of forms for by FDB upon request by the District Health Administration with support from the INESS Safety coordinator -INESS Safety team will be responsible for monitoring and supervision

8.  Targeting Accuracy & Provider Compliance -Training of staff planned -Assessment of drug stock levels done  Patient and Community Acceptability – Communities selected  Adherence yet to start  Other measures of contextual determinants yet to start

9.  Changes to the initial design for blood sample taking-may require protocol amendment and ethical considerations -Now all members in sampled households are included in the blood sample taking  Sampled households have substantial number of moved outs

10. Thank You