NIGERIA Roadmap to Achieve 31.12.2010 RBM

TargetsSeptember 2009 – December 2010

Country Summary

Intervention Need to 2010 Already covered

Funded and expected to be distributed before end 2010

Gap

LLINs 62.9m LLINs: (22.3m from Sept 2009; 40.5m in 2010 @2LLINs /HH with 5pers/HH +wastage)

4.4m 49.378m 9.2m

ACTs 129,194,824 doses: Sept 2009: 28,175,491;

2010: 101,019,333 (80% coverage)

8.3m 94,267,437 34,927,387

IRS 2,540,843 HHs:2009: 280,000; 2010: 2,260,843

840,000 280,000 (2009)

560,000 (2010)

4.24m

RDTs 59, 202,251 tests: 2009: 29,135,153 tests (30% coverage)

2010: 30,067,098tests

0 34,353,875m 28,848,376

IPTp 18.3m dosesSept-Dec 2009: 2,340,830

2010: 16m

18.3m 0

Quinine

Population at risk: (158.9m in 2010)

Country Summary -2.

Intervention Need to 2010 Already covered

Funded and expected to be distributed before end 2010

Gap

M&E $20.4m

(About 10% of Total budget)

WBBP = 15.4m

GF-R8 = 2.4m

WHO = $354,000

2.2m

BCC/IEC $15,768,9782009: 7,940,265; 2010: 7,828,713

1m WBBP: $9m

GF R8: $4.8m

WHO: $350,000

WBBP: $2m (NIFAA)

Human Resources (Capacity Bldg)

10.5m in trainings and TAs (Excluding salaries)

WB = 3.0m

GF R8 = 4.1m

Govt = Salaries of health workers and prog managers at all levels

RBM = TAs

Others:

Service Delivery

Population at risk: (158.9m)

LLIN resources available to achieve the 2010 targets

FUNDS AVAILABLE (US $)

SOURCE COMMENT

Mechanism and when

Available Total Need Gap

140,000 LLINs8,300,00 LLINs3,966,786 LLINs1,949,763 LLINs590,000 LLINs2,782,749 LLINs1,259,048 LLINs3,390,609 LLINs629,533 LLINs

FGN/MDGWB 1WB 2DFIDUSAIDUNITAID / UNICEF GF R4 GF R8USAID

Campaign 2009Campaign 2009Campaign 2009Campaign 2009Campaign 2009Campaign 2009Campaign 2009Campaign 2009Mop-up 2009

22,378,956

629,533

22,378,956

629,533

0

0

3,717,251 LLINs17,807,958 LLINs

UNITAID/UNICEFGF R8

Campaign May-Jun 2010 Campaign May-Jun 2010

21,525,209 21,525,209 0

9,177,755 LLINs GF R8 Campaign Oct-Nov 2010

9,177,755 18,444,832 9,177,755

53,800,775 LLINs TOTAL TOTAL 53,800,775 (4.4m was distr. in Jun-Aug. 09)

62,978,530 9,177,755

LLIN Ordering & Distribution to end 2010

Quantities 62.8m

Procurement dates VPP July 14, 2009[WB, UNITAID/UNICEF]

Expected delivery In country. Oct. 19, 2009

Campaign Date Sept 2009; Nov. / Dec 2009; May –Dec 2010

BCC Tools and materials; TV/Radio jingles/Talk shows; Drama; Community channels

Community mobilization Demand creation; LLIN hang-up campaign

Distribution 2 per HHs

Mechanisms of distribution Stand-alone campaigns

Monitoring and evaluation LQAS (Sept 2009); MIS (2010);

LLIN Follow-up Survey: USAID (2009, Kano) and SuNMap (2009, Anambra)

Case management (ACTs)ACTs required 2009: 37,877,320 doses (30% coverage)

2010: 130,297,982 (100% coverage)

Already distributed: 8.3m

Procurement schedules (ACTs)

Ordered: 2m (GF); 2m (WBBP 1), delivery date: August 2009

Procurement initiated already: 7m (WBBP II)

Procurement to be initiated after R8 is signed : 56m

Procurement to be initiated in 2010: 8m WBBP II; FGN and States 9.5m; DFID/ SuNMap = 2m; USAID 1.2m;

BCC Continuously: Improve Health seeking behaviour and informed demand for commoditiesEarly recognition of signs and symptoms and management by COPRsCommunity sensitizationEmpowerment of CORPs for prompt referral in suspected complicated cases

Mechanisms of distribution HF treatments (Public and Private),

Community and Home Management (PPMVs and RMMs, CBDs, etc),

Drug Efficacy Monitoring Sentinel Sites monitoring sites increased from 6 to 14 in 2008

2009: 3 Sites may commence DET in 2009

2010: National DET implementation, planning and training has commenced

Monitoring and evaluation 2009: Results of NDHS 2008 released, showed 25% and 22% IMR and U5MR reduction respectively

2009: Evaluation of WBBP performance using LQAS in selected States

2009: HF Assessment conducted for WBBP States and 2 non WBBP States

2009: Planning for MIS, Program Performance review commenced

ACTs resources available to achieve the 2010 targets

ACT doses SOURCE COMMENT

when Available Total Need Gap

3,374,509 ACTs3,250,000 ACTs2.400,000 ACTs

FGN/MDGSFHGF R4

Distributed 2009Distributed 2009Distributed 2009

9,024,509 (early 2009)

37.2m for 2009 28,175,491 as @ August 2009

850,000 ACTs9,354,707ACTs600,000 ACTs

GF R4WBUSAID

Expected 2009Expected 2009Expected 2009

10,804,707 (2009)

28,175,491 as @ August 2009

17,370,784 for remaining 2009

18m ACTs53.3m ACTs600,000 ACTs9.5m2.0m

WB GF R8USAIDMDGDFID

Expected 2010Expected 2010Expected 2010Expected 2010Expected 2010

83,462,730 (2010)

101,019,333 17.556,603

TOTAL 103,291,946 (entire 2009 -2010)94,267,437 (expected so far for Sept 2009 -2010)

138,219,333 (entire 2009-2010)129,194,824 (from Sept 2009-2010)

34,927,387

Case management (Parasite based diagnosis -1)

Microscopy Total required: 1000 (2009)

Acquired: 14 (Baseline=14 in Sentinel sites)

Gap: 986 microscopes

Cost is @ USD450 / microscope

Procurement schedule:

-- Nov 09 (175 by WBBP);

-- Procurement commences when R8 grant is signed, 405 in 2009 and 406 in 2010.

RDTs required 2009: 29,135,153 (30% coverage nationwide)

NB: Discounting potential 70% coverage in 2009 in 7 WBBP States)

2010: 30,067,098 (30% nationwide)

NB: Discounting 60% coverage in 7 WB States

Total: 59,202,251

Cost = USD1 / strip

Procurement schedules (RDTs)

2009: Procurement initiated already: 7.1m (WBBP II);

Procurement to be initiated in 2010: 5.03m (GF); 20.12m WBBPII)

Training Policy revised; Tools updated; Tool production is on-goingTrained 14 Sentinel Sites Lab. Scientists; User-friendly training manuals are being producedToT commences in October 2009Support from: GF R8 and WBBP

Case management (Parasite based diagnosis -2)

BCC Continuously: Health care Worker reorientation on RDTs Awareness creation for Health Care Seekers on RDTs

Mechanisms of distribution

Using morbidity data from HFs direct distribution will be to:

HF treatments (Public and Private)

Under GF R8: Two PRs (NMCP and SFH in 3 Northern and 3 Southern States respectively)

WBBP: 4 Northern and 3 Southern States

Drug Efficacy Monitoring / Quality Assurance

In all Sentinel Sites monitoring sites

WHO TDR certified Laboratories will quality assure

Monitoring and evaluation

Supportive supervision

2009: Evaluation of WBBP performance using LQAS in selected States

2009: HF Assessment conducted for WBBP States and 2 non WBBP States

2009: Planning for MIS, Program Performance review commenced

RDT resources available to achieve the 2010 targets

FUNDS AVAILABLE (US $) SOURCE COMMENT

BCC resources available to achieve the 2010 targets

FUNDS AVAILABLE (US $)

SOURCE COMMENT

when Available Total Need Gap

LLINs CampaignsRoutineIRSEnv. MgtCase Mgt (jingles)Printing MaterialsKnow the FactsIPTLLINs CampaignsLLINs CampaignsRoutineIRSEnv. MgtCase Mgt (Jingles)

WBWBWBWBWBWB WB WBWBGF R8WHOAMFmWB (NIFFA)USAID

Already coveredAlready coveredAlready coveredAlready coveredAlready coveredAlready coveredAlready coveredAlready coveredExpected 2010Expected 2010Expec ted 2010Expected 2010Expected 2010Expected 2010

$220,400 $72,782$72, 782$34,220$757,789$72,782$38,114$72,782$1m$4.8m$350,000$............$2m$350,000

$1,334,417.66(2009)

$8,500,000

0

0

IRS resources available to achieve the 2010 targets

FUNDS AVAILABLE (US $) SOURCE COMMENT

Indoor Residual Spraying:Total HHs targeted 8% coverage of Total HHs = 2,540,843

85% of HHs/structures per targeted LGAs;

Pyrethroids required Lamdacyhalothrin CS 10%: 0.030 g/m2Alphacypermethrine WP10%: 0.030 g/m2Bifenthrine 10% WP: 0.050 g/m2Carbamate

Procurement schedules Procurement of IRS logistics: Some in 2008; more in Sept. 2009

Release of funds by WBBP to the IRS Contractors: Dec 2009

Distribution Distribution of IRS logistics to the target districts

Implementation of IRS: Sept 2009; March 2010; Sept 2010.

Training Training of spray personnel – commenced already; March 2010; Sept 2010

(ToTs in collaboration with private sector partners)

Implementation of IRS: Sept 2009; March 2010; Sept 2010

BCC Advocacy and BCC/IEC campaigns: July 2009 – Dec 2010

Spraying Supervision and monitoring including quality assurance: Sept 2009; March 2010; Sept 2010. Data management and report writing: Oct 2009; July 2010Feedback Nov 2009; August 2010; Dec 2010

Monitoring and evaluation (bioassays, insecticide resistance etc)

Conduct insecticide susceptibility studies: Sept 2009; March 2010 (Sentinel sites PIs)

Baseline entomological and epidemiological studies: July 2009;

TA from WHO Reconnaissance and Evaluation, ANVR, etc: (Nov 2009; July 2010; Jan 2011

IPTp resources available to achieve the 2010 targets

FUNDS AVAILABLE (US $) SOURCE COMMENT

Intermittent Preventive Therapy:SP doses required Distributed 5,353,098 doses(as @ July 2009);

Required 2009 = 7,693,928 @ 50% coverage (Gap =2,340,830)

Required in 2010 = 16m @ 100% coverage

Total = 23,081,584m; 18.3m (from Sept 2009-Dec 2010)

Procurement schedules All doses of SPs will be procured by Governments and Partners

WBBP II in & States: August 2009; Dec 2009; 2010

Government (MDG and States) in all FMCs and States: April 2010

DFID / SuNMap in selected States: Dec 2009

Distribution Logistics support through WBBP and States, LGAs

Implementation through ANC clinics; DOT at public and private health facilities; on a continuous basis

Training Training: On-going with GF-R2 Phase II and WBBP; More trgs through in all States with support from GF-R8. It will go on till 2010

BCC Improve ANC attendance to increase IPT uptake; Improve Health seeking behaviour and informed demand for commoditiesEarly recognition of signs and symptoms

Monitoring and evaluation HF Assessment done (May / June 2009)

Community Survey using LQAS (2009)

Program Performance Review (June 2009 - 2010)

MIS Evaluation (Sept 2009 - 2010)

Other core interventions to be delivered over the next 17 months

• HSS issues:– Improving utilization of ANC services– Recruiting and training community health workers– Community systems strengthening

• GF R8 HSS Component

– Strengthen NHMIS• GF R8 MAL and HSS Component

– Expand HR capacity• Recruitment at all levels

• Secondment

• TAs from Partners and Private-Publication Partnership

– Coordination:• ATM task Force, CCM, PRs’ Forum; TWGs, Partners, Bi-Annual

Review and Planning ; State Support Teams; State Partners forum; etc

Summary of rate-limiting factors over the next 17 months

• Gap of 10m LLINs and key operational issues (costs, taxes and tariffs) to achieve SUFI including shortage in operational costs

• Sub-optimal capacity at sub-national levels

• Under utilization of commodities (Nets)

• Surveillance, M&E: delay and under-reporting

Summary of technical assistance needs to end 2010

Need From whom

Capacity building for program managers on CM, LLIN, IRS, MIP, M&E and PM

WHO, UNICEF, WB, AMP, JHIPIEGO,

Financial Management support KPMG, GF,

Partnership / Coordination RBM-HWG, All Partners

Program performance review WHO, CDC,

Malaria Indicator Survey (MIS) WHO, UNICEF, MEASURES, MERG, WB, GF

Drug Efficacy Trial WHO, WAMNAT, WB, GF, Consortium of RBM Experts in Research / Academia, NAFDAC,

Capacity building for program managers on IRS, WHO, IRS Partners e.g.

Capacity building on Pharmaco-vigillance WHO, MSH, CF

Capacity building on PSM MSH, USAID Deliver, WHO,

STATE Region Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10

7Benue NC         1,956,504            

15FCT NC       657,956            

23Kogi NC                     1,520,266  

24Kwara NC         1,099,497            

26Nasarawa NC                   864,019  

27Niger NC                    

32Plateau NC         1,452,658            

2Adamawa NE                      

5Bauchi NE                      

8Borno NE         1,962,617          

16Gombe NE                      

35Taraba NE                 1,061,704    

36Yobe NE                   1,102,929    

18Jigawa NW                        

19Kaduna NW         2,731,188            

20Kano NW                      

21Katsina NW       2,686,074            

22Kebbi NW         1,463,712            

34Sokoto NW                        

37Zamfara NW                   1,526,355    

1Abia SE                   1,295,126  

4Anambra SE                        

11Ebonyi SE         998,126            

14Enugu SE         1,510,440            

17Imo SE                     1,842,435  

3Akwa Ibom SS                        

6Bayelsa SS         786,037            

9Cross River SS                    

10Delta SS                   1,918,986  

12Edo SS                 1,470,764  

33Rivers SS                        

13Ekiti SW                      

25Lagos SW         4,220,400            

28Ogun SW                    

29Ondo SW                     1,595,636  

30Osun SW                 1,602,999  

31Oyo SW                     2,643,613  

Total             12,681,618 8,843,591 4,555,007 13,889,825

21,525,209 18,444,832