Annual Report 2011 Malaria 20120309 - info.undp.org Annual Report Malaria... · malaria epidemiology in zimbabwe Malaria transmission is highly variable over space and in time in

ZIM-809-G13-M

Towards universal access: Scaling up effective malaria control interventions in Zimbabwe

Annual Report 2011Annual Report 2011Annual Report 2011Annual Report 2011

1

Table ContentsTable ContentsTable ContentsTable Contents

1 INTRODUCTION1 INTRODUCTION1 INTRODUCTION1 INTRODUCTION ........................................................................................................................................... 2

2. MALARIA EPIDEMIOL2. MALARIA EPIDEMIOL2. MALARIA EPIDEMIOL2. MALARIA EPIDEMIOLOGY IN ZIMBABWEOGY IN ZIMBABWEOGY IN ZIMBABWEOGY IN ZIMBABWE .................................................................................................. 3

3. GRANT OVERVIEW3. GRANT OVERVIEW3. GRANT OVERVIEW3. GRANT OVERVIEW ...................................................................................................................................... 4

3.1 GOAL, OBJECTIVES AND SERVICE DELIVERY AREAS .................................................................................................. 4

3.2 COORDINATION OF THE GRANTS .......................................................................................................................... 4

4. ACTIVITIES IMPLEMENTED ........................................................................................................................... 5

3.3.1. VECTOR CONTROL ......................................................................................................................................... 5

3.3.2 Prompt effective management and treatment of Malaria cases. ........................................................ 9

3.3.4. Behavior Change Communication (BCC) .......................................................................................... 10

3.3.5 Program management and coordination .......................................................................................... 11

3.3.6 Budget Reprogramming .................................................................................................................... 11

3.4 TARGETS AND RESULTS ACHIEVED ..................................................................................................................... 12

3.5 MALARIA PROGRAM REVIEW ............................................................................................................................. 14

3.6 INTER AGENCY SUPPORT AND SUPERVISION ......................................................................................................... 15

4. FINANCIAL SUMMARY4. FINANCIAL SUMMARY4. FINANCIAL SUMMARY4. FINANCIAL SUMMARY .............................................................................................................................. 15

5. PROCUREMENT AND S5. PROCUREMENT AND S5. PROCUREMENT AND S5. PROCUREMENT AND SUPPLY MANAGEMENTUPPLY MANAGEMENTUPPLY MANAGEMENTUPPLY MANAGEMENT ......................................................................................... 16

6. CAPACITY DEVELOPM6. CAPACITY DEVELOPM6. CAPACITY DEVELOPM6. CAPACITY DEVELOPMENT PLANENT PLANENT PLANENT PLAN .............................................................................................................. 17

7777. CHALLENGES, SUCCES. CHALLENGES, SUCCES. CHALLENGES, SUCCES. CHALLENGES, SUCCESS STORIES AND LESSONS STORIES AND LESSONS STORIES AND LESSONS STORIES AND LESSONS LEARNEDS LEARNEDS LEARNEDS LEARNED .................................................................... 19

7.1 CHALLENGES .................................................................................................................................................. 19

7.2 SUCCESS STORIES ............................................................................................................................................ 21

7.3 LESSONS LEARNED .......................................................................................................................................... 21

PROJECT TITLE: Towards universal access: Scaling up effective malaria control interventions in Zimbabwe

GRANT NUMBER: ZIM-809-G13-M

GRANT PERIOD : (PHASE 1) 1 January, 2010—31 December, 2011

APPROVED BUDGET: (PHASE 1) $32,810,290

PRINICPAL RECIPIENT: UNDP ZIMBABWE

SUB-RECIPIENT: Ministry of Health and Child Welfare- National Malaria Control Programme and Natpharm

SUB-SUB-RECIPIENT: PLAN and PSI

2

1 INTRODUCTION

Current national malaria prevention, treatment and support strategies are articulated in the National Malaria Control Strategic Plan 2008–2012 of the MoHCW. The strategic plan is aligned with the Roll Back Malaria (RBM) 2010 targets for achieving universal access of key interventions and the 2015 Millennium Development Goals. The current National Malaria Control Strategy is currently being reviewed, following recommendations from the findings of the Malaria Programme Review of June 2011.

Malaria remains a major public health problem in Zimbabwe. In 2006, 1,547,177 clinical malaria episodes were reported with 1,035 deaths (hospital case fatality ratio: 4.43%); malaria was responsible for 15% of all outpatient visits and 12% (23,340) of all inpatient admissions to public health facilities, and 7.8% of total maternal mortality. The national programme seeks to reduce malaria incidence from 10.6% in 2006 to 6.5% in 2012.

Furthermore, the malaria case fatality ratio (inpatient admissions only) will be reduced from 4.43% to 1% by 2012. This will be achieved by rapid scale-up to universal access of malaria prevention and control interventions in malarious areas. The move to universal access means that the entire population is now targeted for malaria interventions, not just high risk groups such as children <5 years and pregnant women. Universal access will become ever more important as transmission levels are expected to drop with the scaling up of key interventions, however putting a larger proportion of the population at risk of epidemics.

The following are major components of Malaria control in Zimbabwe:

Programme management: Programme management: Programme management: Programme management: The NMCP is responsible for the implementation of a national malaria strategy in Zimbabwe and provides leadership and coordination for partners to implement activities within the strategic plan’s framework. To guide programme implementation, NMCP has developed policy documents to cover Insecticide Treated Nets (ITNs), case management, epidemic response and communications approaches. Under the current strategy, malaria control programming has been strengthened through financial and human resource management, logistics support and procurement and supply management.

Vector control: Vector control: Vector control: Vector control: The strategy aims for universal access to malaria prevention interventions by scaling up Indoor Residual Spraying (IRS) and ITNs to cover at least 90% of the population in high transmission areas by 2012. IRS is the mainstay of malaria prevention in 35 moderate and high transmission districts where coverage is currently estimated at 59% (Malaria Indicator Survey [MIS], 2008). Since 2001, distribution of ITNs has targeted only pregnant women and children under five years in 26 high transmission districts.

Case management: Case management: Case management: Case management: Improved diagnosis and treatment of uncomplicated and severe malaria is to be achieved by providing access to malaria treatment within 24 hours of onset to 85% of fever cases and to confirm and correctly treat all malaria cases. The use of Artemisinin based Combination Therapies (ACT) has been recommended since 2000 because of high treatment failure rates with chloroquine (CQ). However, national roll out of ACTs and Rapid Diagnostic Tests (RDTs) only began with Global Fund R5 funds, and the first batch of Artemether- Lumefantine arrived in December 2007. Health personnel are being trained in the use of ACTs and RDTs

Epidemic control: Epidemic control: Epidemic control: Epidemic control: The strategy aims to build epidemic response capacity in all provinces through improvements in surveillance and case detection and placement of response stocks of IRS equipment and ACTs.

Behaviour chBehaviour chBehaviour chBehaviour change communication and community participation: ange communication and community participation: ange communication and community participation: ange communication and community participation: The national malaria BCC strategy uses the ACADA (assessment, communication, analysis, design and action) planning model to maximize stakeholder participation in development and implementation of communications. The operational framework includes advocacy, social mobilization and programme communication through community participation. Malaria knowledge is high in the population with 80% (MPR, 2011) able to identify the causes and symptoms of malaria. However, treatment seeking behaviour remains low (40.9%) and ITN utilizations falls below the target of 80%, which demonstrates the need for significant BCC to turn this knowledge into practice.

Information management, operational research, monitoring & evalInformation management, operational research, monitoring & evalInformation management, operational research, monitoring & evalInformation management, operational research, monitoring & evaluation: uation: uation: uation: The strategy aims to strengthen malaria surveillance, monitoring, evaluation and operational research. Malaria disease

3

surveillance is part of the overall Health Management Information System (HMIS) and includes weekly surveillance for epidemic detection, monthly (T5) surveillance of outpatient cases and quarterly (T9) surveillance of inpatient cases and deaths. Quarterly drug stock data is also collected, using the Zimbabwe Informed Push (ZIP) System. Operational research capacity will be improved with the establishment of vector sentinel sites to monitor mosquito populations and insecticide resistance.

2. MALARIA EPIDEMIOLOGY IN ZIMBABWE

Malaria transmission is highly variable over space and in time in Zimbabwe ranging from areas of little or no transmission to those with relatively moderate to high transmission. In total, 45 of Zimbabwe’s 61 districts have conditions that support moderate to high transmission. These districts cover large geographic areas and a range of epidemiological strata, so malaria control is targeted to the ward level to allow for more accurate matching of interventions to the epidemiological profile of malaria; as such 476 wards containing 3.2 million people are targeted for Malaria activities. The highest transmission occurs along international border areas, especially in the North (Zambia) and the East (Mozambique). The borders to the West (Botswana) and South (South Africa) support little transmission but are epidemic prone. The central highlands area is largely malaria free. Malaria stratification last took place in 2002 and will be updated during the lifetime of this proposal to take into account the effect of the scale up of malaria control Interventions and recent mass population movements. Interventions are planned based on the local epidemiology. IRS will be used to protect the entire risk population in 35 districts (476 wards) while other interventions, such as ITNs, improved case management and epidemic surveillance and preparedness are scaled up and strengthened.

Recently the MPR have noted a shift in the distribution of malaria cases in the country (see the map above) due to various factors, including climatic change, extensive population migration due to land resettlement

and intensification of malaria interventions in the previously malaria endemic areas.

4

3. GRANT OVERVIEW

3.13.13.13.1 GGGGOALOALOALOAL ,,,, OOOOBJECTIVES AND BJECTIVES AND BJECTIVES AND BJECTIVES AND SSSSERVICE ERVICE ERVICE ERVICE DDDDELIVERY ELIVERY ELIVERY ELIVERY AAAAREASREASREASREAS

Goal of the project: Goal of the project: Goal of the project: Goal of the project: To reduce malaria incidence rate from 10.6% in 2006 to 6.5% in 2014.

Objectives:Objectives:Objectives:Objectives:

1. By 2014, at least 90% of households in targeted malaria endemic areas are covered by IRS. 2. By 2014, at least 85% of the populations in targeted malaria endemic areas have slept under an ITN

the previous night. 3. By 2014, at least 90% of malaria cases are managed according to the national treatment Guidelines. 4. By 2014, at least 95% of people in malaria endemic areas know the cause, symptoms, 5. Preventative measures and treatment of malaria. 6. By 2014, 45 districts will have the capacity and resources to rapidly detect and respond to malaria

epidemics. 7. By 2014, to have strengthened evidence-based programme management including establishment

of 16 sentinel sites for vector bionomics, drug resistance monitoring and operational research

SSSService Delivery Areas ervice Delivery Areas ervice Delivery Areas ervice Delivery Areas (SDAs(SDAs(SDAs(SDAs):):):):

• Vector control: IRS & ITNs

• Case management: training, malaria diagnosis and treatment

• Behaviour change communication

• Epidemic preparedness and response

• Supporting evidence based programming and management

3333 .2.2.2.2 CCCCOORDINATION OF THE OORDINATION OF THE OORDINATION OF THE OORDINATION OF THE GGGGRANTSRANTSRANTSRANTS

During the period under review the grant was implemented through 2 Sub Recipients and 2 Sub-Sub

Recipients, as indicated below with UNDP as Principal Recipient.

Role of UNDP: Role of UNDP: Role of UNDP: Role of UNDP: UNDP as Principal Recipient is legally responsible for program results and financial accountability. In addition UNDP provides the following support:

• Receives disbursements from the GFATM, and periodic disbursements to NMCP/SSRs for use to implement the project as per approved work plan.

• Program Monitoring, evaluation and reporting.

• Technical support to ongoing activities for compliance and targets achievement.

• Commodities procurement and delivery to the implementing authority (NMCP).

• Reports periodically to CCM and GFATM through LFA.

• Capacity development activities to strengthen the capacity of the implementing partners.

5

SubSubSubSub----recipientrecipientrecipientrecipients: s: s: s: The sub-recipients are the MOHCW/National Malaria Control Program (NMCP) and NatPharm. Under NMCP, there are two sub-sub recipients who are; Population Services International and Plan International. SR: MOHCW/National Malaria Control Program (NMCP)SR: MOHCW/National Malaria Control Program (NMCP)SR: MOHCW/National Malaria Control Program (NMCP)SR: MOHCW/National Malaria Control Program (NMCP)

• The NMCP is responsible for the implementation of a national malaria strategy in Zimbabwe.

• Provides leadership and coordination for partners to implement activities within the strategic plan’s framework.

• To guide programme implementation, NMCP has developed policy documents to cover Insecticide Treated Nets (ITNs), case management, epidemic response and communications approaches.

• Under the current strategy, malaria control programming will be strengthened through financial and human resource management, logistics support and procurement and supply management.

SR: SR: SR: SR: NNNNatPharm atPharm atPharm atPharm

• National body responsible for storage and distribution of pharmaceuticals.

SSR: Population Services International (SSR: Population Services International (SSR: Population Services International (SSR: Population Services International (PSIPSIPSIPSI))))

• This International non-governmental organization is sub-sub-recipient under two SDAs: ITNs and BCC.

• PSI/Z will work with the NMCP to distribute free LLINs in 22 of 30 target districts by providing technical and operational oversight and assistance to MOCW implementers.

• PSI/Z is also responsible for the development and reproduction of BCC materials.

• PSI will assist the NMCP to facilitate trainings at national, district and ward level to update staff on these new materials and the participatory BCC activities and will promote IRS, ITNs, IPTP, ACTs and healthy treatment-seeking behaviours.

SSR: SSR: SSR: SSR: PPPPlan Internationallan Internationallan Internationallan International

• This non-governmental organization is sub-sub-recipient under two SDA: ITNs and IRS

• Plan’s role is to provide oversight and technical assistance to NMCP activities at community and district level and support in planning and implementation of ITN activities.

• Plan International will work with the NMCP to distribute free LLINs in 8 of 30 target districts by providing technical and operational oversight and assistance to MOCW implementers.

• Plan International will work with the NMCP in the implementation of IRS program in 8 districts.

• Plan has long standing links with the 8 districts in which it works and has built up strong community networks through which it can channel BCC messages, developed by PSI/Z, and provide community mobilization support to IRS and ITN activities.

4. ACTIVITIES IMPLEMENTED

Significant progress was recorded over the year 2 of the implementation of the Round 8 Malaria grant. Below is a summary of activities carried out and the achievements recorded in 2011:

3.3.1. VECTOR CONTROL

3.3.3.3.3333.1.1. Annual.1.1. Annual.1.1. Annual.1.1. Annual Indoor Residual House Indoor Residual House Indoor Residual House Indoor Residual House spraying spraying spraying spraying programme programme programme programme rrrrevieweviewevieweview

• A national planning and review meeting on IRS was done during the 2nd Quarter of 2011 in Masvingo. The meeting was done for three days and was attended by a total of 37 officers from districts and provinces. The aim of the meeting was to review the vector control programme from the 2010 season and plan for the 2011 vector control programme.

6

3.3.3.3.3333.1.2. Training.1.2. Training.1.2. Training.1.2. Training of spray operators and supervisors in IRSof spray operators and supervisors in IRSof spray operators and supervisors in IRSof spray operators and supervisors in IRS

• National TOT for IRS supervisors was done at Kwekwe and total of 49 (90%) officers participated in the exercise that was done to plan for 2011 IRS season.

• A total of 436 (100%) field supervisors from districts and Provinces were trained in the basics of spraying and program management. The exercise was done jointly between NMCP and Plan International with support from WHO and UNDP.

• A total of 1,240 spray operators were trained in IRS spraying techniques in the 3rd Quarter of 2011, and these are the people who were involved in spraying exercise that was done in 4th Quarter. This program was jointly done by NMCP and Plan International.

3.3.1.3 3.3.1.3 3.3.1.3 3.3.1.3 VectorVectorVectorVector control control control control coveragecoveragecoveragecoverage for 2011for 2011for 2011for 2011,,,, Indoor Residual spraying programmeIndoor Residual spraying programmeIndoor Residual spraying programmeIndoor Residual spraying programme

Spraying in progress in one on the districts in Masvingo province

• Zimbabwe with support from Government of Zimbabwe, Global Fund and other partners, implemented IRS in 45 districts as shown in the Table below. The population protected by IRS in Zimbabwe for 2011 spraying season was 3,291,474 compared to the target population of 3,496,756 achieving 94.1% population protected.

ProvinceProvinceProvinceProvince DistrictDistrictDistrictDistrict Target Target Target Target RoomsRoomsRoomsRooms

Rooms sprayedRooms sprayedRooms sprayedRooms sprayed % % % %

CoverageCoverageCoverageCoverage Target Target Target Target

PopulationPopulationPopulationPopulation Population Population Population Population protectedprotectedprotectedprotected

% Pop. % Pop. % Pop. % Pop. ProtectedProtectedProtectedProtected

Mash WestMash WestMash WestMash West Kariba 21,172 20,316 96 38,993 37,076 95

Chegutu 22,093 22,342 98 26,985 26,209 97

Hurungwe 59,976 57,594 96 92,660 88,430 95

Kadoma 42,933 41,917 98 60,664 59,304 98

Zvimba 23,227 22,200 96 29,490 28,088 95

Makonde 49,422 47,391 96 65,189 60,750 93

Subtotal Subtotal Subtotal Subtotal 6666 218,823218,823218,823218,823 211,760211,760211,760211,760 97979797 313,981313,981313,981313,981 299,857299,857299,857299,857 96969696

Mash CentralMash CentralMash CentralMash Central Mbire 53,882 50,408 94 94,757 85,813 91

Centenary 49,192 47,473 96 78,733 73,174 91

Mt. Darwin 71,516 65,584 92 112,768 105,335 93

Rushinga 52,637 50,758 96 82,165 78,419 96

Shamva 49,282 47,763 97 71,937 68,264 95

Bindura 28,248 28,024 99 44,393 43,200 97

Mazowe 31,383 29,949 95 38,374 36,925 96

Guruve 33,244 31,254 94 59,486 56,066 94

Subtotal Subtotal Subtotal Subtotal 8888 369,384 351,213 95959595 582,613 547,196 94949494

7

ProvinceProvinceProvinceProvince DistrictDistrictDistrictDistrict Target Target Target Target RoomsRoomsRoomsRooms

Rooms sprayedRooms sprayedRooms sprayedRooms sprayed % % % %

CoverageCoverageCoverageCoverage Target Target Target Target

PopulationPopulationPopulationPopulation Population Population Population Population protectedprotectedprotectedprotected

% Pop. % Pop. % Pop. % Pop. ProtectedProtectedProtectedProtected

ManicalandManicalandManicalandManicaland Chipinge 107,943 92,182 85 160,665 145,982 91

Mutare 103,591 92,199 89 120,670 120,409 99.8

Mutasa 86,021 74,084 86 93,897 87,116 93

Nyanga 78,400 68,688 88 78,336 84,213 108

Chimanimani 54,603 48,523 89 72,501 59,739 82

Buhera 65,156 62,191 95 96,219 92,219 96%

Makoni 44,370 44,199 100 55,000 54,158 98


Mat SouthMat SouthMat SouthMat South Mangwe 12,052 10,679 89 15,068 12,876 86

Beitbridge 54,352 46,024 87 93,938 82,607 88

Gwanda 24,167 21,275 88 33,529 30,230 90

Matopo 17,560 15,812 90 20,553 18,677 91

Bulilima 30,678 27,376 89 40,290 38,987 96


MidlandsMidlandsMidlandsMidlands Gokwe North 106,217 94,862 89 172,447 254,508 90

Gokwe South 88,579 96,097 111 124,342 140,768 113

Kwekwe 63,908 67,722 106 98,961 93,394 93

Mberengwa 22,090 21,278 96 32,580 30,630 93


Mat NorthMat NorthMat NorthMat North Binga 49,753 42,079 85 132,563 82,925 64

Hwange 80,080 80,617 94 144,689 130,385 90

Lupane 65,000 50,414 95 10,900 82,188 71

Tsholotsho 42,935 40,539 96 42,153 55,418 92

Nkayi 31,852 30,505 96.7 56,852 46,055 81

Bubi 13,740 13,391 97 23,267 19,862 85

Subtotal Subtotal Subtotal Subtotal 7777 283,360 257,545 94949494 410,424 416,833 81818181

MasvingoMasvingoMasvingoMasvingo Chiredzi 80,570 80,556 100 155,800 154,744 99

Mwenezi 77,209 70376 91 119,219 116,633 99

Bikita 36,563 38,610 106 52,192 52,437 100

Zaka 40,737 37,226 91 65,386 53,674 82

Masvingo 15,725 15,096 96 24,659 22,030 89


Mash EastMash EastMash EastMash East Mudzi 103,515 82,423 80 140,182 113,539 81

UMP 87,934 75,578 86 116,503 99,562 85

Murehwa 56,811 44,318 78 75,910 59,668 79

Mutoko 101,224 88,865 87 130,891 108,788 83


Grand Total Grand Total Grand Total Grand Total 45454545 2,423,0912,423,0912,423,0912,423,091 2,150,3832,150,3832,150,3832,150,383 93939393 3,496,7563,496,7563,496,7563,496,756 3,291,4743,291,4743,291,4743,291,474 94949494

The non-achievement of the planned national program target of 100% population protected was due to errors in targeting as it is not possible to achieve 100% population protection in IRS. The performance was high and the achievement of the programme was impressive. In the 35 Global Fund Supported Districts 90% (2,877,403) of the target population (3,200,000) people were protected by IRS. The number of people protected in 2011 increased by 6% (189,788) compared to those protected in 2010 in the same districts. The programme experienced some challenges which impacted negatively on the achievement of the set targets including the following: breakdown of vehicles, locked rooms, refusals from some households and shortage of spares for the repair of the spray pumps. 3.3.1.43.3.1.43.3.1.43.3.1.4 DDTDDTDDTDDT Local support servicesLocal support servicesLocal support servicesLocal support services Local DDT services for Year 1 were done during the first quarter of the year and the services included delivery of DDT to implementing sites and waste management (collection and incineration of DDT waste). The local services were provided by Nets for Africa. In year 2, DDT local support services were provided during the spraying programme and a joint verification exercise was done in December 2011. It is noted that the following services had been provided: distribution of DDT to 21 districts, training of spray operators and

8

supervisors in DDT use, handling and disposal; and provision of DDT waste handling facilities (all was in compliance with contract).

Part of the DDT consignment that was delivered to Mt Darwin district for 2011 IRS season.

3.3.1.53.3.1.53.3.1.53.3.1.5 MonitoringMonitoringMonitoringMonitoring InsecticidesInsecticidesInsecticidesInsecticides Resistance and bioassaysResistance and bioassaysResistance and bioassaysResistance and bioassays

• All the 16 entomological sentinel sites conducted vector surveillance studies which included larval sampling and bioassays. The following sentinel sites were active during the year:

ProvinceProvinceProvinceProvince DistrictsDistrictsDistrictsDistricts Name of the siteName of the siteName of the siteName of the site

Manicaland Mutare Burma Valley

Mutasa Zindi

Mashonaland Central Centenary Muzarabani

Rushinga Mazowe Bridge

Mashonaland west Kadoma Chikari

Hurungwe Kasimure

Mashonaland East UMP Maramba

Mudzi Kotwa

MIDLANDS Gokwe Kamhororo

Kwekwe Sidhakeni

MASVINGO Bikita Mashoko

Chiredzi Chiredzi Chiredzi Chiredzi Chilonga

Matebeleland North Binga Manjolo

Lupane Jotsholo

Matebeleland South Matobo Tshilanyemba

Beit Bridge Beit Bridge Beit Bridge Beit Bridge Makhakhavhule

• The programme procured and distributed vector surveillance equipment for effective collection of vector surveillance information: Stevenson screens, Hygrometers, rain gauge and min/max thermometer.

• A National workshop was done to environmental health workers on how to assemble vector surveillance equipment.

9

An environmental health worker doing practicals on how to assemble vector surveillance equipment.

• Cone bioassays on sprayed surfaces were done in all provinces and the average knock out rate was above 60% and 24hour Mortality rate above 90% and as the year ended bioassays were continuing. The bioassays were done mainly on huts walls and roofs and only a few were done on LLINs.

Weather station equipment NMCP Vector Control Officer, NIHR and UNDP officials inspecting the weather station equipment

3333.3.2.3.2.3.2.3.2 PromptPromptPromptPrompt effective effective effective effective managememanagememanagememanagement and nt and nt and nt and treatment of Malaria cases.treatment of Malaria cases.treatment of Malaria cases.treatment of Malaria cases.

The grant supported training on Malaria case management training of health workers, training on IDSR, and training in entomological surveillance, in use of PDA machines and CBHWs, including school health masters in malaria prevention and control and media personnel were trained on malaria prevention and control activities. Media personnel were trained so that they disseminate widely correct malaria messages.

Type of trainingType of trainingType of trainingType of training Year 1Year 1Year 1Year 1 Year 2Year 2Year 2Year 2

TargetTargetTargetTarget AchievedAchievedAchievedAchieved TargetTargetTargetTarget AchievedAchievedAchievedAchieved

IRS Level 1 50 45 N/A N/A

IRS supervisors Level 2 436 436 436 342

IRS spray operator Level 3 1230 1230 1230 1240

Case Management training to Health workers 1120 965 2392 1854

Basic entomology training to health workers 70 74 N/A

IDSR 157 157 N/A

TOT in PHHE 56 56 N/A

Training of media personnel in Malaria control 75 76 N/A

TOT in Vector Mapping 38 65 N/A

Community health training 6755 2863 N/A

• Vector Surveillance visits were done regularly by the Provincial and National malaria control teams.

• Most provinces engaged one cadre who was trained in basic entomology to conduct cone bioassays in the districts as spraying continued. Nets for Africa also assisted in conducting bioassays in DDT targeted districts throughout the country.

10

• 1,854 health workers were trained in Malaria Case Management in Q8, bringing the health workers trained in Malaria Case Management under Rd 8 Phase 1 to 2819, this signified 80.3% achievement. The training encompassed management of both uncomplicated and severe malaria and prevention of malaria in pregnancy, treatment of malaria using the new malaria treatment policy. The cadres trained were drawn from various stations - Rural Health Facilities, District Hospitals, City Health Centers, Provincial and Central Hospitals as well as from the Uniformed Forces (Police, Prison and Army). The training sessions were 3 days long and all categories of professional health workers were trained; nurses, doctors, pharmacists, environmental health officers/technicians and laboratory scientist/technicians. The inability of the national program to achieve the target is attributed to the inadequate budget to support the training.

• At least three Case Management trainings were monitored for compliance in line with Global Fund training requirements to strengthen fiduciary measures and were all seen to be compliant.

• Additional anti-malarial medicine and testing kits were procured under budget reprogramming and as the year ended additional orders of antimalarials and testing kits had been placed.

• A total of 2,863 community health workers comprising of School Health Coordinators and Village Health Workers were trained in malaria prevention and control which included management of uncomplicated malaria cases, diagnosis and treatment of malaria.

• During the year the average testing rate of suspected malaria cases with microscopy and RDTs for malaria confirmation was as high as (93.3%). This high achievement was attributed to the increased number of trained health personnel and the improved stocks of RDTs in the Health Facilities.

During 2011, the PR has strengthen monitoring of training activities and has put in place the following fiduciary measures:

• Pre and post training assessment for all trainings. • Quarterly summary of assessments of training outputs to be produced • Spot checks done in coordination with the NMCP • List of participants to be submitted to PR during the training week.

During this period training spot checks and Quarterly summary assessment training reports were produced.

3.3.3.3.3.43.43.43.4.... Behavior Change Communication (BCBehavior Change Communication (BCBehavior Change Communication (BCBehavior Change Communication (BCCCCC))))

Focus group discussions on hang up campaigns

Various activities on BCC were conducted to support uptake of malaria control interventions. PSI conducted road shows, mass media and electronic media campaigns. The programme also conducted net hang up campaigns to demonstrate to the community on proper ways of hanging the net as a way of ensuring maximum protection. NMCP commemorated the World Malaria and SADC Malaria days, which were done to

promote advocacy and social mobilization in malaria control and prevention.

11

3.3.53.3.53.3.53.3.5 ProgramProgramProgramProgram management and cmanagement and cmanagement and cmanagement and coordinationoordinationoordinationoordination

• NMCP is responsible for coordination of the malaria programme, which was achieved through routine coordination meetings held with key stakeholders, which includes the academic sectors (University of Zimbabwe-College of Health Sciences), private sectors (Private Hospital Association, Sygenta, HEDEC, Nets for Africa and Arysta Life Sciences, etc) , UN Family (WHO,UNICEF and UNDP), USG(CDC, USAID), Local authority, Plan and PSI.

• The programme conducted 4 technical committee meetings every quarter namely; malaria case management, Vector control, Monitoring and Evaluation and Behavoiur Change Communication Sub-committees.

• The National Malaria Programme hosted the National Malaria Conference in October 2011, which was attended by key stakeholders. The main purpose of the conference was to review progress, performance, challenges and opportunities in implementation of 2010/11 malaria interventions and develop strategies for 2011/2012.

• Furthermore, UNDP as PR also spearheaded monthly and quarterly coordination meetings with all the implementing partners and WHO. The purpose of the meetings were to review progress in implementation of the GFATM grant, address identified challenges and this strategy effectively reduced the turnaround time for the submission of disbursement requests and payments.

• NMCP is supported by provincial coordinators who are responsible for malaria coordination in the provinces; they conducted regular support and supervision, coordinated malaria control activities, including the IRS programme, Case management trainings and village health worker trainings. They facilitated introduction and monitoring of RDTs and ACTs in the community.

3.3.3.3.3.63.63.63.6 BudgetBudgetBudgetBudget RRRReprogrammingeprogrammingeprogrammingeprogramming

Budget reprogramming which started in September 2010 was finally approved in July 2011 and the following were the major highlights:

• Increase of Spray operators’ allowances from $3 per day to $6 per day was also approved by Global Fund to give way for the smooth implementation of the IRS programme.... The spray operators’ allowances increased to $6 per day for 20days per month for 3 months. This was after the Ministry of Health and Child Welfare faced some challenges in recruiting the spray operators at a lower pay (traditionally spray operators are graded the same and receive a minimum of $120 per month which translates to $6 per day for 20 days per month).

12

• Reprogramming of funds from within the budget was also approved by Global Fund to cater for procurement of additional ACTs and RDTs. The first reprogramming was done in Quarter 5 and this was a result of quantification problems at the inception of the grant which had resulted in lower that national antimalarials requirements. The second reprogramming was done in Quarter 7 where funds were taken from pyrethroids budgets towards procurement of ACTs and RDTs.

• Reprogramming of funds was also done towards provisions of funds for review and development of pre-elimination tools and national strategic documents.

3.3.3 .3 .4444 TTTTARGETS AND ARGETS AND ARGETS AND ARGETS AND RRRRESULTS ESULTS ESULTS ESULTS AAAACHIEVED CHIEVED CHIEVED CHIEVED

The grant has seen continuous improvements in the achievement of targets as indicated in the table below.

QUARTER 1QUARTER 1QUARTER 1QUARTER 1

Jan Jan Jan Jan ---- MarMarMarMar 10101010


Apr Apr Apr Apr –––– Jun 10Jun 10Jun 10Jun 10


Jul Jul Jul Jul –––– Sep 10Sep 10Sep 10Sep 10


Oct Oct Oct Oct ––––Dec 10Dec 10Dec 10Dec 10


Jan Jan Jan Jan –––– Mar 11Mar 11Mar 11Mar 11


AprAprAprApr–––– Jun 11Jun 11Jun 11Jun 11


JulJulJulJul----Sep 11Sep 11Sep 11Sep 11


OctOctOctOct----Dec 11Dec 11Dec 11Dec 11

B2 B1 A2 A2 A2 A2 A2 N/A

This consistent performance has been made possible by an improvement in the working relationship between the PR and SR and SSRs. This relationship opened up communication channels among partners at all levels thereby providing a swift platform for resolving challenges as well as giving feedback to requests in circumstances where there is a variation of the detailed work plan and budget. The targets and results achieved in 2011 are indicated in the table below:

Indicator Indicator Indicator Indicator

Quarter 5Quarter 5Quarter 5Quarter 5 QuQuQuQuarter 6arter 6arter 6arter 6 Quarter 7Quarter 7Quarter 7Quarter 7 Quarter 8Quarter 8Quarter 8Quarter 8

TargetTargetTargetTarget ResultResultResultResult TargetTargetTargetTarget ResultResultResultResult TargetTargetTargetTarget ResultResultResultResult TargetTargetTargetTarget ResultResultResultResult

% of population in targeted areas covered by IRS

90% 84% N/A N/A N/A N/A 100% 89.9%

The set target for the indicator was achieved by 90% in the 35 Global Fund supported districts. The target for the indicator was set very high and could not be met due to challenges such as breakdown of vehicles, locked rooms, refusals and shortage of spares for spray pumps. Some of the challenges highlighted such as refusals and locked rooms are Inherent to a spraying programme which makes the achievement of 100% unattainable. Compared to the 2010 spraying programme, in 2011 there was a significant improvement in the coverage of IRS by 6% (189,788). The timely delivery of IRS insecticides in 2011 ensured that all programme activities were implemented on time resulting in the high performance. The National coverage in the 45 districts eligible for IRS in the country was 94.1% (3,291,474) out of a target of 3,496,756.

Number of Community Health Workers trained in malaria prevention(indoor residual spraying, BCC-Community Outreach)

N/A N/A N/A N/A 3,000 2,783 6,755 2,863

This indicator was cumulative annually and the set target of 6,755 was achieved by 42.4%. The poor performance of the indicator was due to budgetary constraints. The targets set in the Performance Framework and the budgets were not coherent. The approved training plan could only cater for 2,464 against the set target of 6,755.Using the target in the Approved Plan, the achievement was 116% The trained Community Health Workers comprised of 1,254 Spray Operators 1,525 Village Health Workers, and 84 School Health Coordinators. The Village Health Worker and School Health Coordinator’s workshop encompassed the confirmation of malaria infection using RDTs and the treatment of uncomplicated malaria using ACTs. The thrust and focus is to promote Community Malaria Case Management in a bid to improve early access to treatment.

13




Number of Insecticide Treated Nets Distributed

N/A N/A N/A N/A N/A N/A N/A N/A

No Targets were set for 2011 because no nets were earmarked for distribution

Proportion of uncomplicated Malaria cases receiving correct treatment according to national guidelines

N/A N/A N/A N/A N/A N/A 85% 84%

Proportion of Suspected Malaria cases with Laboratory confirmation (Microscopy/RDT)

85% 92.9% 85% 97.3% 85% 86.6% 85% 90.8%

During the year the average testing rate of suspected malaria cases with microscopy and RDTs for malaria confirmation was high (93.3%). This high achievement was attributed to the increased number of trained health personnel and the improved stocks of RDTs in the Health Facilities throughout the year.

Number of health workers trained in Malaria Case Management

N/A N/A N/A N/A N/A N/A 3,360 2,403

This indicator was cumulative over the programme term (phase 1). For the entire period of phase 1 the set target was achieved by 71.5%. The target for 2011 was 2,240 and it was met by 64% (1,435). The main challenge for failure in meeting this target was the delay in the transmission of training reports from the implementing entities and the submission of incomplete reports. Various categories of Health workers directly involved in patient care were trained in the use of RDTs, treatment of both complicated and uncomplicated malaria and Intermittent Preventive Therapy.

Ratio of Community Health Workers to House holds

1:145 1:68 1:97 1:68 N/A N/A N/A N/A

This indicator is measuring the ratio of Community Health Workers to Households as a proxy of measuring accessibility of individuals to the 1st point of health care. The CHWs used in reporting against this indicator were all trained in 2010, but the indicator continued to be measured through to 2011. Cumulatively a total of 9,423 CHW were trained in 2010 in Malaria prevention and control. The CHWs trained comprise of the following cadres: Village Health Workers (5,400), LLINs Distributors (2,751), Spray Operators (1,230), and School Health Masters (222). The Nursing Department of the MOHCW contributed 57.3% to the achieved results and NMCP 15.4%. PSI, Planned International and the NMCP jointly trained the LLINs distributors which contributed 29.5% of the overall total. The target for Q5 was surpassed by 213.2%.The high performance of the indicator is attributed the active collaboration amongst all the implementing partners. The lower ratio of CHWs to Households will ensure that there is active and effective knowledge dissemination and prevention as well as control of Malaria in the communities. School Health Masters (SHMs) were trained on Participatory Health and Hygiene Education tools in 2010 to enable them provide continuous education and to train pupils and communities on Malaria prevention. Spray Operators are also actively involved in the management and control of malaria within the communities. They have been trained on diverse subjects on malaria to equip them in the prevention, management and control of malaria within their communities even after the spraying programme. Spray operators are also engaged in other vector control interventions such as Larviciding and carrying out bioassays and management of breeding sites of mosquitoes. The involvement of the LLIN Distributors includes the distribution of the 2010 nets. In addition, the cadres ensure the proper use of nets by households by ensuring that nets are hung up properly within the households and there is

14




also no abuse of the nets within the communities for fishing or using on chicken runs

Percentage of people reached through BCC activities

N/A N/A N/A N/A N/A N/A 90% N/A

Number of Districts with staff trained in IDSR

N/A N/A N/A N/A N/A N/A N/A N/A

No Targets were set for 2011

% of outbreaks detected and

responded according to the national EPR Guidelines.

N/A N/A N/A N/A 85% N/A N/A N/A

The country recorded no outbreak during the quarter under review. This is an expected result because reporting period is winter and transmission is low resulting in the period being characterized by very low malaria cases country wide which would make the occurrence of an outbreak less likely.

Number of sentinel sites carrying out vector bionomics studies

N/A N/A 8 16 N/A N/A N/A N/A

The target was achieved by 200%.

In the 2010-2011 malaria season all the 16 sentinel sites carried out Vector Bionomic studies. The activities conducted at the sentinel sites included Bioassays on LLINS, sprayed households, Monitoring vector density and Larval sampling. The results from the Bioassays on the walls sprayed during the 2010-2011 IRS programme showed that the insecticide sprayed was still efficacious by Q6.

All the 16 sentinel sites could conduct vector bionomic studies because the Provincial and District Health teams supported the insectaries with basic entomological kits (bioassay cones, sucking tubes, Mosquito holding cages and larval sampling bowels. As a result the sentinel sites were able to carry out vector bionomic studies despite the delays experienced in the procurement of the entomological kits.

There were some challenges that were incurred during the reporting period and these hampered the smooth running of operations at the sentinel sites. Some of the challenges were the delay in the procurement of entomological kits, lack of funding for renovations and refurbishment of insectaries and shortage of transport.

However, during the course of the year the sentinel sites were adequately equipped with entomological kits.

3.53.53.53.5 MMMMALARIA ALARIA ALARIA ALARIA PPPPROGRAM ROGRAM ROGRAM ROGRAM RRRREVIEW EV IEW EV IEW EV IEW

The programme conducted the Malaria Programme Review (MPR) in June 2011. The (MPR) is a periodic joint programme management process for reviewing progress and performance of country programmes with the aim of improving performance and refining or redefining the strategic direction and focus.

15

One of the key recommendations of the MPR was the review of the National Strategic and the Monitoring and Evaluation Plan. The Global Fund supported the review of these documents.

3.3.3 .3 .6666 IIIINTER NTER NTER NTER AAAAGENCY GENCY GENCY GENCY SSSSUPPORT AND UPPORT AND UPPORT AND UPPORT AND SSSSUPERV IS ION UPERV IS ION UPERV IS ION UPERV IS ION

The programme conducted an interagency support and supervision mission in November. The teams comprised of representatives from UNDP, WHO, NMCP, PSI, PLAN and MOHCW (from various departments including pharmacy, nursing department, reproductive health and environmental health). The main objective of the mission was: (i) to assess programme implementation of scheduled activities e.g. IRS, CHW training and Health Worker trainings (ii) to take stock of malaria commodities (SP, RDTs, Chemicals, and ACTs) and other supplies; (iii) assess malaria records and data management; (iv) Strengthen the commitment of stakeholders to malaria control activities at the various levels through advocacy; (v) Build the capacities of both the supervisees and supervisors through providing support, understanding and mentoring and (vi) Identify challenge/bottlenecks/gaps in programme implementation and proffer on-site solutions where possible.

4. FINANCIAL SUMMARY

• From the total budget approved for the Phase 1 Malaria Grant – US$ 32,810,290 - a total of US$ 31,550,106 (96% of the approved budget) was disbursed by the Global Fund

• A total of US$31,126.814 are the expenditures recorded as of 31 December 2011, representing 95% of the approved budget for R8 Phase1.

. From the US$31.1 million, a total of US$10,2 million is the amount disbursed to SRs/SSRs as indicated in the Table below and the PR’s total expenditure amounts to US$20.9 million.

16

IPIPIPIP

Cumulative Q1 Cumulative Q1 Cumulative Q1 Cumulative Q1 –––– Q8Q8Q8Q8

BudgetBudgetBudgetBudget ActualActualActualActual VarianceVarianceVarianceVariance % Disb % Disb % Disb % Disb

(A) (B) (C) = (A) – (B) ((((D) = (B)/(A))))

NatPharm 727,233 654,326 32,412 90%

NMCP 5,752,410 5,825,347 (72,937) 101%

Plan International

673,431 584,730 88,701 87%

PSI 1,138,190 1,146,724 (8,534) 100.7%

Crown Agents 2,337,779 2,035,481 302,298 87%

TotalTotalTotalTotal 10,629,04410,629,04410,629,04410,629,044 10,246,60810,246,60810,246,60810,246,608 341,940341,940341,940341,940 96%

• Total expenditure for NMCP was more than the budget. This is because procurement of insectary equipment initially budgeted under PR was transferred to NMCP because of technical challenges by the PR. Funds were disbursed direct to NMCP.

• The over expenditure of $8,534 on PSI was because of an error in the reprogrammed budget of admin costs under activity 6.5.27 which did not take into account the initial agreement between the GF and the PR. The agreement was to expense 10% (admin costs) of the activities implemented.

• Commitments as at 31 December 2011 amounted to $794,605. The details by cost category and the variance is as indicated in the Table below:

Expenditures by Cost CategoryExpenditures by Cost CategoryExpenditures by Cost CategoryExpenditures by Cost Category

Category Category Category Category BudgetBudgetBudgetBudget ExpenditureExpenditureExpenditureExpenditure VarianceVarianceVarianceVariance

Communication Materials 784,551 784,551 (0) Health Products and Health Equipment 13,462,145 12,676,159 785,986 Human Resources 3,326,149 2,961,750 364,399 Infrastructure and Other Equipment 2,211,960 1,856,820 355,141 Monitoring and Evaluation (M&E) 2,004,378 1,947,149 57,229 Overheads 3,826,231 3,467,182 359,049 Pharmaceutical Products (Medicines) 1,196,907 809,950 386,957 Planning and Administration 1,245,128 1,245,182 (54) Procurement and Supply Management Costs (PSM) 2,702,870 3,192,023 (489,153) Technical & Management Assistance 76,909 76,909 (0) Training 1,973,062 2,109,139 (136,077) Health Products and Health Equipment 13,462,145 12,676,159 785,986 Grant TotalGrant TotalGrant TotalGrant Total 32,810,290 32,810,290 32,810,290 32,810,290 31,126,813 31,126,813 31,126,813 31,126,813 1,683,477 1,683,477 1,683,477 1,683,477

5. PROCUREMENT AND SUPPLY MANAGEMENT

The procurement and supply management of health and non-health products constituted 63% of the Round 8 phase 1 budget approved for the Malaria grant. In 2011, the programme procured a total of 162 tonnes of DDT, which was used in the 22 districts during the 2011 spraying programmes. Due to erratic supply of ACTs and RDTs, Global Fund approved the reprogramming of $945 936 meant for pyrethroids and procured ACTs and RDTs. A total of $128 000 was used to procure Weather Station and Insectary identification keys for Sentinel sites in Zimbabwe. Procurement of communication-Radio equipment could not be done because the budget was only enough to procure about 15 radio stations against 1500 health facilities. The Annex 1 provides the details of the procurement implemented under the Malaria grant.

17

independent Quality Assurance Pharmacist to work with the Medicines Control Authority of Zimbabwe (MCAZ) to enhance the NDRA laboratories to WHO standards. This move being the first of its kind in Zimbabwe is aimed at capacitating MCAZ to become a WHOPES collaborating center with ISO: 17205 certification to conduct all levels of laboratory tests and analysis. In addition, UNDP has issued a Quality Control testing guidance note for all countries where UNDP is PR to the GFATM Grants. UNDP together with MCAZ are in the midst of finalizing an adapted version for Zimbabwe. The Quality Assurance Plan suitable for general use by the government of Zimbabwe and all PSM partners in country, will guide the processes on testing quality analysis of all drugs imported into Zimbabwe and stored within the health facilities in country. UNDP is working alongside other public health partners such as JSI and UNICEF to come up with a coherent and coordinated solution for storage condition by inputting to the NatPharm Roadmap. Leverage on WFP role as global lead of the Logistics Cluster to enhance supply chain management by effective logistics coordination and monitoring between suppliers, streamline customs clearance procedures, enhance transparency and accountability in the Receiving, Inspection and Certifying Acceptance service including record keeping and technical advice.

6. CAPACITY DEVELOPMENT PLAN

The Phase 1 of the Round 8 Capacity Development Plan, implemented from November 2010 to December 2011, focused on individual skill building and awareness raising, mainly through the provision of workshops covering particular thematic or functional areas. The information below summarizes the key achievements from the implementation of the overall Capacity Development Plan supporting the Global Fund Round 8 grants in Phase 1:

Training of Key SR PersonnelTraining of Key SR PersonnelTraining of Key SR PersonnelTraining of Key SR Personnel

The training included a strong focus on improving Monitoring and Evaluation skills in individuals; refreshing financial skills with an emphasis on GF requirements and systems; and improving individuals’ capacity to use relevant software to improve processes and systems within the Global Fund Grant, such as Pastel for financial management, and Microsoft Navision to support the management of supply and distribution of essential drugs. Where possible a ‘Training of Trainers’ format was used to ensure the sustainability of all capacity development.

External TrainingExternal TrainingExternal TrainingExternal Training

National Monitoring and Evaluation officers from four Sub Recipients attended an external training workshop on Monitoring and Evaluation. This was organized by the Graduate School of Public and Development Management, University of the Witwatersrand, Johannesburg, South Africa; in partnership with the World Bank. The course took place from 15th November - 4th December 2010.

Additionally one manager from each SR was identified to attend a Management Development Program organised by the The Management Development Institute (MDI). The course focuses solely on Health Care Organizations and is an intensive program designed to enhance the leadership and management skills of program managers and leaders of sub-Saharan African organizations, (both governmental and non-governmental) that are devoted to delivering health care services to underserved populations. The major goal of the MDI is to provide participants with the requisite management and leadership capacity to

implement their stated national health priorities.

The program was designed by the management faculty from the UCLA Anderson School of Management at the University of California at Los Angeles (UCLA) and by leaders of the African Medical and Research Foundation (AMREF). The MDI is delivered by instructors from UCLA, AMREF and by outstanding faculty from

18

other African universities, including the Ghana Institute of Management and Public Administration (GIMPA), and the Graduate School of Business at the University of Cape Town (UCT).

Stanbic Bank Financial Management Training ProgramStanbic Bank Financial Management Training ProgramStanbic Bank Financial Management Training ProgramStanbic Bank Financial Management Training Program

As part of the pro-bono agreement between the Global Fund and the Stanbic Bank, the Stanbic Bank within Zimbabwe agreed to facilitate a package of financial management workshops. The aim of the overall agreement with the Global Fund is to strengthen capacity of GF fund recipients to allow them to perform

their functions in a more effective and sustainable manner.

As a result of this agreement, a comprehensive package of Financial Management Training was developed for all partners working under the Round 8 grants. The aim was to refresh existing financial management skills and to discuss new or additional GF financial management requirements with all SRs and SSRs. This was

implemented from November 2010 to February 2011.

The program consisted of the following activities:

1. Basic Financial Management training for all Sub Sub-recipients and Finance Officers from Sub Recipients.

2. Advanced Financial Management training for all Finance Managers from Sub Recipients. 3. Finance for Non Finance Officers training for all Sub Recipients to support programmatic personnel

in the interpretation and use of budgets and financial monitoring, with a focus on the link between funds and programmatic results i.e.: ‘Performance Based Funding’.

PR Capacity Development of SRsPR Capacity Development of SRsPR Capacity Development of SRsPR Capacity Development of SRs

The PR designed and implemented three key workshops to ensure that these were accessible to all SRs working in the Round 8 grants. A training workshop was held for program managers on Managing a Global Fund GrantManaging a Global Fund GrantManaging a Global Fund GrantManaging a Global Fund Grant. The training was facilitated by the Heads of Unit and supporting Officers from within the PR. The curriculum covered the roles and responsibilities of different groups within the GF; program planning and management; M&E; financial planning and management; asset verification; auditing; and data quality.

A training workshop was held on Managing SSRsManaging SSRsManaging SSRsManaging SSRs or managing implementation and staff at the province and district level. The aim of the workshop was to enhance knowledge and skills of participants in selecting, assessing, managing and building the capacity of Sub Sub-Recipients.

The final workshop focused on StrategStrategStrategStrategic Planningic Planningic Planningic Planning from 26-28 May. The workshop was targeted at decision makers and key staff from sub-recipient organizations. The curriculum covered:

o The Strategic Plan Development Process o Developing Vision, Mission and Core Values o Situational Audits o Goal Setting o Strategic Plan Implementation Framework

Mentoring ProgramMentoring ProgramMentoring ProgramMentoring Program

To ensure additional one-on-one support to individuals, the Capacity Development Plan included a program of mentoring for each of the three diseases. This was implemented by the three technical support positions embedded within the plan. The aim was to provide individual guidance and support to key individuals on agreed areas, to better enable them to do their job and as a result to improve the performance of the Global Fund grants. The three mentors worked with the three Ministry of Health disease programs and identified:

1. Key personnel to focus the mentoring on. 2. The methodologies through which the mentoring would be implemented (one-on-one meetings;

phone calls; internet etc. 3. The means by which the success of the mentoring program would be measured.

19

The measurement of the mentoring has been achieved by setting up the following:

1. The Mentor and each Mentee shared documents such as 2011 workplans, personal job descriptions and the GF Annual workplan format as part of the ‘Mentoring Needs Analysis’.

2. Mentor and Mentee together prepared a ‘Mentee Development Plan’ detailing activities that hinder the achievement of planned targets on priority work areas, how these will be supported and the measures by which this will have seen to been achieved.

3. Mentor and Mentees sign a ‘Mentoring Agreement’ which outlines how often the two will meet, the overall objectives of the mentoring and an agreed time when these will have been achieved.

4. Contact Logs and Mentee assessments are completed monthly to track progress.

Global Fund Implementation ManualGlobal Fund Implementation ManualGlobal Fund Implementation ManualGlobal Fund Implementation Manual

There was a need identified by the majority of SRs to have an operational manual to support Global Fund grant implementation. As this benefitted all SRs, the PR led on this activity and developed an ‘Implementation Manual for Global Fund Grant Sub Recipients’.

RecruitmentRecruitmentRecruitmentRecruitment

The recruitment included within the Capacity Development Plan aimed to fill some essential gaps in staff supporting the grant implementation, focusing on the key areas of M&E, finance and support to activities being implemented at the provincial level. Although capacity development is not about employing more personnel, in these scenarios the additional positions were considered essential to increasing the capacity of the SRs to enable them to implement the GF grants. These positions have now been transferred to the main grant workplans.

ProcurementProcurementProcurementProcurement

Procurement of IT equipment to support the staff recruited under the CD plan and Pastel evolution software to strengthen the finance management capacity of the SRs on the implementation of the GF grants.

Asset Management Asset Management Asset Management Asset Management

As there has been considerable procurement under the Round 8 GF grants, there was a need to increase the capacity of SRs to manage and verify these assets. The Capacity Development Plan included support for developing SR capacity to manage assets and to implement asset verification during Phase I. The following activities were successfully implemented:

1. Training on Asset Management – Included within both the Financial Management Training Program and the Program Management Training.

2. The development of guidance on how to manage assets (included in the Implementation Manual for Global Fund Grant Sub Recipients’.

3. The development of Asset Management Tools, such as Asset Verification forms and Asset Handover forms.

4. The development and implementation of plans to verify assets by the SRs in collaboration with the PR.

7. CHALLENGES, SUCCESS STORIES AND LESSONS LEARNED

7777 .1.1.1.1 CCCCHALLENGESHALLENGESHALLENGESHALLENGES

The following are the major challenges that were faced during the implementation of grant: Monitoring of product quality in the inMonitoring of product quality in the inMonitoring of product quality in the inMonitoring of product quality in the in----country supply chaincountry supply chaincountry supply chaincountry supply chain While procurement action to ensure that only pharmaceuticals that meet GFATM’s stringent Quality Assurance policy can be complied, it is a challenge to monitor product quality in the in-country supply

20

chain. This is contributed by a basket of factors such as absence of WHO prequalified NDRA laboratory in Zimbabwe and absence of a macro/comprehensive GFATM protocols and Standard Operating Procedures that may be used for Quality Control testing and reporting of results. Storage conditionStorage conditionStorage conditionStorage condition Storage condition in compliance to WHO Good Distribution Practices (GDP) remains a challenge at the warehouses at all levels particularly in regards to reliable power source to ensure integrity of consistent and proper temperature especially for temperature sensitive products. Customs clearance and Bonded Warehouse clearance issuesCustoms clearance and Bonded Warehouse clearance issuesCustoms clearance and Bonded Warehouse clearance issuesCustoms clearance and Bonded Warehouse clearance issues Complex customs clearance and bonded warehouse issues can contribute to bottlenecks that impede the ability of the PR to provide pharmaceuticals and health products for up to several months. Procedure may change over time and absence of viable alternative cold room facility and bonded warehouse at Harare airport led to a monopoly. Procurement and Quantification of Malaria commoditiesProcurement and Quantification of Malaria commoditiesProcurement and Quantification of Malaria commoditiesProcurement and Quantification of Malaria commodities

• The grant experienced some delays in procurement of commodities and services that affected implementation of programming, including the following:

� Delays in signing of DDT local support services. � Delays in IRS insecticides procurement, e.g. DDT � Delays in receiving specifications from implementing partners, e.g. RDTs resulted in

procurement delays.

• The programme experienced shortage of ACTs and RDTs due to changes in disease epidemiology and approaches to incorporate community health workers as treatment holder and quantification gaps. During the year, the programme requested to reprogramme funds twice towards procurement of ACTs and RDTs.

Data QualityData QualityData QualityData Quality

• Data Quality challenges, especially testing rates due to data interpretation challenges at health facility level.

• Delay in submission of supporting documents resulting in records being disregarded in PUDR by LFA.

• Delays in notification of training dates resulting in UNDP failing to conduct many training spot checks.

TrainingsTrainingsTrainingsTrainings Trainings as one of major activities done during the period under review, the following challenges were therefore met during the implementation of the plan:

• The budgets for trainings were resulting in the reduction of training days or failing to achieve the targets e.g. Case Management trainings and IRS trainings in Y2 the GOZ had to contribute towards the trainings to meet the required training days.

• One of the requirements of Global Fund on the training plan is to have the trainings monitored. Challenges faced were that notification of trainings to Principal Recipient were not reaching in time, resulting in Principal Recipient failing to do spots checks at majority of trainings.

Capacity DevelopmentCapacity DevelopmentCapacity DevelopmentCapacity Development

• Capacity development is rarely a short term activity. Implementing a year’s CD workplan in only nine months was a challenge for all partners, especially given the heavy demands already in place to implement the full GF programs. This was exacerbated by the two challenges below.

• There were delays on the recruitment of positions designed to support the implementation of capacity development activities within all SRs, by providing facilitation and curriculum development. As a result some key SR training workshops as well as the mentoring programs were delayed by over six months. As the implementation timeline was only nine months, this further delay impacted heavily.

• There was a challenge in coordinating the capacity development plan both between Ministry of Health SRs (where M&E training could have been directed at the same individual working in the district level for all three disease programs) as well as with other technical support activities being implemented by other donors.

21

7777 .2.2.2.2 SSSSUCCESS UCCESS UCCESS UCCESS SSSSTORIESTORIESTORIESTORIES

• The grant has seen continuous improvements in the achievement of targets. The grant was rated B2 in Quarter 1, improved to B1 in Quarter 2, A2 Quarter 3 - Quarter 6, and A1 in Q7. Prospects are high for the grant to maintain the same rating in Quarter 8. This consistent performance has been made possible by an improvement in the working relationship between the PR and SR and SSRs. This relationship opened up communication channels among partners at all levels thereby providing a swift platform for resolving challenges as well as giving feedback to requests in circumstances where there is a variation of the detailed work plan and budget.

• There has been cofounding on IRS, the Ministry of health and Child welfare supported additional two days for training of spray operators and supervisors which was very important in achieving the programme targets and standards for trainings in IRS.

• IRS was completed in December which was well in time and this was attributable to the timely delivery of IRS commodities and changes in spraying approaches which emphasized on the provincial team approach.

• MPR conducted in June 2011, made it able to identify current disease trends and disease burden leading to focused intervention and change in the strategic direction.

• Combined Onsite Data Verification with LFA, UNDP and implementing partners helped identify, explain and address challenges identified at implementation levels

• Inter-agency integrated support and supervision to provinces with all the key partners was a good initiative, which made all the parties understand and appreciate the malaria programme.

• National Conference conducted by NMCP was very important because it brought together all stakeholders contributing to malaria programme in the country, to avoid duplication of activities. The meeting was meant to share successes and challenges.

7777 .3.3.3.3 LLLLESSONS ESSONS ESSONS ESSONS LLLLEARNEDEARNEDEARNEDEARNED

Despite the grant operating in a very challenging environment, it should be acknowledged that enormous progress has been made towards the achievement of results. The programme learnt that:

• Regular coordination with other stakeholders improves programme management, through sharing of experiences, identifying and solving challenges at its infancy stage.

• Synergies with other partners such as USAID and UNICEF, assisted in solving challenges of ACTs shortages.

• Team work from the implementing partners (NMCP, PSI and Plan), UNDP and technical partners such as WHO, lead to improvement in the grant rating

• Poor quantification of anti-malaria medicines leads to inadequate and erratic supplies of malaria medicines.

• UNDP PRship is proving to be efficient and the intended beneficiaries are receiving support from the GFATM, this is mainly due to its strong internal procedures and the relationship it has with the government of Zimbabwe.

22

ANNEX ANNEX ANNEX ANNEX 1111: : : : ProcuProcuProcuProcurement Update at 31 December 2011rement Update at 31 December 2011rement Update at 31 December 2011rement Update at 31 December 2011

ActivityActivityActivityActivity No.No.No.No.

DescriptionDescriptionDescriptionDescription

Quantity

Quantity

Quantity

Quantity

UOM

UOM

UOM

UOM

QuarterQuarterQuarterQuarter Amount (US$)Amount (US$)Amount (US$)Amount (US$)

CommentsCommentsCommentsComments

1.1.1 PDA (with pre-installed programme and all necessary GIS program instalment disks)

20 units 1 10,000 Received and handed over

1.2.1 DDT 214,732 kg 1 1,503,124 Completed with final batch receive in April 2011

1.2.1 DDT 217,536 kg 5 1,522,752 Final delivery at end Oct 2011

1.2.1 DDT (Quality testing) Testing : WHO collaborating Centre done - pending Govt Analyst

1.2.2 Pryrethroid 12,969 kg 1 933,768 Completed transaction for year 1

1.2.2 Pryrethroid (Testing) 1

1.2.2 Pryrethroid 13,138 kg 5 945,936 Procurement of Lambda cyhalothrin cancelled and a request for reprogramming to purchase ACT & RDT

1.2.5 Spray pump (distribution included) 468 units 1 117,000 Received and handed over

1.2.6 Spare-parts for spray pump 47 sets 1 5 11,750 Received and handed over

1.2.7 Camping materials for sprayers 4-man tent, stretcher bed, sleeping bag, solar lamp, storage tents)

1,248 sets 1 7 529,519 Received and handed over

1.2.8 Protective clothing Set (Hat, overall(2), bumboot, glove(2), mask(5) goggle, raincoat)

650 sets 1 7 211,640 Received and handed over

2.1.2 LLIN 1,235,345 units 1 8,276,812 1,235,268 LLINs received with a shortfall of 73 nets - distributed and completed

2.1.3 Distribution and management of LLINs 3 248,304 WFP to distribute to District Medical Officers (DMO) and IP - Plan & PSI

3.2.1 Artmether + Lumefantrine 6 x 1 blister 143,226 packs 5 51,561 6,305 box - 157,625b/packs) - Received in country 25 August 2010

3.2.2 Artmether + Lumefantrine 6 x 2 blister 162,000 packs 5 116,640 3,649 box (91,225 b/packs) - Received in country 25 August 2010


23



Quantity

Quantity

Quantity

Quantity

UOM

UOM

UOM

UOM




Quality assurance @ 10% of cost of drugs 5 14,655 Funds to be used as Capital Investment to MCAZ in lieu of service fee for pre and post market surveys. Tenders issued for commodities

3.2.5 RDT 1,800,000 tests 5 1,440,000 24,000 kits of Paracheck received 06 January; 43,750 received May 2011

3.2.6 Laboratory equpiment and consummables 5 144,000 Received PO is shared between Activity No. 3.2.6 and 5.2.6

3.4.1 CHW boxes for storage of ACTs and RDTs at community level

5,600 units 1 112,000 1st consignment - 2,240 Received 1st wk April 2011; 2nd consignment - 3,360 Received May 2011

3.4.2 Provision of T-shirts, caps, umbrellas and bags to CHWs to facilitate work

5,600 units 1 112,000 Received

5.2.1 ACT for epidemic stocks for under 3 years 4,581 packs 3 1,649 102 box (2,550 b/packs) - Received in country 25 August 2010]

5.2.1 ACT for epidemic stocks for under 3 years 6,145 packs 7 8,230 Emergency procurement done through cost savings - 6,145

5.2.2 ACT for epidemic stocks for 3-8 years 10,198 packs 3 7,342 226 box (5,650 b/packs) - Received in country 25 August 2010

5.2.2 ACT for epidemic stocks for 3-8 years 11,430 packs 7 8,230 Emergency stocks procured - 1,902

5.2.3 ACT for epidemic stocks for 9-14 years 3,124 packs 3 3,374 69 box (1,725 b/packs) - Received in country 25 August 2010

5.2.3 ACT for epidemic stocks for 9-14 years 25,446 packs 7 27,481 Emergency stocks procured - 867

5.2.4 ACT for epidemic stocks for over 15 years 4,925 packs 3 6,403 99 box (2,475 b/packs) - Received in country 25 August 2010

5.2.4 ACT for epidemic stocks for over 15 years 7,795 packs 7 10,134 Emergency stocks procured - 5,114

5.2.5 RDTs for epidemic stocks 91,310 tests 3 Procured in conjunction with main RDT requirements

5.2.5 RDTs for epidemic stocks 9,832 tests 7

24



Quantity

Quantity

Quantity

Quantity

UOM

UOM

UOM

UOM



5.2.6 Laboratory consummables for epidemic stocks 3 7 3,192 This PO is shared between Activity No. 3.2.6 and 5.2.6 - Received

5.2.7 Pyrethroids for epidemic prone areas 370 kg 3 26,640 Q3 budget - part of bulk order done

5.5.1 Quality assurance @ 2% of cost of drugs 1 5 1,292 Funds to be used as Capital Investment to MCAZ in lieu of service fee for pre and post market surveys. Tenders issued for commodities

6.1.1 Equipment for insecticide susceptibility monitoring

104 1 3 7 8 10,400 Received and handed over

6.1.2 Bioassay kits 128 1 3 5 7 8 9,408 Received and handed over

6.1.3 Insectary equipment, reagents and supplies (installation included)

224 1 3 5 7 8 134,400 Activity to be done by NMCP - funds transferred 06 May 2011. Procurement completed; assembling of the procured materials and equipment in progress

6.1.4 Weather stations for sentinel sites 16 2 5 7 8 128,000 Received mid Oct 2011

6.1.6 Insect identification keys 16 2 160 Activity to be done by NMCP - funds transferred 06 May 2011. Procurement completed; assembling of the procured materials and equipment in progress

6.5.16 Communication equipment - radios 25 1 15,000 NMCP has been requested to confirm usage of latest specifications. PO to be raised after confirmation

6.5.17 Cell phones (SIM card inclusive) 15 units 1 2,250 Received and handed over

6.5.18 Laptop computer 2 units 1 2,400 Received and handed over

6.5.18 Laptop computer 30 units 1 36,000 Received and handed over

6.5.19 Desktop computer 8 units 1 8,000 Received and handed over

6.5.20 Laser Jet Printer 10 units 1 6,000 Received and handed over

6.5.21 Scanner 9 units 1 9,000 Received and handed over

6.5.22 Photocopier 36 units 1 90,000 Received and handed over

6.5.23 Vehicle (4x4 Hardtop, 9 seater) 18 units 1 630,000 Received and handed over

6.5.24 Lorry (7t) 8 units 1 520,000 Received and handed over

25



Quantity

Quantity

Quantity

Quantity

UOM

UOM

UOM

UOM



6.5.26 Plotter 1 unit 1 1,000 Activity to be done by NMCP - funds transferred 06 May 2011. Procurement completed; assembling of the procured materials and equipment in progress

26

ANNEX ANNEX ANNEX ANNEX 2222: : : : Statement of Assets and Equipment as of 31 December 201Statement of Assets and Equipment as of 31 December 201Statement of Assets and Equipment as of 31 December 201Statement of Assets and Equipment as of 31 December 2011111

GFATM Asset No.GFATM Asset No.GFATM Asset No.GFATM Asset No. Entity (PR, SR & SSR) Entity (PR, SR & SSR) Entity (PR, SR & SSR) Entity (PR, SR & SSR) ActivityActivityActivityActivity No.No.No.No.

Engine/Serial NumberEngine/Serial NumberEngine/Serial NumberEngine/Serial Number LocationLocationLocationLocation DescriptionDescriptionDescriptionDescription CategoryCategoryCategoryCategory Date of Date of Date of Date of

AcquisitionAcquisitionAcquisitionAcquisition TTTTotal otal otal otal

GF000434 NMCP 6.5.24 ADDH0400000001081 GHCW1024 Nissan Diesel Lorry (7t)

MV 30-Nov-09 65,216.91


MV 30-Nov-09 65,216.91

GF000437 NMCP 6.5.24 ADDH0400000001103 GHCW 1027 Nissan Diesel Lorry (7t)

MV 30-Nov-09 65,216.91


MV 30-Nov-09 65,216.91


MV 30-Nov-09 65,216.91

GF000845 NMCP 6.5.23 JT00B71J-X07008206 GHCW1153 LANDCRUISER HARD TOP 5 DOOR

MV 03-Feb-10 36,889.50

GF000846 NMCP 6.5.23 JT00B71J-207008250 GHCW1154 LANDCRUISER HARD TOP 5 DOOR

MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50

GF000848 NMCP 6.5.23 JT00B71J-X07008402 GHCW1156 LANDCRUISER HARD TOP 5 DOOR

MV 03-Feb-10 36,889.50

GF000849 NMCP 6.5.23 JT00B71J-007008280 GHCW1152 & 1151 duplicated LANDCRUISER HARD TOP 5 DOOR

MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50

GF000853 NMCP 6.5.23 JT00B71J-307008385 Manicaland / Chimanimani LANDCRUISER HARD TOP 5 DOOR

MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50

27





MV 03-Feb-10 36,889.50


MV 03-Feb-10 36,889.50


MV 25-Mar-10 65,216.91


MV 25-Mar-10 65,216.91

GF000442 NMCP 6.5.24 ADDH0400000001142 GHCW 1022 Nissan Diesel Lorry (7t)

MV 25-Mar-10 65,216.91

GF001927 NMCP 1.1.1 10HIN0C00003N Mat South PMD Pharos Traveller 565 ICT 13-Dec-10 660.00




















GF002043 NMCP 6.5.20 CNCKJ72368 Mash West PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002044 NMCP 6.5.20 CNC1845168 Mash East / PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002045 NMCP 6.5.20 CNCKJ72482 Mash Central PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

28




GF002046 NMCP 6.5.20 CNCKJ63377 Midlands /' PMD Gweru 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002047 NMCP 6.5.20 CNC1845167 Masvingo / PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002048 NMCP 6.5.20 CNCKJ72364 Mat North PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002049 NMCP 6.5.20 CNCKJ72363 Mat South PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002050 NMCP 6.5.20 CNCKJ72370 Manicaland PMD 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002051 NMCP 6.5.20 CNC1845062 NMCP HQ 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002052 NMCP 6.5.20 CNC1845169 NMCP Vector Control; 1 X HP2055 LASER JET PRINTER

ICT 07-Mar-11 493.50

GF002158 NMCP 3.2CD CNC101VSX2 NMCP HQ Programme asst Office

1 X HP 500B Desk top Core Duo E7500, 4GB, 320GB, Office 2010 Pro nPlus, Norton 2011, 19" LCD Monitor, External Speakers

ICT 24-Mar-11 957.00

GF002194 NMCP 6.5.21 CNO5CVH1T6 Manicaland / PMD (stores) HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002195 NMCP 6.5.21 CN078VH04X NMCP HQ HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002196 NMCP 6.5.21 CN078VH04D Mash West PMD HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002197 NMCP 6.5.21 CN078VH04Z Mash East / PMD HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002198 NMCP 6.5.21 CN078VH04Y PMD Bindura HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002199 NMCP 6.5.21 CNO5CVH1T5 PMD Gweru HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002200 NMCP 6.5.21 CN078VH1TC Masvingo / PMD HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002201 NMCP 6.5.21 CNO78VHD42 Mat North PMD HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002202 NMCP 6.5.21 CN05CVH1TQ Mat South PMD HP Scan jet 5590 ICT 24-Mar-11 458.33

GF002246 NMCP 6.5.22 CN5SC2NOCP CN5SC2NOC5 LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002247 NMCP 6.5.22 CN5SC2NOBC CN5SC2NOBQ LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002248 NMCP 6.5.22 CN5SC2NORS MUDZI LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002249 NMCP 6.5.22 CN5SC2SOKY Mash East / PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002250 NMCP 6.5.22 CN55C2NOKX Mash east / Mudzi Hsp LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

29




GF002251 NMCP 6.5.22 CN5SC2NOCP Mash West PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002252 NMCP 6.5.22 CN5SC2NOBW Mash West / Siakobvu LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002253 NMCP 6.5.22 CN5SC2NOLO Manicaland / PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002254 NMCP 6.5.22 CN5SC2NOC2 Mash Central / Centenary LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002255 NMCP 6.5.22 CN5SC2NOCK Mash Central / Rushinga LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002256 NMCP 6.5.22 CN5SC2NOBO Manicaland / Hauna LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002257 NMCP 6.5.22 CN5SC2NOCF Midlands - PMD Gweru LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002258 NMCP 6.5.22 CN5SC2SONB Midlands / Gokwe South Hospital LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002259 NMCP 6.5.22 CN5SC2NOLD NMCP HQ LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002260 NMCP 6.5.22 CN5SC2NOQ1 Mat South / Beitbridge LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002261 NMCP 6.5.22 CN5SC2NOJ9 Mat South PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002262 NMCP 6.5.22 CN5SC2NOLZ Mildlands / Gokwe North Hsp LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002263 NMCP 6.5.22 CN5SC2NOBL Mat North PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002264 NMCP 6.5.22 CN5SC2NOH6 Masvingo / Chiredzi LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002265 NMCP 6.5.22 CN5SC2NOK8 Masvingo PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002266 NMCP 6.5.22 CN5SC2NOKF Manicaland / Nyanga LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002267 NMCP 6.5.22 CN5SC2NOKX Mat North PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002268 NMCP 6.5.22 CN5SC2NOKL Mat North PMD LASER JET M5025 MFP PHOTOCOPIER

ICT 26-Apr-11 3,807.65

GF002656 NMCP 6.1.2.4 N/A WFP WAREHOUSE

Weather station (stevensons Screen, wet & dry bulb hygrometer,MaxMin thermometer, copper raingauge)

EQUIP 01-Aug-11 2,938.73

GF002657 NMCP 6.1.2.4 N/A WFP WAREHOUSE Weather station (stevensons Screen, wet & dry bulb

EQUIP 01-Aug-11 2,938.73

30




hygrometer,MaxMin thermometer, copper raingauge)



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73

31






EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73



EQUIP 01-Aug-11 2,938.73

Grand Total 1,343,558.90 1,343,558.90 1,343,558.90 1,343,558.90

Annual Report 2011 Malaria 20120309 - info.undp.org Annual Report Malaria... · malaria epidemiology in zimbabwe Malaria transmission is highly variable over space and in time in

Documents