List of Tablesintranet.orbis.org/data/project/monitor/23338_Kedida... · Web viewChat and eucalyptus tree are the main cash products of the woreda. As to infrastructures, the woreda

Report on the 4th Round Zithromax Distribution Campaign in

Kadida Gamela Woreda of Kambata Tembaro zone, as part of

ORBIS Rural Eye Care Kambata Tembaro project, SNNPR,

Ethiopia

DECEMBER 2016

Table of ContentsList of Tables............................................................................................................................................... ii

List of Figure.............................................................................................................................................. iii

1. Introduction.........................................................................................................................................1

1.1 Background information of the woreda.......................................................................................3

2. Goal.....................................................................................................................................................6

3. Eligible/target:.....................................................................................................................................6

4. Methods and instruments/logistics.......................................................................................................7

5. Composition of distribution team........................................................................................................8

6. Achievements....................................................................................................................................12

6.1 Coverage and drug utilization....................................................................................................12

6.2 Woerda 2016 MDA Village Target ------------------------------------------------------------------------------16

7. Monitoring and Evaluation................................................................................................................25

8. Challenges.........................................................................................................................................25

9. Solutions attempted...........................................................................................................................25

10. Limitation......................................................................................................................................26

11. Recommendation...........................................................................................................................26

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List of Tables

Table 1 Summary of trachoma survey findings in Kadida Gamela woreda of Kembata

Tembaro Zone Project.................................................................................................3

Table 2 shows budget utilization by items...........................................................................24

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List of FigureFigure 1 Map of Kadida Gamela Woreda......................................................................................5

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1. Introduction

Trachoma is the world’s leading cause of eye infections but preventable blindness, affecting mankind since

antiquity. An estimated 8 million people are already blind or visually impaired because of the disease, and 84

million have active infection and need treatment. More than 10 percent of the world’s population is at risk of

blindness due to trachoma, which has incapacitated families and communities for centuries in the poorest

regions of Africa, Asia, the Middle East, and in some parts of Latin America, Australia, and Asia. Sub-Saharan

Africa has the highest burden of the disease of which Ethiopian has the highest magnitude. The disease is

caused by repeated infection by the bacterium Chlamydia trachomatis. Trachoma is spread through contact

with infected people (discharge from the eyes and nose can easily transmit the disease). Flies that seek out the

red, sticky eyes caused by trachoma can also transmit the disease from person to person. The disease generally

occurs in poor dry and arid rural communities where people have limited access to water, sanitation, and

primary health care.

Trachoma is the second leading cause of Blindness in Ethiopia next to Cataract. According to the national

blindness, low vision and trachoma survey conducted in 2006 trachoma accounts 11.5% of all blindness and

7.7 of people with low vision. It is estimated that over 138,000 people are already blinded by trachoma2.

The prevalence of active trachoma (AT) in children age 1-9 is 40% for the whole country ranging from 0.5% to

62.6% in different regions of the country. It is fourfold higher in rural children than urban due to poor

sanitation and water supply. Over 9 million children aged 1-9 years have active infection in Ethiopia.

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Trachomatous trichiasis (TT), a chronic form of trachoma is estimated to be 3.1% for the country. This means

there are estimated 1.3 million people age 15 and above who are in immediate risk of blindness unless treated

urgently.

According to the national survey, the prevalence of active trachoma and TT in SNNPR are 33 % and 2%

respectively. However, from the district based baseline trachoma surveys conducted in other ORBIS supported

rural projects in SNNPR, the prevalence of both active and blinding trachoma (active trachoma between 22-

54% and TT between  1.1 and 6.4%) are by far higher than the regional findings as indicated in the national

survey. The prevalence of active trachoma in Kadida Gamela Woreda according to the Woreda based survey

conducted in 2011, reported to be 41% whereas the trachomatis trichiasis rate among people appears to be 1.97%.

ORBIS International Ethiopia has been implementing the WHO recommended SAFE strategy in Kadida Gamela Woreda project

to control and eliminate trachoma over the last ten years through capacity building of the local health worker through training,

provision of supplies and medical equipment to eye care services. Establishing of SECU and PECUs in different districts were the

main activities for the last long years. Hence, trachoma is still a major public health concern and need an immediate trachoma

intervention program. Following these findings and as per the recommendation of WHO, Zithromax distribution program was

planned Kadida Gamela Woreda.

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Table 1 Summary of trachoma survey findings in Kadida Gamela woreda of Kembata Tembaro Zone Project

S.No. Woreda

Prevalence of Active

Trachoma in 1-9 yrs

Prevalence of TT

in >15 yrs

1 Kadida Gamela 41% 1.97%

11. Background information of the woreda

Kadida Gamela woreda is one of the seven woreda partner of ORBIS Rural Eye Care Kambata tembaro project. The woreda is

found at a distance 370 kms from Addis Ababa. The woreda is divided in to 17 rural and 1 urban kebeles It Shares boundaries

with four neighbor woreda. I.e. Damboya in north, Misrak Badewacho in west, Alaba special town in east, and Kachabra in south.

As to 2013 Pre-Zithromax population census conducted by ORBIS International Ethiopia, 91,267 people live in the woreda.

Among these, 46,546 are females; nearly 49,937 are children below 15 years of age. Kambatisa is the mother tongue of the

residents’.estimated 93% of woreda were ‘’Woyna Dega’’ and 7% of the woreda were “kola”, weather condition. Almost all

dwellers of the woreda depend on agriculture. The farmers highly cultivate inset, maize, potatoes and sweet potato as food crops.

Coffee, avocado, Chat and eucalyptus tree are the main cash products of the woreda. As to infrastructures, the woreda has health,

education (KG up to high Schools). Only seven kebeles dwellers have pipeline water and hydroelectric power supply. The safe

and clean water coverage is estimated to be 72% from 2008 e.c woreda report while the latrine coverage is 100 % (2008 E.C

woreda report). Regarding health units, there are four HCs, and 19 health posts. The woreda man power , 1 MPH 20 HOs, 1 BSC

Nurses, 12 mide -wifers, 35 clinical nurses, 13 public nurses, 8 laboratory technician, 6 pharmacy technicians, 5 Environmental

health and 40 HEWs. Malaria, Typhoid fever, acute febrile illness, all respiratory disease Helmintiasis pneumonia, Trauma injury

fracture Infection and Parasitic disease. Urinary tract infection And other unspecified disease of eye trachoma ear and mastoid are

ten top diseases of adults OPD cases in descending order. Malaria, pneumonia and other infection are the leading causes of

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morbidity in children below five years of age. The residents exercise overcrowded living condition, poor safe & adequate water

supply and less practice on personal hygiene which is potential environment for trachoma transmission.

12. Goal To eliminate blinding trachoma from Kadida gamela woreda as part of Kambata Tembaro rural eye care project.

a. Objectives

- To implement “A” components of SAFE strategy to suppress the recurrences of AT by treating pool of infection.

- To reduce the high prevalence of AT41% and TT 1.97% to below 10% and 1% respectively after consecutive mass

drug administration for the eligible population of the woreda.

- To create awareness within the community on trachoma and SAFE strategy.

13.Eligible/target:

More than 99440 people were targeted for the Mass drug administration campaign in this 4 th round campaign. Zithromax is safe

and recommended by Pfizer for all individuals except for children less than 6 months and those pregnant women in 1st trimester

for Zithromax (macrolides) per direction provided from ministry of health. However, the FMOH does not recommend for mothers

in their first three months of pregnancy too. Tetracycline eye ointment (TOE) will replace zithromax for those who are not

eligible for zithromax.

Th eligible population for zithromax and TEO eye ointments is residents of the woreda.

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Target of coverage

ITI recommends that MDA coverage with zithromax above 90% of the eligible population can be considered as a success in eradication of trachoma as “A” component of SAFE strategy. However, the level of our success is to work against 95% and above for effective elimination of AT.

14.Methods and instruments/logistics A two days sensitization/ advocacy , training on the cause, transmission prevention modes of treatment and public health aspect of

trachoma and detailed techniques of the planned mass drug distribution workshop was successfully conducted involving officials

from Kadida Gamela woreda health offices ,kebele cabine members Woreda cabine members , and, Woreda chief administrative

Heads .

Supervisors for the distribution, distribution teams composed of health extension workers, health workers, community

development health arms recruited from the Woreda and Peasant Association Kebele Adimintrion and Leaders were participants of

the workshop. Trachoma control and prevention activities that have been implemented over the last 10 years, the current status of

trachoma and all aspects of MDA were presented and discussed in detail.

Detailed technical planning was also developed in small core groups following the workshop. The planning exercise included

detailed budget for the Zithromax distribution (determining the number and the duration of the distribution for each Kebeles per

Woreda, the corresponding budgets and dates for each activities were clearly outlined per Woreda).

All logistics necessary to conduct the distribution were prepared and obtained to the Woreda health offices before the start of

distribution. These included delivery of registration books, Zithromax tablets and POS,2% Tetracycline eye ointments, height

measuring sticks, colored dosage guides, distributer’s dress (special attire with trachoma message), Zithromax distribution

manuals prepared in Amharic language, different Zithromax reporting and summary formats, transferring budget for Zithromax

distribution to Woreda finance and economic development office on time, determining the number and duration of vehicles to the

woreda and availability of vehicles on time.

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All the necessary human resource required to the Woreda for the Zithromax distribution was determined for each Kebeles during

the micro-planning meeting. Assignments of health workers were based on the accessibility and the population size of each

Kebeles and also on the number of available of health workers (HOs, nurses, HEW and others). Moreover, on average one

supervisor was assigned to closely follow every three kebeles during the distribution. However, the catchments area for each

supervisor may vary depending on the local situation .minimum two and maximum six teams depending on Kebele target

population and infrastructure . Dates for distribution have been determined and the distribution takes 8-10 days on average with

small variation.

15.Composition of distribution team 69teams and 12supervisors were assigned prior to the distribution in the Woreda. Each team is composed of three individuals,

Health extension worker/Health worker, Community Health development army and kebele administrative. 36 HEWs,69

community health development arms, 69 from kebele kabine members , 33 HWs, 12 supervisors and one woreda co-ordinator

and one woreda logistic officer participated during the distribution.

Health education messages and community sensitization about trachoma and Zithromax distribution dates have been announced

on daily basis before and during the distribution days locally.

o Woreda level Launching ceremony was conducted in Kedida gamela woreda at Abonsa kebele. The ceremony was

conducted in the presence of kedida gamela woreda Chief Administrative Ato Takile Gashe ,Head of kedida Gamela

woreda health office Ato Muluneh Degelo ,Vice,Head of kedida Gamela woreda health Ato Tamiru Bolteno other

kabine members of kedida Gamela woreda different office leaders, woreda co-ordineter, school teachers and different

community members were participated. The participants took the drug.

Radio message has been broad casted in local language (Kambatisa) twice per day two days before the start of the camp and

during the distribution this has assisted a lot in mobilizing the population.

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Posters, leaflets have been posted and distributed ahead of the distribution date. Banners were also used to inform people about

the campaign. Prior to the distribution population targeting has been performed from pervious census conversoin.those 2009 E.C

Eligable population estimated to be 99440 Based on the population size, the amount of needed drugs, human resource, number of

teams and supervisors and all other required logistics have been determined.

One MDA coordinator with one vehicle was actively involved in the whole period of the distribution.

A manual is prepared in Amharic to help trainer (Woreda coordinator) trainees in undertaking the Zithromax distribution.

During the census out 442 registration books received 397 were used to enter data of the distribution.

Budget for fuel for motor cycle was allocated for the Woreda.

The use of mobile/wireless cell phone was very vital in effective communication between teams, their supervisors, Woreda

officials, and ORBIS staff. Where there is no network connection, messengers were used to pass information to the general public

and the needed personnel.

Role and Responsibilities HEWs/HWs:

Calculate the required drugs per their catchments area and receive the drugs from the Woreda pharmacy store

Reconstitution of Zithromax suspension

Administering Zithromax tabs and POS and providing 2% Tetracycline eye ointment for the beneficiaries

Documenting the drug provided to the beneficiaries on the registration book

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Daily follow up of the drug balance and reporting to the supervisors for immediate action

Compiling and reporting the data at the end of the distribution

Role and Responsibilities CHDAs:

Health education on trachoma and Zithromax before and during the distribution

Measuring height of individuals and reporting to the HEW/HW for drug administration

Ensuring clean water is always available at the distribution site

Collection of used bottles

Participation during community mobilization

Role and Responsibilities of Kebele Leaders/Peasant Association Leaders:

Community Mobilization and sensitization

Trace residents in their Kebele who did not appear in the distribution site.

Select appropriate sites for drug distribution team in each Kebele of the woreda

Role and Responsibilities of Kebele supervisors

Supervising the overall activities of the distribution team

Provision of technical support to the distribution team

Provision of drug and water in case of shortage

Follow up of the drug balance on daily bases

Compiling and reporting at the end of the distribution

Make sure the drug balance is correct at the end of the distribution

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Daily monitoring and feedback as to how the distribution is reaching every resident through going into the village and

interviewing the residents weather they received Zithromax or not and comparing to the daily report

Role and Responsibilities of Community Mobilizes:

Community mobilizes are Woreda officials including the administrators, cabinet members and other influential community

figures.

They started mobilizing the community members starting one week prior to the distribution dates and during the time of

distributions.

Moved to priority areas depending on local situations.

Made the local leaders participate fully on the distribution with great attention.

Role and Responsibilities of temporarily recruited distribution coordinator/MDA consultants

Provide pre-Zithromax distribution training to distribution team members in the stated woreda.

Provide continuous supportive supervision and technical support during the period of Zithromax distribution in the Woreda.

Oversee the proper final accounting of the Zithromax balances against the issued and the distributed quantities.

Submit detailed Zithromax distribution report as per the standard reporting format provided by ORBIS Ethiopia, including; the

pre-Zithromax distribution training, for each woreda at the completion of the distribution program.

Submit Estimated Zithromax Distribution Cost (Specifically for Per-diem paid to the distribution team, supervisors, etc) for the

Woreda.

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16.Achievements

a. Coverage and drug utilization The distribution was started on December 18, 2016 g.c at all sites. The campaign took ten days excluding reporting sessions in

most kebeles. Report collection was started by December 28, 2016 g.c as most kebeles completed the campaign and ended

December 30, 2016 g.c The woreda’s participants took high initiation to make the coverage remarkable. Ato Takile Gashe

kedida Gamela woreda Chief Adiminstratives ,Head of kedida Gamela woreda health office Ato Muluneh Degelo ,Vice,Head of

kedida Gamela woreda health Ato Tamiru Bolteno other kabine members of kedida Gamela woreda participated wel. took

Zithromax at the end of the training in the meeting hall to demonstrate the launching of the campaign. The community acceptance

of drugs was impressing and distributing teams were found performing well at their duty sites from all aspects. From all Eligable

population 94433 were treated with Zithromax and TEO ,which is 94.96% of the target % population (99440) in all 18 kebeles of

kedida gamela woreda During the campiagn . Finally of 18 kebele ,11 kebele achived 95 and above% of the minimum planed

coverage and 7 each kebele achived an average b/n 91.3 to 94.8 at the end of campaign . As to the beneficiaries sex versus drugs

type from all the target population 81.21 % (80760), 11.91% (11849) and 1.83% (1,824) of the eligible were treated by Zx tabs,

POS & TEO respectively.Target for tablet =84524 from these 80760 received which is 95.54% , Target for POS =12927 from

these 11849 Treated by suspension 91.66 Target for TEO 1988 from these 1824 received which is 91.7 of the target popultion

were treated by tab. Pos ,TEO respectively . which is Among these, 51.59% (48727) of the beneficiaries where females and

48.4%(45706) were males. From all people treated 49927 (52.87 ) were >15 years and 44506 (47.13) where below 15 years of

age . Children below 5 years of age pregnant mothers those treated during the campaign by POS and TEO consist of 13% and

2%.from these <5 children 5807 were mal and 6042 were females. <6 six months 512 males 521 females and 791 were

pregnancy mothers of less than three months treated by TEO two tubes each for 6 weeks. As to the drug consumption, the total

of 247373 tablets,98318 suspension (ml) and 3644 TTC used during the campaign . The distributing team was addressed to

handle drugs with care and taking special consideration drugs to be transported in safe way to distribution site (dispensed with

caution) as a result the wastage was tried to be minimized as much as possible .

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The campaign has also missions of health information dissemination about trachoma and SAFE strategy besides drug

administration. As a result, it was believed that about 99440 people were informed about trachoma & SAFE strategy during

distribution. About 10,000 leaflets which contains message about Trachoma & SAFE strategy were distributed to those who were

able to read. Almost 75% of the distribution coverage was done by selected center sites and the rest was

covered by door to door. Drug balance and coverage was crosschecked with sample villages’ registration books

on collecting report and logistics. Woreda stock balance and Bin Card was prepared for the drugs at last.

Finally; measuring sticks, aprons, bags, registration books, unused drugs and empty tins & bottles were

collected back to Woreda store.

During the campaign about 540 peoples are interviewed about trachoma transmission and prevention methods.

From the total respondents 265 (49%) were males and 275(50.92%) were females. From this respondents

497(92%) has knowledge about trachoma transmission and prevention, latrine utilization and regular face

washing. The respondents asked about SAFE strategy, from the total respondents’ 378 (70%) knows that TT

surgery and by drugs 494(91.48%) like Zithromax and TTC.The mentioned drug source were the village,

health posts and house to house. All this interviewed peoples and their family members received Zithromax or

TTC.

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District Level Trachoma Prevention& Control Distribution Summary Report.

Table 1 shows 4thround Zithromax distribution by sex and drug category in kedida Gamela Woreda DECEMBER 2016

S.N

Name of Kebele

Target Popn

No. of people treated with Zx tabs

No. of people treated with Zx POS No. of people treated with TEO

people Treated by Zx & TEO Coverage

%)M..ale Female Total Male Female TotalPreg. Moth

< 6 months children

TotalMale Female Male Female Total

1 Kerchicho 5873 2117 2508 4525 391 399 790 58 31 38 127 2539 3003 5542 94.3

2 Geshigola 5590 2359 2331 4690 343 336 679 40 33 37 110 2735 2744 5479 98.01

3 Jore 8751 3707 3676 7485 454 457 911 67 41 36 144 4204 4236 8440 96.4

4Taza Gerba

6949 2831 2776 6607 451 427 878 47 36 34 117 3318 3284 6602 955 Abonsa 4833 1986 2122 4108 271 248 519 38 21 18 77 2278 2426 4704 97.33

6Zato Shodera 4451 1817 1758 3575 252 229 481 46 21 19 86 2090 2052 4142 93.05

7 Garame 3796 1621 1574 3195 239 254 493 24 23 20 67 1883 1872 3755 98.9

8Dega Kedida 9175 3388 4036 7424 500 653 1153 67 53 57 177 3941 4813 8754 95.4

9 Azedoboo 6889 2714 2842 5556 935 511 906 78 28 26 132 3137 3457 6594 95.71

0Hamido

3463 1248 1442 2690 232 224 456 13 15 6 34 1495 1685 3180 91.41

1Taza Agara

4125 1620 1710 3330 232 277 509 40 20 22 82 1872 2049 3921 951

2Holegeba Zato 3972

16056 1576 3182 264 237 501 31 27 21 79 1897 1865 3762 94.71

13

Langute4406 1821 1845 3666 272 287 559 17 35 36 88 2128 2185 4313 97.8

1Odame

5596 2264 2360 4624 208 214 422 50 27 31 108 2499 2655 5154 92.1

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41

5Bezena Benera 7326 2748 2949 5697 446 430 876 60 21 35 116 3215 3474 6689 91.3

16

Fullasa4578 1863 1878 3741 273 261 534 48 23 20 91 2159 2207 4366 95.36

17

Sheshera4245 1740 1759 3499 215 223 439 23 30 28 81 1986 2033 4019 94.67

18

Adilo5422 1935 2231 4166 368 375 743 44 27 37 108 2330 2687 5017 92.5

19

Woreda Total 99440

39387

41373

80760

5807 6042

11849 791

512 521 1824

45706 48727 94433 94.96

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Tablet which is not issued (BBF) =1914 SUS which is not issued (BBF)b0ttle =1078 TEO which is not issued (BBF) =2420

Tablet Received from ORIBIS 246500 SUS Received from ORIBIS= 2304 bottie TEO Received from ORIBIS= 4000

Total Tablet 248414 SUS Total = 3382 bottie (101460 TEO which is Utilized or used = 3644

which is Utilized or used)= 247343 SUS which is Utilized or used 3277bottle ( 98318) ml TEO Current Woreda end store )= 2759

(Woreda end store )= 1071 (Woreda end store )= 97 b0ttle

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Table 2: the4th round Zithromax distribution drug balance summary report in Kambata Tambaro Zone Kedida Gamela Woreda in Date DECEMBER 2016S.N

Name of Kebele

Target Person Treated

Cov Drug Issued Drug utilized/dis Balance at hand WastageZith Tab pcs

Zith susp ml

TTC tube

Zith Tab pcs

Zith susp ml

TTC tube

Zith Tab pcs

Zith susp ml

TTC tube

Zith Tab pcs

Zith susp ml

TTC tube

1 Kerchicho5873 5542 94.8 14226 6330 254 14226 6312 254

0 0 0 0 18 0

2 Geshgola 5590 5479 98.01 13801 5760 224 13801 5246 220 0 510 4 0 4 03 Jore 8751 8440 96.4 21620 8460 350 21620 7746 288 0 690 62 0 24 04 Taza Gerba

6949 6602 95 18500 7830

27218500 7770

2340 60

380 0

0

5 Abonsa 4833 4704 97.33 13000 4140 194 13000 4130 154 0 0 40 0 10 06 Zato shodera

4451 4142 93.05 11441 4350

178 11441 4200174

0 120

4

0 30

0

7 Garame 3796 3755 98.9 9500 4140 152 9103 4132 148 393 0 4 4 8 08 Dega Kedida

9175 8754 95.4 22389 8220 367 22278 8204334

111 013

0 160

9 Azedoboo 6889 6594 95.7 17000 7380 286 16661 7230 264 339 150 22 0 0 010 Hamido 3463 3180 91.4 8533 3660 138 8533 3660 68 0 0 70 0 0 011 Taza Agara 4125 3921 95 10000 4140 166 10000 4072 164 0 30 2 0 38 012 Holegeba zato

3972 3762 94.71 10850 4320 159 10848 4050 158 2 2701

0 00

13 Langute 4406 4313 97.8 11000 4950 176 11000 4480 176 0 450 8 0 20 814 Odame 5596 5154 92.1 14000 5760 224 14000 5686 216 0 60 8 0 14 015 Bezena

Benara 7326 6689 91.3 17747 7650294

17744 7320232

0 30062

3 300

16 Fullasa 4578 4366 95.36 11595 4470 184 11595 4186 182 0 270 2 0 14 017 Sheshera 4245 4019 94.67 10500 4350 170 10495 4350 162 0 0 8 5 0 018 Adilo

5422 5017 92.5 12500 5550217

12498 5544216

0 0 1 2 60

Woreda Total 99440 94433 94.96 248202 101460 4005 247343 98318 3644 845 2910 349 14 232 0

Kedida Gamela woreda 2016 MDA targetS.No

Name of Kebeles

Name of Villages

2015 MDA projected population

2016 MDA projected population Illigible popuation for drug required

All people treated

coverage

Popn. Popn Popn

Tab(85%)

POS(13%) TEO Tab

POS(bott) TEO

1 Hamido lagna-Goforo 412 436 449 371 57 9 1112 19 17 453 100Ejersa 230 244 251 207 32 5 621 11 10 256 101Anesheko 132 140 144 119 18 3 356 6 6 118 81Wishira 171 181 186 154 24 4 462 8 7 173 93Sabola 176 186 192 158 24 4 475 8 7 197 101Yebu 577 611 629 519 79 12 1558 26 24 550 87Abaonbe 462 489 503 416 64 10 1247 21 20 489 97Moche 290 307 316 261 40 6 783 13 12 277 87Omoshogola 338 358 368 304 47 7 913 16 14 309 83Taracho 390 413 425 351 54 8 1053 18 17 359 84

Total 10 3178 3365 3463 2860 437 67 8581 146 135 3180 91.42 Zato

ShodaraBezena Hantesho

796843 867 716 110 17 2149 37 34

867 100

Dimayo 1009 1068 1099 908 139 21 2724 46 43 920 83.7Andure 577 611 629 519 79 12 1558 26 24 623 99Beko Menkise 805

852 877 725 111 17 2174 37 34775 88.4

weraboya 898 951 978 808 124 19 2425 41 38 957 97

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Total 5 4085 4325 4451 3677 562 87 11030 187 173 4142 93.563 Aze

DebeoWonko & 2nd Bula

862913 939 776 119 18 2327 40 37

908 96

1st Bula 262 277 285 236 36 6 707 12 11 286 100Shofa 251 266 273 226 35 5 678 12 11 256 93.7Tach Wite 317 336 345 285 44 7 856 15 13 328 95Aze Mishgido 317 336 345 285 44 7 856 15 13 340 98.5Godana 506 536 551 455 70 11 1366 23 21 543 98.5Lay Wite 429 454 467 386 59 9 1158 20 18 466 99.7Beko 263 278 287 237 36 6 710 12 11 269 93.7Tekora 266 282 290 239 37 6 718 12 11 273 94Mulata 184 195 200 166 25 4 497 8 8 198 99Maekelawi 892 944 972 803 123 19 2408 41 38 955 98lay Debeo 279 295 304 251 38 6 753 13 12 285 93.7Deneka 366 388 399 329 50 8 988 17 16 400 100Fuchare 712 754 776 641 98 15 1922 33 30 698 89Doke 417 442 454 375 57 9 1126 19 18 389 85

Total 15 6323 6695 6889 5691 870 134 17072 290 268 6594 95.714 Jore village 01 204 216 222 184 28 4 551 9 9 240 108.1

village2 404 428 440 364 56 9 1091 19 17 455 103.4village3 185 196 202 167 25 4 500 8 8 212 104.9village4 501 530 546 451 69 11 1353 23 21 543 99.4village5 386 409 421 347 53 8 1042 18 16 414 98.3village6 132 140 144 119 18 3 356 6 6 152 105.5village7 268 284 292 241 37 6 724 12 11 309 105.8village8 597 632 650 537 82 13 1612 27 25 587 90.3village9 473 501 515 426 65 10 1277 22 20 512 99.4village10 605 641 659 545 83 13 1634 28 26 653 99village11 340 360 370 306 47 7 918 16 14 285 77village12 400 424 436 360 55 8 1080 18 17 430 98.6village13 132 140 144 119 18 3 356 6 6 114 79.1village14 292 309 318 263 40 6 788 13 12 265

83.3

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village15 262 277 285 236 36 6 707 12 11 280 98.2village16 410 434 447 369 56 9 1107 19 17 440 98.4village17 491 520 535 442 68 10 1326 23 21 533 99.6village18 450 476 490 405 62 10 1215 21 19 476 97.1village19 395 418 430 356 54 8 1067 18 17 414 96.2village20 312 330 340 281 43 7 842 14 13 322 94.7village21 430 455 469 387 59 9 1161 20 18 434 92.5village22 363 384 396 327 50 8 980 17 15 370 93.4

Total 22 8032 8505 8751 7229 1106 170 21687 369 340 8440 96.45 Geshgola Lemereda 1239 1312 1350 1115 171 26 3345 57 52 1325 98.1

Kodade 1004 1063 1094 904 138 21 2711 46 43 1072 97.9Kalada 1067 1130 1163 960 147 23 2881 49 45 1147 98.6Shalame 773 818 842 696 106 16 2087 35 33 878 104.2Gabara 1048 1110 1142 943 144 22 2830 48 44 1057 92.5

Total 5 5131 5433 5590 4618 706 109 13854 235 217 5479 98.016 Abonsa Fulasa 1270 1345 1384 1143 175 27 3429 58 54 1354 97.8

Deketa 1431 1515 1559 1288 197 30 3864 66 61 1499 96.1Borara 382 404 416 344 53 8 1031 18 16 412 99Shodera 381 403 415 343 52 8 1029 17 16 404 97.3Orata 972 1029 1059 875 134 21 2624 45 41 1035 97.7

Total 5 4436 4697 4833 3992 611 94 11977 204 188 4704 97.337 Benara

BezenaTotenke 1348 1427 1469 1213 186 29 3640 62 57 1345 91.5Benara 1496 1584 1630 1346 206 32 4039 69 63 1464 90Gashara 1511 1600 1646 1360 208 32 4080 69 64 1489 90Bezena 1193 1263 1300 1074 164 25 3221 55 51 1176 90.46Ajencho 1176 1245 1281 1058 162 25 3175 54 50 1215 94.9

Total 5 6724 7120 7326 6052 926 142 18155 309 285 6689 91,38 Odame Gao 834 883 909 751 115 18 2252 38 35 1015 111.7

Bongore 696 737 758 626 96 15 1879 32 29 724 95.51Gulba 486 515 530 437 67 10 1312 22 21 381 71.88Tachigna Odame

564597 615 508 78 12 1523 26 24

650 105.7

Odora 576 610 628 518 79 12 1555 26 24 383 61

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Bote 525 556 572 473 72 11 1418 24 22 399 69.7Taracho 768 813 837 691 106 16 2074 35 33 893 107Dawe 686 726 747 617 94 15 1852 31 29 709 94.91

Total 8 5135 5437 5595 4622 707 109 13865 236 217 5154 92.19 Sheshera Lagna Chefe 283 300 308 255 39 6 764 13 12 339 110

Taracho 439 465 478 395 60 9 1185 20 19 371 77.5Mehal Chefe 319

338 348 287 44 7 861 15 14384 110

Sabola 552 584 601 497 76 12 1490 25 23 576 95.8Lagna Shashara

207219 226 186 28 4 559 9 9

201 88.9

Merab Sheshera

510540 556 459 70 11 1377 23 22

487 87.5

Umata 563 596 613 507 77 12 1520 26 24 540 88Torombora 332 352 362 299 46 7 896 15 14 327 90Anesheko 320 339 349 288 44 7 864 15 14 399 114Abareko 371 393 404 334 51 8 1002 17 16 395 95

Total 10 3896 4125 4245 3506 536 83 10519 179 165 4019 94.6910 Teza

Gerba2nd Keta 1189 1259 1295 1070 164 25 3210 55 50 1312 101Gerba 1162 1230 1266 1046 160 25 3137 53 49 1258 99.31st Keta 1726 1828 1881 1553 238 37 4660 79 73 1834 981st Duro 1332 1410 1451 1199 183 28 3596 61 56 1170 812nd Duro 969 1026 1056 872 133 21 2616 44 41 1028 97

Total 5 6378 6753 6949 5740 878 135 17221 293 270 6602 9511 Fulaasa Ashawo 497 526 542 447 68 11 1342 23 21 519 96

Ginbicho 331 350 361 298 46 7 894 15 14 337 93Libona 737 780 803 663 101 16 1990 34 31 779 97lagna Fulasa 585

619 637 527 81 12 1580 27 25618 97

Shafa 392 415 427 353 54 8 1058 18 17 385 90.1Gawadame 377 399 411 339 52 8 1018 17 16 385 94Fugmana 568 601 619 511 78 12 1534 26 24 603 97.4Lay Sulula 366 388 399 329 50 8 988 17 16 618 97

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Tach Sulula 349 370 380 314 48 7 942 16 15 360 95Total 9 4202 4449 4578 3782 578 89 11346 193 178 4366 95.36

12 Teza/Agara

Hanibo 696 737 758 626 96 15 1879 32 29 710 94Teza Agara 300 318 327 270 41 6 810 14 13 315 96.3Buecho 640 678 697 576 88 14 1728 29 27 685 98.2Woldayo 677 717 738 609 93 14 1828 31 29 698 94.5Shafa 263 278 287 237 36 6 710 12 11 235 82Libona 345 365 376 311 47 7 932 16 15 357 95Wadaya 417 442 454 375 57 9 1126 19 18 449 99Weramo 448 474 488 403 62 9 1210 21 19 472 96.7

Total 8 3786 4009 4125 3407 521 80 10222 174 160 3921 9513 Kerchicho Garba 1466 1552 1597 1319 202 31 3958 67 62 1559 97.6

Nike 661 700 720 595 91 14 1785 30 28 634 88Ambericho 391 414 426 352 54 8 1056 18 17 421 99Doano 1244 1317 1355 1120 171 26 3359 57 53 1249 92Adama 942 997 1026 848 130 20 2543 43 40 965 93.6Girme 686 726 747 617 94 15 1852 31 29 718 96

Total 6 5390 5707 5873 4851 742 114 14553 247 228 5542 94.314 Garame

AmberichDugo 263 278 287 237 36 6 710 12 11 278 96.8Dushero 539 571 587 485 74 11 1455 25 23 570 97Bite 200 212 218 180 28 4 540 9 8 209 95.8Gozo 489 518 533 440 67 10 1320 22 21 524 97.5Garame 493 522 537 444 68 10 1331 23 21 514 96.4Gocho 364 385 397 328 50 8 983 17 15 388 98Garbicho 390 413 425 351 54 8 1053 18 17 418 97Gegera 244 258 266 220 34 5 659 11 10 322 100Geyoma 230 244 251 207 32 5 621 11 10 339 100Gamela 272 288 296 245 37 6 734 12 12 193 98.5

Total 10 3484 3689 3796 3136 480 74 9407 160 148 3755 98.915 Dega

KedidaJilo 770 815 839 693 106 16 2079 35 33 816 97.2Homba 412 436 449 371 57 9 1112 19 17 447 99.5Lay Gamela 890 942 970 801 123 19 2403 41 38 935 96.4Tach Gamela 534 565 582 481 74 11 1442 25 23 563 97

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Tachgna Haro 1265 1339 1378 1139 174 27 3416 58 54 1367 99.2Laygna Haro 781 827 851 703 108 17 2109 36 33 818 96.1Dogo 1 1184 1254 1290 1066 163 25 3197 54 50 1144 89Sigezo 676 716 737 608 93 14 1825 31 29 692 97Chocha 709 751 772 638 98 15 1914 33 30 735 95.2Hara Elcho 674 714 734 607 93 14 1820 31 29 673 91.6Nagage 526 557 573 473 72 11 1420 24 22 563 98.2

Total 11 8421 8917 9175 7579 1159 178 22737 386 357 8754 95.4116 Langute Dudiye 384 407 418 346 53 8 1037 18 16 397 94.9

1st Gube 276 292 301 248 38 6 745 13 12 303 99.72nd Gube 344 364 375 310 47 7 929 16 15 374 99.7Kuche 479 507 522 431 66 10 1293 22 20 410 95.1Langute 466 493 508 419 64 10 1258 21 20 504 99.8Kodade 324 343 353 292 45 7 875 15 14 352 99.4Bariko 577 611 629 519 79 12 1558 26 24 611 98.2Lay Chefe 271 287 295 244 37 6 732 12 11 298 99.6Wanchaber 318 337 346 286 44 7 859 15 13 405 92.8Mehal Chefe 344

364 375 310 47 7 929 16 15373 99.4

Edola 261 276 284 235 36 6 705 12 11 287 99.6Total 11 4044 4282 4406 3640 557 86 10919 186 171 4313 97.8

17 Holegeba Wonto Fulaasa 531 562 579 478 73 11 1434 24 22 551 95.1Betemereja 296 313 323 266 41 6 799 14 13 301 91.4Zato 388 411 423 349 53 8 1048 18 16 391 92.2Sharaka 447 473 487 402 62 9 1207 21 19 460 94.4Ware 396 419 431 356 55 8 1069 18 17 403 93.35Lay Edola 361 382 393 325 50 8 975 17 15 357 95.4Wacho 538 570 586 484 74 11 1453 25 23 620 105.8Tach Edola 467 494 509 420 64 10 1261 21 20 484 95Melga 222 235 242 200 31 5 599 10 9 195 82.9

Total 9 3646 3861 3972 3281 502 77 9844 167 154 3762 94.7118 Adilo Village 1 965 1022 1051 869 133 20 2606 44 41 859 81.73

Village2 898 951 978 808 124 19 2425 41 38 697 71.2

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Village3 1050 1112 1144 945 145 22 2835 48 44 1187 103.7Village 4 1139 1206 1241 1025 157 24 3075 52 48 1200 96.69Village 5 311 329 339 280 43 7 840 14 13 570 168.14Village 6 613 649 668 552 84 13 1655 28 26 504 75.4

Total 6 4976 5269 5422 4478 685 105 13435 228 211 5017 92.5# Grand

total160

91267 96637 99440 82142 12563 1933 246425 4188 3865 94433 94.96

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Post Distribution Zithromax and Tetracyline eye ointment Inventory Status rerport Organization ORBIS International Ethiopia program area ------------------- Zone—kembata Tamaro -----Woreda (Disrict) Kedida Gamela ---Date----20/ 04 /2009 E.C ----

s.no Product Name Biginning balance

Amount recevied

Amount ditributed(utilized + wastage )

Loss/adjustment

Ending balane

Ending balance status Expiring in next 1 year

Expiring in next 1 -2 year

Expiring after 2 year

1 Zithromaxtablet (pcs) 1914 246500 247343 0 1500 - - Feb -20202 Zithromax pos (bottle) 1078 2304 3285 0 220 - - Dece-20183 Teteracyline ointment

(tube)2420 4000 3644 17 2759 - - Octo-2017&2018

Name of distrbution coordinator –Tefera Tumebo -Name of store person Dawit Desalegn -------- Signature -------------------------- Signature --------------

Cost

The budget transferred to the Woreda as a running cost to conduct the distribution was 281145 ETB. The finance scale perdiem

rate was used for distribution fee for government workers and 50 birr per day for HAD and Volunteers

Finance

The budget transferred to the Woreda to conduct the pre distribution training Refershment ,fuel and the actual distribution was

ETB 281145 The overhead budget utilization status is as indicated by table below.

Table 2 shows budget utilization by items.

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S.No Descriptions Budget plan Budget Utilized Variance Remark

1 Training Perdiem - 73103.00 0 Liqudifid

2 Refreshment - 4802.40 0 Liqudifid

3 Fuel purchase - 3696.00 0 Liqudifid

4 Post campaign Perdiem - 199543.6 0 Liqudifid

17. Monitoring and Evaluation

The progress of the distribution was monitored daily at Kebele and Village level and challenges, best practices and other

experiences were communicated with respective Kebele supervisors and Woreda administrator. There was also woreda level

every three days meeting with site supervisors at woreda level to discuss on issues related to campaign. Daily communication

about the progress of the distribution among supervisors, distribution teams, and the woreda co-ordinator was held regularly

during the whole period of the distribution. The supervisors, coordinator, and WoHO co-ordinator were interviewed the residents

on the way of site supervision to assure the community reached by drugs.

18.Challenges Interference of unplanned activities.

Reluctance of a few supervisors on supervision and report compilation and submission.

Inability of some teams and supervisors to make drug balance.

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Double registering of the family members and registry of non permanent dwellers during pre-Zithromax distribution census

believing the registration was for other aids.

Presence of missed registered censes population.

Drug shortage

19.Solutions attempted Dedication and commitment of teams.

Prioritization of activities.

Co-operation among teams.

Closed supervision of teams

Team leaders and supervisors were reoriented at duty station on report compilation and drug balance.

The WoHO made persistent follow up on MDA coordination till the final step and the accomplishment from teams and

supervisors went consistently.

Target population of some kebeles and villages which showed data discrepancy due to PLs, double registration, census

report error and non-permanent residents’ registration; were rearranged by crosschecking with the registration books.

Shifting drugs from Kebeles to Kebele

20.Limitation Mobility of the productive age group residents to other areas for labor work affected the coverage of some kebeles.

21.Recommendation1. Drugs dosage on measuring sticks and laminated dose guides should be rearranged as per the revised Program Manager’s

Manual for Zithromax distribution.

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2. There must be post MDA distribution evaluation at all level to address gaps found and strengths for next distribution.

3. Pre-test questioner provision at community level should conducted

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