National Malaria Control Programme in Nigeria by edt34384

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									                                                         National Malaria Control
                                                              Programme in
                                                                  Nigeria

                                                                                    2005
                                                                      Annual Report




          FEDERAL MINISTRY OF HEALTH, ABUJA

 _______________________________________________________________________________________________________________

NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
MALARIA CONTROL IN NIGERIA
                      2005 ANNUAL REPORT



                                                Published by:
                        National Malaria Control Programme,
                                   Federal Ministry of Health.




                            nd
                          2      Floor, Yobe House, First Avenue,
                                     Off Shehu Shagari Way,
                                         Central Area, Abuja,
                                                     Nigeria.




                                                  Compiled by:
                              Dr. Olusola Bukola Oresanya - NMCP


      _______________________________________________________________________________________________________________

     NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                                                     Edited by:
Dr. T. O. Sofola, Mrs. O. O. Otsemobor – National Malaria Control Programme
TABLE OF CONTENTS
FOREWORD -----------------------------------------------------------------------------------------------------------------------------iv

GLOSSARY ------------------------------------------------------------------------------------------------------------------------------- v

ACKNOWLEDGEMENT ---------------------------------------------------------------------------------------------------------------vi


1.0 PREAMBLE---------------------------------------------------------------------------------------------------------------------------1
   1.1 Geographic and Demographic Information on Nigeria
   1.2 Overview of Health Status of the Population
   1.3 Malaria Burden

2.0 PROMOTING ACCESS TO EFFECTIVE CASE MANAGEMENT------------------------------------------------------3

3.0 PROMOTION OF INTERMITTENT PREVENTIVE
TREATMENT (IPT) OF MALARIA INPREGNANCY (MIP)---------------------------------------------------------------------6

4.0 ITNs AND ENVIRONMENTAL MANAGEMENT ---------------------------------------------------------------------------8
   4.1 ITN Massive Promotion And Awareness Campaign
   4.2 Environmental Management

5.0 CAPACITY BUILDING ----------------------------------------------------------------------------------------------------------12

6.0 BEHAVIOURAL CHANGE COMMUNICATION
(BCC)/IEC/ADVOCACY ACTIVITIES ---------------------------------------------------------------------------------------------13

7.0 2004 AFRICA MALARIA DAY (AMD) CELEBRATION ------------------------------------------------------------------14

8.0 ADVOCACY VISIT TO NIGER STATE --------------------------------------------------------------------------------------14

9.0 MONITORING AND EVALUATION ------------------------------------------------------------------------------------------ 15

10.0 EPIDEMIOLOGICAL REPORT ON MALARIA----------------------------------------------------------------------------15

11.0 RESEARCH -----------------------------------------------------------------------------------------------------------------------16

12.0 RESOURCES --------------------------------------------------------------------------------------------------------------------16

13.0 RESOURCE MOBILIZATION ------------------------------------------------------------------------------------------------17

14.0 GFATM MALARIA GRANT ACTIVITIES ---------------------------------------------------------------------------------17
           14.1 Meetings Held
           14.2 Other GFATM Activities

15.0 SPECIAL EVENTS/MEETINGS ATTENDED ---------------------------------------------------------------------------- 18

16.0 LOGISTICS ----------------------------------------------------------------------------------------------------------------------- 20

17.0 DONATION ---------------------------------------------------------------------------------------------------------------------- 20




      _______________________________________________________________________________________________________________
                                                                    ii
     NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
18.0 PARTNERSHIP ------------------------------------------------------------------------------------------------------------------21
        18.1 Implemented Activities
        18.2 List of Partner

19.0 HUMAN RESOURCES---------------------------------------------------------------------------------------------------------22
       19.1 NC, NMCP (FMOH)
       19.2 State Malaria Control Programme Managers

20.0 CHALLENGES ------------------------------------------------------------------------------------------------------------------24

21.0 WAY FORWARD --------------------------------------------------------------------------------------------------------------- 25

ANNEXES ---------------------------------------------------------------------------------------------------------------------------- a - e




      _______________________________________________________________________________________________________________
                                                                   iii
     NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
FOREWORD
Malaria still remains a major public health problem I this part of the world and accounts for over 60%
outpatient visits in Nigeria and is responsible for 30% and 11% mortality in under five years old and pregnant
women respectively.

The Roll Back Malaria programme focuses on the three major interventions including Case Management,
Promotion of Intermittent Preventive Treatment (IPT), Promotion of the use of Insecticide Treated Nets (ITNs)
/Integrated Vector Management (IVM) and with linkages to other cross-cutting issues such as monitoring and
evaluation, focused research and Information, Education and Communication (IEC) / Behavioral Change and
Communication (BCC).

The year 2005 was a significant one in the efforts of the country in malaria control. It marked the termination of
the 2000-2005 National Strategic Plan and the mid-term evaluation of the Roll Back Malaria initiative.
It was a year to assess our implementation strategies geared towards achieving the Abuja Targets to see how
much success has been made or otherwise. Nigeria therefore, in tamdem with other African Countries,
conducted a mid-term evaluation of the 200-2005 National Strategic Plan in the year under review.

Furthermore, one of the major constraints encountered by the National Malaria Control Programme has been
inadequate office space and equipment to function. I am therefore happy to report that in the year under
review, a new and more spacious office space was secured for the programme and also furnished and
equipped to strengthen programme management at the national level. This was supported by the GFATM.

The year 2005 also witnessed the implementation of several other activities in the area of improving prompt
and effective management of malaria, promotion of use of Insecticide Treated Nets (ITNs) amongst pregnant
women and children under five years, Intermittent Preventive Treatment of malaria in pregnancy; including
massive awareness campaign for behavioral change amongst the populace.

This report is produced by the NMCP as a compilation of the activities of the programme implemented in
collaboration with its various development partners, non-governmental organizations and other relevant
stakeholders of RBM.

My ministry and the Federal government are committed to the global effort to reduce the problem of malaria by
50% by the year 2010, and are poised to do this with the best available arsenals.




Prof. Eyitayo Lambo
Honourable Minister of Health


                                                          iv
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
GLOSSARY

ACT                  - Artemisinin-based Combination Therapy
DFID                 - Department for International Development
DTET                 - Drug Therapeutic Efficacy Test
FMOH                 - Federal Ministry of Health
GFATM                - Global Fund to Fight AIDS, Tuberculosis and Malaria
IEC                  - Information, Education and Communication
IPT                  - Intermittent Preventive Treatment
ITNs                 - Insecticide Treated Nets
IMPAC                - Insecticide treated Nets Massive Promotion and Awareness Campaign
JHPIEGO              - John Hopkins Programme for International Educational Gynecology and
                       Obstetrics
MAC                  - Malaria Action Coalition
MCPM                 – Malaria Control Program Manager
MCP                  - Malaria Control Program
NCZ                  - North Central Zone
NEZ                  -North East Zone
NPHCDA               - National Primary Health Care Development Agency
NDHS                 - National Demographic Health Survey
RBM                  - Roll Back Malaria
RH                   - Reproductive Health
SFH                  - Society for Family Health
SMOH                 - State Ministry of Health
SOGON                - Society of Obstetrics and Gynecology of Nigeria.
SWZ                  - South West Zone
TOT                  - Training of Trainers
POA                  - Plan of Action
PHC                  - Primary Health Care
UNICEF               - United Nations International Children’s Emergency Fund
WHO                  - World Health Organization
WHO/AFRO             - World Health Organization Regional Office for Africa


ACKNOWLEDGEMENT
                                                          v
       _______________________________________________________________________________________________________________

      NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                   The National Malaria Control Programme wishes to acknowledge the
                             Honorable Minister of Health, Prof. Eyitayo Lambo,
           the former Honorable Minister of State for Health, Princess Olufunke Adedoyin (mni),
                                    the current Minister of State for Health,
                                             Architect Halimat Alao,
                    the Permanent Secretary, I. Talba, the former Director Public Health,
                         Dr. E. A. Abebe (mni), the present Director Public Health,
              Dr. S. Sani , other Directors and the Roll Back Malaria team in the Federal and
                State Ministries of Health for their active participation, unwitting support and
                                      hard work during the reporting year.


  We appreciate our partners who supported us both technically and financially in the year under review,
             GFATM, WHO, UNICEF, USAID, DFID, ENHANSE Project, SFH, NETMARK.


               Our appreciation also goes to our collaborating Ministries, Parastatals,
          Commercial Partners, Academic Institutions, Community Based Organizations (CBOs),
                             Non-Governmental Organizations (NGOs) etc
                     for their unrelenting contributions to the fight against malaria.


                 Most importantly we thank God Almighty for his protection over the
             NMCP team and those who in one way or the other contributed to the process of
                                   achieving this level of success.




                                                   Dr. T. O. Sofola
                                               National Coordinator,
                                       National Malaria Control Programme




                                                         vi
1.0 PREAMBLE
   _______________________________________________________________________________________________________________

  NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
         1.1 Geographic and Demographic Information on Nigeria

Nigeria is located along the West coast of Africa and has a landmass of about 923,768 square kilometers. It is
bounded on the west by republic of Benin, on the east by Republic of Cameroon, on the northwest by Niger
republic, on the northeast by Chad republic and on the south by the Atlantic Ocean. The country’s vegetation
changes from sahel savannah in the far north followed by Sudan savannah merging into guinea savannah in
the middle belt, then rain forest in the south and mangrove forest in the coastal areas. The population of
Nigeria was 88,992,220 based on the 1991 National Population Census however; the population is expected
to have risen to about 255.6million by the year 2025 at a growth rate of 2.8%. Presently, National population
commission (NPC) puts the population at 133million. Nigeria is made up of six geopolitical zones and 36
States including the Federal Capital Territory as represented in the map below:



                                       N IG E R IA G E O -P O LIT IC A L Z O N E S


                              Sokoto
                                                  Katsina
                                                  K atsina
                                                  Katsina
                                                                     Jigawa             Yobe
                                      Zamfara
                                                          K ano
                                                          K ano
                                                          K ano                                     Borno
                 K ebbi
                 K ebbi                                      5


                                                  K adunaa
                                                  Ka dun           B auchi         G ombe
                                                                      11
                                                                       11
                                  M IN
                                N iger NA

                                                                                               Adamaw a
                                                 FCT                 Plateau
                       Kw ara
                                                       Nasarawa                                             ZONES
              O yo                                                             Taraba
                                        K ogi
                      O sun
                              Ekiti
                                                Kogi                                                        S o u th W est Z o n e
                                                             Benue
                                                                                                            S o u th E as t Z o n e
             O gun
                        Ondo                      Enugu
                10
              Lagos                                                                                         N o rth W e st Z o n e
                                Edo                       Ebonyi
                                        A nam bra
                                 5                                                                          N o rth Ea st Z o n e
                                                             C ross R iver
                                 D elta         Im o A bia                                                  N o rth C en tral Z o n e
                                  B ayelsa iversA kw a Ibom
                                         R                                                                  S o u th S o u th Z o n e




                                                                                                                                        3




Fig. 1

          1.2 Overview of Health Status of the Population

     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
The health status of the population is relatively poor as reflected in the health indicators below:
                  Infant Mortality rate:                                              100 per 1,000 live births*
                  Under-5 Mortality Rate:                                             201 per 1,000*
                  Maternal mortality Rate:                                            800 per 100,000*
                  Crude birth rate:                                                   48 per 1,000 live birth**
                  Crude death rate:                                                   16 per 1,000**
                  Life expectancy at Birth:                                           48.8 years**

                   Prevalence Rate of Major causes of Morbidity:
                   Malaria                                                                 1858 per 100,000
                   Diarrhea                                                                896 per 100,000
                   Pneumonia                                                               208 per 100.000
                   Measles                                                                 141 per 100,000

*NDHS 2003         **World Health Report 2004


                                 Prevalence Rate of Major Causes of Morbidity
                                                 per 100,000


                                1858                                                 2000

                                                                                     1500
                                                                                                  M alaria
                                                                                                  Diarrhe a
                                            896                                      1000         Pne umonia
                                                                                                  M e asle s
                                                                                     500
                                                       208       141
                                                                                     0




Fig. 2

         1.3 Malaria Burden in Nigeria

Malaria still constitutes a serious public health problem in Nigeria. It is responsible for 60% outpatient visit to
health facilities, 30% childhood deaths, 25% of deaths in children under one year and 11% of maternal death
(4,500 die yearly). In Nigeria, a child will be sick of malaria between 2 and 4 times in one year and 70% of
pregnant women suffer from malaria; contributing to maternal anaemia, low birth weight, still birth, abortion
and other pregnancy-related complications. The financial loss due to malaria annually is estimated to be about
by 132billion Naira in form of treatment cost, prevention, loss of man-hours etc.




     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                                      Percentage breakdown of under-5 mortality
                                               by reported causes, 1999
                              (source: National Health Management Information Systems)




                            35%
                            30%
                                                                                                Malaria
                            25%
                                                                                                VPD
                            20%                                                                 Diarrhoea
                            15%                                                                 ARI
                            10%                                                                 Typhoid

                             5%                                                                 Others

                             0%




Fig. 3

         1.4 Reported Malaria Cases in Nigeria (2004- Mid-2005)

The graphs (Fig. 4- ) below shows reported malaria cases and deaths in Nigeria between 2004 and June
2005.


                 MALARIA CASES AND DEATHS IN SOUTH EAST ZONE IN
                             2004 AND 2005 Jan-Jun.

                                                 100000
                                                          100000
                                                 90000
                                                           90000
                                                 80000     80000
                                                 70000     70000
                                                 60000     60000

                                                 50000     50000

                                                 40000     40000
                                                           30000
                                                 30000
                                                           20000
                                                 20000
                                                           10000
                                                 10000
                                                               0
                                                 0                   ABIA           EBONYI             IMO

                A bia                                                                             2004 CASES
                A nambra                                           Malaria Cases and Deaths
                Enugu                                                      compared               2004 DEATHS
                Ebonyi     Malaria Cases Only
                                                                                                  2005 Jan-Jun CASES
                Imo
                                                                                                  2005 Jan-Jun DEATHS




Fig. 4




     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                                             TRENDS IN SOUTH-SOUTH ZONE



                                                                         160000
    STATES               2004                 2005 Jan-Jun
                                                                         140000
                 CASES     DEATHS            CASES   DEATHS
                                                                         120000
    A/IBOM       35996          29           13909        2                                                                                           2004
                                                                         100000                                                                       CASES
    BAYELSA      43111          53           20680       28
                                                                          80000                                                                       2004
    C/RIVER      26628          64           10328       72                                                                                           DEATHS
                                                                          60000
    DELTA        149733         361          59496       16                                                                                           2005 Jan-
                                                                                                                                                      Jun CASES
                                                                          40000
    EDO          108000         54           25167        5                                                                                           2005 Jan-
                                                                          20000                                                                       Jun
    RIVERS       98250          29           5310         4                                                                                           DEATHS
                                                                              0




                                                                                                  SA
                                                                                  M




                                                                                                                                      S
                                                                                                           ER



                                                                                                                     A


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                                                                                 O




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                                                                                          L


                                                                                                         IV
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                                                                                        YE




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                                                                                                                                  IV
                                                                                                        /R
                                                                             A/




                                                                                                                D




                                                                                                                                 R
                                                                                      BA



                                                                                                       C




Fig. 5




                                                     TRENDS IN THE SOUTH WEST ZONE




              STATES                  2004                2005 Jan-Jun
                                                                                      OYO
                           CASES        DEATHS       CASES      DEATHS

              EKI TI       20280              2          5705       0             OSUN

              LAG OS       324224             43      70095         4             OGUN                                                                            2005J an-J unDEATHS

              ONDO         128012             9       86067        43
                                                                                                                                                                  2005J an-J unCASES
                                                                                  ONDO
                                                                                                                                                                  2004DEATHS
              OGUN          NR               NR       55125        17
                                                                                  LAGOS                                                                           2004CASES
              OSUN         391333             8      239600         0

              OYO          73684              0       18613         0                 EKITI


                                       NR: No Re por t
                                                                                              0        50000 100000 150000 200000 250000 300000 350000 400000




Fig. 6


     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                                                  TRENDS IN NORTH CENTRAL ZONE




                  80000                                                                                 STATES                 2004                 2005 Jan-Jun

                  70000                                                                                                CASES      DEATHS          CASES        DEATHS

                  60000                                                                                BENUE           58051          34          47469          16
                  50000                                                          2004CASES             FCT             44804          11          12159          9
                  40000                                                          2004DEATHS            KOGI            58046          10          31912          0
                  30000                                                          2005Jan-JunCASES      KWARA           45084          0           51694          0
                  20000                                                          2005Jan-JunDEATHS     NIGER           75206          91          22207          30
                  10000                                                                                NASARAW         29490          34          8342           0
                                                                                                           A
                     0
                          BENUE    FCT     KOGI   KWARA      NIGER   NASARAWA                          PLATEAU         3796           0            NR           NR



                                                                                                                        NR: No Report




Fig.                                                                                                                                                                        7




                           MALARIA CASES AND DEATHS IN NORTH WEST ZONE




         400000
         350000                                                                                              STATES               2004                     2005 Jan-Jun
         300000                                                                              KEBBI
                                                                                                                         CASES        DEATHS         CASES           DEATHS
         250000                                                                              KADUNA
         200000                                                                                              KEBBI       164280            617       114648           262

         150000                                                                              KATSINA         KADUNA      92846              74          36850           4
         100000                                                                              SOKOTO          KATSINA     344768            1044      164103           627
          50000
              0                                                                                              SOKOTO      97278             111          36413           42

                          CASES          DEATHS           CASES         DEATHS                               JIGAWA      45224             135            NR           NR
                                                                                                             KANO        274589            347            NR           NR

                                  2004                       2005 Jan-Jun
                                                                                                                                  NR: No Report




Fig. 8


        _______________________________________________________________________________________________________________

       NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                 MALARIA CASES AND DEATHS IN NORTH EAST ZONE




                          MALARIA CASES IN 2004                                 MALARIA CASES IN 2005 Jan-Jun




                ADAMAWA     ZAMFARA     BORNO       GOMBE
                TARABA      BAUCHI      YOBE                                 ADAMAWA    ZAMFARA   BORNO   GOMBE    TARABA




Fig. 9




     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
 2.0 STATUS OF IMPLEMENTATION OF ABUJA TARGETS




 Fig. 10

 African heads of States met in Abuja on April 25, 2000, to express commitment to the Roll Back Malaria
 initiative. The ABUJA TARGETS highlighted in the table below were borne out of the Abuja summit:

 Table 1:

RBM technical strategies                    Abuja target (by 2005)
                                                60% of those at risk for malaria, particularly children under 5
Vector control via insecticide-                  years of age and pregnant women, will benefit from a suitable
treated nets (ITNs)                              combination of personal and community protective measures,
                                                 such as ITNs.
                                                60% of individuals suffering from malaria should have access
Prompt access           to    effective
                                                 to and be able to use correct, affordable, and appropriate
treatment
                                                 treatment within 24 hours.
                                                60% of pregnant women at risk of malaria will be covered with
                                                 a suitable combination of personal and community protective
Prevention and control of malaria                measures, such as ITNs.
in pregnant women
                                                60% of pregnant women at risk of malaria will have access to
                                                 intermittent preventive treatment (IPT)


 These targets were to be met by the end of 2005, hence, many African countries, including Nigeria, carried out
 evaluation of the targets in 2005.

 The Roll Back Malaria process focuses on the three major interventions including Case Management,
 Promotion of Intermittent Preventive Treatment (IPT), Promotion of the use of Insecticide Treated Nets (ITNs)
 /vector management and with linkages to other cross-cutting issues such as monitoring and evaluation,

      _______________________________________________________________________________________________________________

     NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
focused research and Information, Education and Communication (IEC) / Behavioral Change and
Communication (BCC).

         2.1 Review of 2001-2005 National Strategic Plan: The year under review marked the termination of
the national strategic plan for malaria control in Nigeria and therefore, a year to assess and evaluate the level
of implementation of the strategic interventions for malaria control in Nigeria vis a vis the Abuja Targets. The
results of the review would also inform the development of the new strategic plan for 2006-2010. The basic
monitoring indicators for the selected interventions, based on the major outcome indicators in the Strategic
Plan (2001-2005) and its corresponding impacts are listed as follows:-
Outcome Indicators:
     • Proportion of Children under five with fever in the last 2 weeks who received anti-malaria treatments
         according to National Policy within 24 hrs of onset of fever.
     • Proportion of household at least with one ITN
     • Proportion of children under five who slept under ITN the previous night.
     • Proportion of women who receive IPT for malaria during the last pregnancy.
     • Proportion of pregnant women who slept under ITN the previous night.

Expected Impacts:-
   • % Mortality/morbidity of children under five due to malaria.
   • % Mortality due to malaria among pregnant women.
   • % of malaria case fatality and its effect among pregnant women and children.

The methodologies adopted to determine the level of implementation of the planned activities in the strategic
plan (2001-2005) were Desk-top review of relevant documents and Field Surveys.

         2.2 Result of Desk-Top Review: The methods used for the desk top review included Key informant
interview [FMOH, Partners, Donors, NGOs etc.], completion of Data tracking forms by programme officers and
partners, websites browsing (USAID, UNICEF, WHO, Global Fund, DFID, MSF etc), review of Annual and
project reports, Electronic databases (PUBMED and Cochrane Library): malaria + Nigeria, 2000-2005,
published, unpublished or ongoing research/control projects of Research institutions and NAFDAC pharmaco-
vigilance reports and drug registration status.

The desk top review revealed that with regards to treatment of malaria within 24 hours of onset though the
target was 60% by the end of 2005, only 34.6% (DHS 2003) had treatment within 24hours of onset of
symptoms. 11.9% (Niger Delta, Africare 2005) had aappropriate treatment. As regards malaria prevention in
pregnancy, 34% had chemoprophylaxis in the urban region while in the rural area, only 15% had
chemoprophylaxis.

The desk top review also revealed that although political commitment was still expressed, it was not matched
with commensurate budgetary support. Less than 25% of funds required to implement strategy was provided
at all levels. Moreover, monitoring and evaluation structure (personnel, system, equipment) were found to be
grossly inadequate at the national level and barely existing at sub-national levels; and although partnership is
strong and productive at the national level, it’s weak and poorly organized at States and LGA (sub-national)
levels.

There is evidence of improved infrastructure at national level (new office, equipment, vehicles) and training to
improve staff efficiency (e.g. programme and data base management) were conducted.

            2.3 Strategic Plan Evaluation Survey: A survey was carried in 12 states of the six geopolitical
zones of the Federation in October 2005. Two states were selected from each zone and three LGAs were
randomly selected from each state (1 urban and 2 rural), one from each senatorial district, not sharing
boundaries with another state/country. From each LGA, two communities/villages (one with and the other
without a health facility) were selected for the community-based survey.

States Programme Managers, M&E officers and LGA Focal Persons were trained on the survey protocols
following advocacy visits to the States Commissioners of Health and LGA Chairmen.
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
Sample size and Method: 100 households were sampled from each community, 200 per LGA and 600 per
state, making a total of 7000 households nationally. Households were selected randomly by spinning a bottle
from the market/Community leader’s house; the direction in which the bottled pointed was followed to sample
households with target group/respondents – under-five children, women of reproductive age group and
pregnant women.

Malaria indicator survey tools and management survey forms were used. Household and women
questionnaires were administered and key informants interviews were conducted

Preliminary result of survey: After the field work the data collected were entered and cleaned up. The analysis
of the data is on going using the Epi-info software; the final results of the survey are pending. However
preliminary results available show
     • Chloroquine is the most commonly used medicine to for treatment of malaria / fever in children.
     • One-fifth of children received treatment with Chloroquine within 24hrs of onset of fever.
     • One-third of children with fever did not receive any anti-malarial drugs.
     • About 20% of Households had at least one mosquito net
     • About 7% of pregnant women slept under an ITN the previous night before the survey.
     • About 6% of children under 5 yrs slept under an ITN the previous night before the survey.
     • About 70% of pregnant women use antimalarial chemoprophylaxis.
     • Chloroquine, Sulphadodixe and Pyrimethamine are the drugs used for chemoprophylaxis in pregnant
         women.
     • Chloroquine is the most commonly used drug for chemoprophylaxis in pregnant women.
     • Less than 10% of pregnant women use SP for IPT




     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
3.0 PROMOTING ACCESS TO EFFECTIVE CASE MANAGEMENT




Fig. 11

Case Management addresses one of the Abuja Declarations on Roll Back Malaria, which states that 60% of
persons affected by malaria will have prompt access and appropriate treatment in 24hrs. It is based on the
principle of early recognition of disease with prompt treatment using, appropriate and effective anti-malarial
drugs. Quite a number of activities were carried out by the NMCP to improve access to effective case
management. Highlighted below are some of these activities:

         3.1 Updating of Antimalaria Treatment Training manuals: Sequel to the change in the anti-malaria
treatment policy to adopt the use of Artemisinin-Based Combination Therapy (ACT), there was a need to
update the national training manuals. This was done in February 2005.

           3.2 Interactive meeting with PMG-MAN on Anti-malaria Treatment Policy: On 24th Jan. 2005, a
one-day interactive meeting was held with the PMG of MAN at the Nigerian Institute for Medical Research to
1) intimate the PMG of MAN on the updated anti-malarial treatment policy and discuss the process of change,
2) clarify issues related to the policy change and role of PMG of MAN and 3) solicit the cooperation of PMG of
MAN in the successful implementation of the policy. Participants at the meeting were Hon. Minister of Health,
Prof. Eyitayo Lambo, National Coordinator NMCP, Dr. T. O. Sofola, other NMCP and FMOH staff, chairman –
PMG-MAN, representatives various pharmaceutical manufacturing companies, ENHANSE, WHO and SFH.
The National Coordinator, in her presentation, noted that this change in policy should have taken place about
10years ago when Chloroquine sensitivity hit the ‘red’ mark. The Honorable Minister of Health assured PMG-
MAN of the government’s determination to collaborate with the private sector to ensure that systems put in
place for the transition process are sustainable. At the end of the meeting, a communiqué was issued, see
Annex 1 for details. The meeting was sponsored by SFH.

         3.3 Inauguration of the National Anti-malarial Treatment Policy Implementation Transition
Committee: The decision to change the anti-malarial treatment policy and the subsequent implementation of
the policy brought with it challenges and complexities at every level, hence there was a need to constitute a
multidisciplinary committee comprising relevant agencies and organizations to articulate, guide and assist in
setting up benchmarks for scaling up the process.

The Hon. Minster of Health, Prof. Eyitayo Lambo, therefore on 24th March, 2005 at crystal Palace Hotel,
Abuja, inaugurated the National Antimalarial Treatment Policy Implementation Transition Committee. The
committee is made up of a Steering committee and four Technical Working Groups (TWG); Drug registration,
Supply and Management TWG, Treatment Guidelines and Training TWG, Information, Education and
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
Communication (IEC)/ Behavioural Change Communication (BCC) and Advocacy TWG and Monitoring and
Evaluation TWG. Membership was drawn from relevant ministries, Parastatals, regulatory bodies, Private
sector, Pharmaceutical Manufacturing Group of the Manufacturers’ Association of Nigeria and Development
Partners among others.

The Director, Public Health, Dr. Edugie Abebe mni, gave the opening address at the inauguration ceremony
after which Dr. Olugbenga Mokuolu, Chairman, Medical Advisory Committee, University of Ilorin, presented the
lead paper titled ‘Current Trends in the Management of Malaria’. Other participants at the ceremony were the
NC, NMCP, other NMCP and FMOH staff, representatives of WHO, DFID, ENHANSE, SFH etc.

The TWGs were mandated to meet twice in a quarter and to make recommendations to the Steering
committee, which meets quarterly. Since inauguration, the TWGs have met twice while the Steering committee
has met once and have made recommendations to the FMOH as regards the transition process. Notable
among the recommendations is the declassification of ACTs from prescription-only medicines to over-the-
counter medicines and discouraging NAFDAC registration of oral artemisinin monotherapies. Letters have
been written to the relevant bodies to set the process in motion.

          3.4 Adaptation of Generic Tools for Drug Management Documents: A stakeholders’ meeting was
held at Ikeja Airport Hotel from 18th – 20th May 2005 with the support of the Malaria Action Coalition (MAC)
and the Rational Pharmaceutical Management (RPM) Plus for strengthening drug management in Nigeria to
adopt generic tools for drug management. Participants were drawn from FMOH (Food & Drug Department),
NMCP, NAFDAC and Central Stores of the States Ministry of Health where 2004 Rapid Assessment of drug
use was carried out namely Bornu, Calabar, Kano and Lagos. USAID, WHO, UNICEF and SFH were also
represented

The meeting was organized with a view to adapting the Management Sciences for Health (MSH)’s generic
document for Pharmaceutical management training to be used to train Drug Store Officers on proper handling
and storage of Anti-malaria medicines, especially Artemisinin-Based Combination Therapies (ACTs). A
comprehensive plan for Training of Trainers at the federal, state and LGA level was also developed at the
meeting.

         3.5 Drug Supply Management Training: Later on in the year, Rational Pharmaceutical Management
plus, based on its commitment to ensuring access to effective treatment and rational drug use, organized a
training workshop on drug supply management in Ghana in August 2005. The NC – Dr. T.O. Sofola, Dr. E.
Nwokolo (AD- Case Mgt) and Mrs. T. Abumere represented the FMOH at the training.

          3.6 One Day Round Table Conference on the Challenges and Opportunities of Local
Production of Artemisinin-Based Combination Therapies: This conference was held at the instance of
Federal Ministry of Health at Rockview Hotel, Abuja on the 9th June 2005 with the support of GFTAM. The
objectives were to explore the possibility of growing artemisia annua in Nigeria, discuss the attendant
challenges and opportunities and to discuss and ascertain the technical services and facilities needed for the
cultivation of the plant and extraction of the raw materials.

Participants were drawn from various Departments of the Federal Ministry of Health, related line Ministries
(Agriculture, Commerce, Industries,) States Ministry of Health, Research Institutions (NIMR, NIPRID),
Academia, Pharmaceutical Manufacturing Group of Manufacturing Association of Nigeria (PMG of MAN),
Importers of Pharmaceuticals, Development Partners, Regulatory Agencies (NAFDAC) and the Private
Sectors. The meeting was declared open by the Secretary the Government of The Federation (SGF) Obong
Ufot Ekaete. The then Hon. Minister of State for Health (Pricess Funke Adedoyin) gave the welcome address
whiles the Hon. Minister of Health (Prof. Eyitayo Lambo) gave the key note address. The Special Adviser to
Mr. President on Local Manufacturing and Private Sector (Alh. Abdulkadir) chaired one of the technical
sessions and Prof. Brisibe Ebiamadon presented a lead paper titled “The challenges and opportunities of
Local manufacturing of Artemisinin – Based Combination Therapies”. At the end of the meeting, it was agreed
that:
         •    A broad-based multi sectoral technical committee should be constituted and inaugurated to
              follow the process through.
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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
         •    The Artemisia annua seed should be obtained and cultivated in nurseries by the various
              research institutes as pilot studies for the cultivation of Artemisia annua.
          • A memo to the FEC on the outcome of the meeting be drafted by the Federal Ministry of Health.
A joint statement of partnership was then drafted.
Subsequently, a presidential committee, chaired by the Special Adviser to Mr. President on Local
Manufacturing and Private Sector (Alh. Abdulkadir), was set up to work out the modalities for local production
of ACTs. The committee has been meeting.

        3.7 West Africa Network for Monitoring Antimalarial Treatment (WANMAT II Workshop On
Quality Assurance For Anti-malaria Drug Efficacy Monitoring This training workshop was held at Errata
Hotel, Ghana on 28th-29th June 2005 in response to the growing problem of anti malaria drug resistance in
the West African sub region (Benin, Burkina Faso, Cote d’Ivoire, Ghana, Mali, Niger, Nigeria, Sierra Leone and
Togo) The workshop was designed to set up training programme for the focal person involved to empower
them to set up quality assurance in drug efficacy trials. National Malaria and Vector Control Division was
represented by Dr. Ernest Nwokolo.

           3.8 Drafting of Working Document Trade-Related Intellectual Property rights (TRIPS): With the
adoption of the use of ACTs as the first line medicines in the treatment of uncomplicated, malaria in Nigeria,
availability and access to these medicines pose a great challenge to the implementation of the policy since the
medicines are not yet being manufactured in the country.

The Drug Registration, Supply and Management technical working group of the National Anti-malaria
Treatment Policy Implementation Transition committee in recognizing the need to ensure that prices of ACTs
do not act as a barrier against access and availability, set up an 8-member mini committee to collect, collate
and prepare a comprehensive working paper on TRIPS and the patentability of the necessary drugs. The mini
committee had a two-day meeting at Halal Hotel, Kaduna on 3 rd - 4th August to develop a draft working
document on TRIPS, having carried out several underground enquiries prior to that date at the Federal
Ministry of Trade, Commerce and Industry and the legal department of the FMOH. Represented in the
committee are NMCP, F&DS, NAFDAC, PCN, NIPRD, SFH and YGC.

         3.9 Pre-packaging of Anti-malarials in Nigeria: As part of its efforts to ensuring access to prompt
treatment and effective treatment of malaria (within 24hrs), the case management unit of the NMCP organized
a 2-day meeting with PMG-MAN, NAFDAC, F&DS, RBM Partners and other stakeholders to discuss the pre-
packaging of ACTs and develop a frame work for pre-packaging in Nigeria, including harmonizing colour
coding and age-specifications. The meeting was held on August 22nd – 23rd 2005 at the conference room of
the Nigerian Institute for Medical Research (NIMR), Yaba, Lagos. As an outcome of the meeting, a framework
for pre-packaging of anti-malarials in Nigeria was developed. A follow-up meeting was held on September 30,
2005. SFH supported the two meetings.

         3.10 2nd Annual Meeting of RAOPAG (West African Network for Malaria Prevention and
Control): The 2nd annual meeting of RAOPAG was held in Cotonou, Benin on 3-7 October, 2005. Countries
currently involved in RAOPAG include Benin, Burkina Fasso, Ivory Coast, Guinea-Conakry, Mali, Niger,
Senegal and Togo. Nigeria was invited to join the network at this meeting. Other participants at the meeting
were WHO, USAID and UNICEF. The general objectives of this meeting were to review the functioning,
strategies and activities of RAOPAG at the sub-regional and national levels and to make proposals for the
improvement of the performances of the network. The National Coordinator, NMCP represented Nigeria at the
meeting.

          3.11 Development of Guideline for Home Management of Malaria: In preparation for the adoption
of Home Management of Malaria as part of Case Management Strategy, NMCP held a 3-day workshop on 19 th
– 21st Dec. 2005 at the Conference Room, NIMR, Yaba, Lagos. The objective of the workshop was to develop
a guideline for Home Management of Malaria. The materials used for the development of the guideline
included the “The Roll Back Malaria Strategy for improving access to treatment through home management of
malaria’’ WHO/HTM/MAL/2005.1101. Results of desktop analysis of studies conducted in the country on home
management of malaria were also used to enrich the document on best practices. Participants at the meeting
were drawn from WHO, UNILORIN and NMCP.

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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
           3.12 Development and finalization of Draft Orientation Package for Role Model Mothers: The
Case Management unit of the NMCP developed a draft orientation package (training manual) for training Role
Model Mothers on the Home Management of malaria. This was done at Port Harcourt between 30 th Nov. and
1st Dec. 2005. This draft document was the reviewed and finalized at stakeholders’ meeting involving some
facilitators, consultants and partners on 14th Dec. 2005. Training of role model mothers is expected to
commence early in 2006

          3.15 Stakeholders’ Meeting on Establishment of New Sentinel Sites in Nigeria: In line with the
resolutions reached at the WANMAT II Workshop on quality assurance for anti-malaria drug efficacy
monitoring held on June 28th –29th 2005 in Accra, Ghana, a meeting of stakeholders involved in the Drug
Efficacy Trials was conveyed on 15th – 16th Dec. 2005 at the Nigerian Institute for Medical Research (NIMR)
Yaba, Lagos with a view of strengthening the existing sentinel sites and establishing additional six sentinel
sites. The specific objectives of the meeting were to take the inventory of sentinel sites and assess their needs
and functionality; build the capacity of the Principal Investigators and Supervisors for data analysis; appoint
the new sentinel sites PI's on the processes of DET in Nigeria and intimate the PI’s on anti-malaria
surveillance using Pharmacovigilance forms. The proposed six new sentinel sites are situated Bayelsa, Kwara,
Sokoto, Lagos, Imo, and Yobe States. Participants at the meeting included Principal Investigators of the old
and proposed sentinel sites, Sentinel site supervisors, WHO, Food and Drugs Services department and
NAFDAC.




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4.0           INTERMITTENT PREVENTIVE TREATMENT (IPT)




Fig. 12

          4.1 Procurement and distribution of SP
NMCP procured 500,000 Sulphadoxine – Pyrimethamine through the Global Fund for IPT and distributed to 12
states of the federation. These were to be administered as Directly Observed Treatment (DOT).

          4.2 Printing of IPT Guideline and Strategic document
The National IPT Guideline and Strategic Document was printed and distributed to all the states, for onward
distribution to LGAs and health facilities. The printing was supported by ENHANSE.

         4.3 Distribution of Focused Ante-Natal Care Orientation (FANC) package and Algorithm
FANC orientation packages and Malaria in Pregnancy algorithm were distributed according to the size of the
states so that each LGA got at least 20 each.




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5.0           INSECTICIDES TREATED NETS AND ENVIRONMENTAL MANGEMENT




Fig. 13

5.1 Environmental Management

       5.11 Procurement of Integrated Vector Management equipment: In the year under review, IVM
equipments were purchased by the federal ministry of Health. These were distributed to the states through the
Programme Managers at the Annual programme managers’ review meeting.

            5.12 Development and submission of Guideline on environmental management: In March
2005, a guideline on environmental management was developed and submitted to the top management
committee.

The unit also participated in conducting Certificate Examination for Environmental health Professionals in
January 2005 and at a meeting of Environmental health officers’ registration Council of Nigeria in March 2005.

5.2 Promotion of Use of Insecticides Treated Nets

        5.21 Handing over of the Chinese Government-donated ITNs and Cotecxin: The Chinese
government donated 163,630 ITNs and some cartons of cotecxin to the Nigerian Government in the year
under review. These were handed over to the Hon. Minister of Health, Prof. Eyitayo Lambo on 27th January,


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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
2005 at a handing-over ceremony held at the minister’s conference room, Federal Secretariat Complex. These
commodities have since been distributed to the states, teaching hospitals and federal medical centers.

          5.13 Participation at a Training Workshop on Malaria Vector Identification: The ITN unit
participated at a training workshop on malaria vector identification with focus on resistance and application of
Polymarase Chain Reaction (PCR) on 22nd February, 2005. It was organized by Nigerian Institute for Medical
Research.

          5.14 Launching of RBM Initiative by the Nigerian Army: The Nigerian Army, in the year under
review (March 2005), launched the RBM initiative and established an RBM unit to oversee RBM activities
within the Nigerian Army. The HMH was represented at the occasion by the Director, Public Health, Dr. Edugie
Abebe mni. The National Coordinator, NMCP and some other staff of NMCP also participated at the event.
The ITN unit presented a paper on “the Role of ITN and LLITN in Malaria Control Programme” at the event.


         5.15 Participation in monitoring of ITN Distribution Systems in Malawi: NMCP participated in the
monitoring of ITN distribution systems in Malawi in April, 2005. This was sponsored by SFH.

        5.16 Distribution of ITNs/LLINs: A total of 87,840 ITNs were distributed to various tertiary hospitals
and Federal Medical centers and organizations during the second quarter for some activities. Other recipients
were the Nigerian Army, the Carter Center, Rotary international, some Non-governmental Organizations etc.
SFH also distributed about 80,000 LLINs in the year under review.

          5.17 Coverage Survey of ITNs: NMCP participated in the coverage survey of ITNs for the control of
malaria and Lymphatic filariasis in Kanke LGA, Plateau State and Akwanga LGA in Nasarawa State between
26th April and 4th May 2005. The survey was supported by Carter Centre. Preliminary report of the survey
showed that ITNs coverage was as high as 90% in both LGAs. However, the final Evaluation report is being
awaited from CDC Atlanta, USA.

         5.18 Dissemination Meeting on the Outcome of ITN Household Survey: NetMark conducted a
Household survey on ITN use in some parts of Nigeria. A dissemination meeting was held in May 2005 at
Crystal Palace Hotel, Abuja, during which a report of the outcome the survey conducted in 9 States, was
presented to Partners and stakeholders. The results of the survey showed 10% ownership of ITNs and 60%
awareness creation in these States. The NMCP participated at this meeting.

         5.19 Malawi Nationwide Study Tour on Implementation of ITNs: A study Tour of Malawi
Nationwide Insecticide Treated Nets (ITNs) Programme implementation was undertaken by the National
Malaria Control Programme Coordinator, Dr. T. O. Sofola, Mrs. C. N. Amajoh, Focal Person for ITNs/IVM and
two Representatives of Society for Family Health/PSI from 7th -14th May, 2005. The Study Tour was supported
by SFH/PSI and the objectives of the study were:
     • To see what has worked and how?
     • Use the lessons learned from Malawi to develop/finalize the national guidelines on ITNs.
     • Initiate appropriate distribution mechanisms with community based organizations
     • Incorporate lessons learned from the study for improving the malaria programme implementation in
         Nigeria.
One of the outstanding lessons learned from the Malawi study is the uniqueness of their model which
combines traditional social marketing with heavily subsidized highly targeted distributions through the
nationwide public health facilities.

         5.20 Assessment of Long Lasting Insecticides Treated Nets: NMCP participated in an
assessment study of two Long Lasting Insecticidal Nets (LLINs) - Olyset and Permanet in Cross River State
from 2nd -18th May 2005. The study communities were Ehom and Betem in Biase LGA of Cross River State.
The objectives of the study were to: Examine consumers’ relative acceptability of Olyset vs Permanet,
understand advantages and disadvantages of Olyset and Permanet in the consumers’ eyes and establish
consumer perception of relative cost of Olyset and Permanet.

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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
        5.21 Sensitization Meeting on RBM in Kwara State: NMCP participated in a sensitization meeting
on RBM to LGA Chairmen, HODs, Health and malaria control Managers in Kwara State on 8th and 9th June
2005. Mr. C. N. Amajoh represented NMCP.

           5.22 Integration of Community Directed Treatment with Ivermectin (CDTI): The ITN unit also
participated in the special meeting on integration of CDTI for the control of Schistosomiasis, Lymphatic
filariasis and Malaria at the Rock View Hotel, Abuja from 27 th - 29th June 2005. He presented a paper on
integration of CDTI with malaria control programme. Mr. J. D. Akilah represented NMCP.

        5.23 Launching of Syngenta Initiative on Malaria and Mosquito (SIMAMO)
NMCP, on 24th June 2005, participated in the launching of SIMAMO by Syngenta. It was an initiative aimed at
promoting ITNs for malaria control in Nigeria.

          5.24 Finalization of ITNs/LLINs Policy
The ITNs/LLINs policy was finalized at an ITNS/Environmental Sub-committee meeting held at the Nigerian
Institute of Medical Research, Lagos on 29th June 2005. This was supported by Society for Family Health
(SFH).

         5.25 Procurement of LLINs for use in NIgeria: A meeting between the Federal Ministry of Health,
Yakubu Gowon Centre and the ITNs Association of Nigeria was held in April 2005. The objective of the
meeting was to discuss the progress on the procurement of Long Lasting Insecticidal Nets (LLINs). At the end
of the meeting, the need to protect the local industries in order to allow them survive was identified.

         5.26 Integrated Vector Manangement Stakeholders’ Meeting: A meeting of all Stakeholders in
Integrated Vector Management (IVM) was held at the Protea Hotel, Obudu Ranch Resort, Cross River State
on 21st – 23rd July, 2005. The objectives of the meeting were to adapt the Regional Framework on IVM for
Nigeria and develop Guidelines for IVM implementation in Nigeria. At the end of the meeting, IVM Policy,
Guidelines and a Five-year (2006-2010) Plan of Action for IVM implementation in Nigeria were developed and
steps forward for IVM implementation in Nigeria were identified.

         5.27 Supply Chain Logistics for Commodity Security: A training course on supply chain logistics
management for commodity security was organized by DELIVER/USAID in collaboration with the Federal
Ministry of Health at the NAF Club, Kaduna on 15th -31st August 2005. The purpose of the course was to
strengthen capacities of Officers who are responsible for planning, managing and monitoring of HIV/ AIDS,
TBL, Malaria control and Reproductive Health logistics at the national level. The training covered thematic
areas such as Logistics management information systems, Inventory control systems, Storage and quality
assurance, including Logistics systems assessment, Monitoring and Evaluation. Mrs. Chukwurah and Mr. D. A.
Ordu attended the training.

          5.28 Meeting on Taxes and Tariffs: A meeting on Taxes and Tariffs was organized by NetMark in
Ghana in September 2005. The objectives of the meeting were to 1) discuss the status of taxes and tariffs for
ITNs in the participating countries and analyze opportunities and constraints to addressing them 2) Train
advance Teams to develop advocacy strategies and organize country-wide specific activities using available
tools such as More nets Spreadsheet and 3) Outline follow-up and support needs for country level activities.
Mrs. C. N. Amajoh (AD, ITNs) who attended the meeting, recommended urgent creation of a separate local
HS code for mosquito nets and listing it as part of the public health commodities rather than textile by fiscal
Policy Department of the Federal Ministry of Finance and the removal of taxes and tariffs on Long Lasting
Insecticidal Nets (LLINs) and reduction of same on mosquito nets, considering the great economic burden of
malaria in Nigeria.

         5.29 LLINs Subsidy Project: SFH and COMPASS conducted a pilot study of the Malawi model of
ITNs distribution (LLINs subsidy project) in Nasarawa State between 7th and 9th September, funded USAID.
The project, which was facility based and targeted at pregnant women and children under five years of age,
was carried out in 7 LGAs in Nasarawa State. General hospitals and other health facilities were visited to
observe the distribution of ITNs. LLINS were supplied and sold at subsidized rates at the health facilities. The
money realized from the sales of the LLINs will be utilized for the upgrading of the health facilities and
purchase of SP for IPT in these States. Mrs. C. N. Amajoh participated in the study. The study was replicated
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in Kano, Bauchi and Lagos States and the Federal Capital Territory (FCT). The model is expected to be
adapted in Nigeria if successful hoping that this will strike a balance between equity and sustainability to
achieve health impact.

          5.30 Long Lasting Insecticidal Nets Technology Transfer: A workshop on LLINs technology
transfer was organized by USAID/NetMark in Nairobi, Kenya on September 27 -30, 2005. The USAID NetMark
programme formed a joint effort with Bayer, Siandutch Mosquito Netting Company and Anovotek to develop a
mechanized process for the mass treatment of nets at the factory level that would produce an LLIN meeting
WHOPES specification. The goals of the workshop were to 1) Unveil the new technology for the mechanized,
mass LLIN treatment of mosquito nets at the factory level that can be transferred to African net manufacturers,
2) Review other LLIN technologies that African companies might develop 3) Identify potential sources
international financing and technical assistance to help the technology transfer process and find markets for
the new nets and 4) Provide net manufacturers with an opportunity for private consultations with the NetMark
technical Team on how they might add an LLIN capacity to their factories. Mrs. C. N. Amajoh attended the
workshop.

         5.31 NETMARK Dissemination meeting: In March 2005, NETMARK held a dissemination meeting
at Crystal Palace Hotel to intimate NMCP and the RBM partnership with the results of a survey carried out by
the organization on ITN utilization by households in Nigeria. The NETMARK survey revealed that percentage
of ITN use Nigeria was 10%.




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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
6.0 MONITORING AND EVALUATION




                                   ORGANIZATIONAL CHART FOR M&E DATA FLOW


               NMCP M&E Unit                                  FEDERAL M&E + IDSR



                                                                                     NPHCDA OFFICES
                                                               ZONAL
                                                                                       MONTHLY


                                                                STATE MAL. + STATE EPID:
             STATE Malaria Unit.                            DPH / DPHC M&E: DPRS + HMIS SURV.
                                                                        OFF: WHO



                                             MEETINGS OF LGA DSNOs                     MONTHLY


                                                               LGA HOD Health/PHCC, Mal. Focal
                    LGA DSNOs
                                                               Person, DSNOs, + M&E (Coord.)


                             FP {PRIVATE STAKEHOLDERS}                                           WHO SUPPORTED (EPI)
                             {PRIVATE& PUBLIC HFs}




Fig. 14

Monitoring and evaluation is one of the crosscutting issues in malaria control activities. The M&E unit of NMCP
engaged in monitoring activities during the year under review. Also, as 2005 marked the termination of the
five-year strategic plan for malaria control in Nigeria, the unit coordinated the strategic plan evaluation
process. Details of the activities are highlighted below:

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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
          6.1 Supervisory visits to 36 states and FCT for data collection and collation: Monitoring and
evaluation is one of the key components of RBM Strategies to control malaria in the country. However, data
generation from LGAs and states had been a major problem. This necessitated the need to conduct
supervisory visit to state and in order to fill the gap. A supervisory visit was carried out in all the 36 states of
the Federation from 7-11 March 2005. the objectives of visit were to monitor the implementation of RBM
activities in the state, pay advocacy visit to policy makers in the state Ministry of Health in order to solicit their
support for the implementation of RBM activities in the state, assess the level of awareness of RBM strategies
such as treatment policies, use of ITNs, IPT and other preventive measures, introduce the State RBM
Programme Manager and the State M&E focal person to the new M&E formats and to assess RBM
commodities and supplies in the states.
          6.2 Monthly Partners Meeting: During the year under review, regular Partners’ meetings were held
with the support of the partners.

          6.3 Monitoring and Evaluation Consultative Meeting Held in RBM Office, Abuja on The 7th June
2005: The M&E unit held a meeting with the Global Fund team on Monitoring and Evaluation of RBM
Implementation by the Global Fund. The purpose of the meeting was to fine-tune the M&E tools to be used for
tracking the indicators of the Abuja targets.

          6.4 Development of Framework for Evaluation 2001- 2005 Strategic Plan development of 2006
- 2010 Strategic Plan: A meeting of RBM FMOH and WHO Mission to develop framework for evaluation of
2001-2005 and development of 2006 – 2010 Strategic Plan was held in August, 2005. The framework was to
guide the evaluation process in terms of methodology for data collection, management and analysis;
identification of the teams to conduct the evaluation and cost estimation of the process. The lessons learnt
from the evaluation of the 2000-2005 Strategic Plan were to inform the development of the new Strategic Plan
for 2006-2010.

          6.5 National Training of Trainers on Survey Protocols for Strategic Plan Evaluation: A two-day
training workshop was carried out in Jos, Plateau State in September 2005 to introduce the Field Officers to
the Evaluation protocols for the 2001-2005 Strategic Plan. Participants at the workshop included FMOH staff,
Principal Investigators and Partners. The objectives of the meeting were to 1) train on collection of data on
relevant indicators using standardized tools at HF and community levels from randomly selected States in
Nigeria, 2) train on how to analyze collected data and report findings and 3) train on how to provide feedbacks
at all levels and utilize the findings to facilitate the development of the 2006 – 2010 National RBM Strategic
Plan.

          6.7 The Stakeholders’ Meeting On The Evaluation Of 2001 – 2005 RBM Strategic Plan And
Preparation For New Strategic Plan 2006 – 2010: a stakeholders’ meeting was held on Novermber 7, 2005
at rock view hotel, Abuja to debrief the Honourable Minister of Health and other Stakeholders of Roll Back
Malaria on the preliminary results of the evaluation survey on the 2001 – 2005 strategic plans conducted in the
12 selected states in the six geo-political zones of the country. The meeting was also an avenue to brainstorm
on the challenges of implementation of RBM in Nigeria and the way forward. Participants at the meeting were
Director Public Health, Dr. Edugie Abebe, mni; National Coordinator NMCP, Commissioners for Health from six
states, permanent secretaries, State Programme Managers, Representatives of World Bank, DFID,
ENHANSE, UNICEF, NMCP staff. The National Coordinator gave an outline of the Strategic Decisions that will
inform the development of the new Strategic Plan; Dr. M. Meremikwu (Consultant, UNICAL) presented the
result of the Desk top Review while Dr. H. Akpan (NMCP) and Mrs. O. Otsemobor (NMCP) presented the
preliminary results of the Evaluation Survey to the stakeholders present. A Guideline for Preparation of 2006-
2010 strategic plan was presented to the stakeholders and it was agreed that NMCP should provide technical
assistance to the states to help develop their strategic plans and 2-year Operational Plans.

         6.8 Development Of State 2006-2010 Strategic Plan: As part of the resolutions of the stakeholders’
meeting held in Abuja on the Strategic Plan, a three-day Strategic and Operational Plans Development
Workshop was held from the 7th – 10th of December, 2005 in the six Geo-Political Zones simultaneously. The
objectives of the meeting were to assist States Malaria Programme Managers and Directors of Public Health
in developing their Strategic Plans for 2006 – 2010 in the standard formats for the document. Two FMOH staff
were deployed to each zone to provide technical assistance at the workshop. At the close of the workshop, the
deliverables expected were the draft Strategic Plan for each state and a 2-years Operational Plan. The final
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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
copies of the documents were to be endorsed by the States Commissioners for Health and these are being
collated.




7.0 BEHAVIOURAL CHANGE COMMUNICATION/ INFORMATION, EDUCATION                                                           AND
COMMUNICATION




Fig.15

Highlighted below are the activities implemented by the BCC/IEC unit of the NMCP.

         7.1 Guidelines for participation of Non-Governmental Organizations (NGOs) in RBM
implementation in Nigeria: In order to coordinate the hitherto fragmented and uncoordinated activities of
NGOs in RBM implementation and to prepare a fair playing ground for better participation, a national guideline
was developed and finalized in March 2005 and launched at the Nigeria Institute for Medical Research, Yaba,
Lagos in April, 2005. The launching was carried out as one of the activities to commemorate the Africa malaria
Day in the year under review. At the launch, it was agreed that a networking of NGOs should be initiated and
NGOs mapping be carried out.




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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
Fig. 16: The First Lady of Lagos State, Chief Mrs Oluremi Tinubu, and former Minister of State for Health,
Princess Olufunke Adedoyin mni co-launching the NGO Guideline.

        7.2 Printing of BBC Communication Strategic Document March 2005: In January 2004, a
workshop was held to develop a draft BBC Strategic Document, which was later presented to the southern
and northern states for adoption. The finalized document was printed in the first quarter of the year under
review and dissemination has since been carried out.
         7.3 Development of Information, Education and Communication (IEC) and BCC Materials At
Rosebud Hotel Gimbiya Street Abuja:. In order to raise the awareness of the public and further sensitize
them on the activities of RBM in Nigeria, NMCP, through the support of GFTAM hired advertisement agents to
develop media messages on the Roll Back Malaria interventions. At a meeting held at Rosebud Hotel, Abuja
on the 3rd June, 2005, the consultants presented the developed messages to NMCP and RBM partners, who
made inputs. The agents were told to liaise with the Technical Working Group on Behavioral Communication
change for technical guidance and for further inputs in the materials. These materials include television spots
and posters.

         7.4 Meeting with NetMark on Full Market Impact: This was held on 3rd August 2005 to discuss
NetMark’s areas of possible collaboration with FMOH for increased coverage and funding for ITNs. The
participants were RBM partners from UNICEF, YGC, NetMark Team and RBM FMOH staff members. At the
end of the meeting, the TV commercials presented by NetMark was accepted to be used as one of the TV
commercials for RBM.

         7.6 Advocacy Visit to States: During the year under review, Advocacy visits were paid to Lagos,
Nasarawa, Abia, Cross River and Yobe States as part of the AMD celebration. This was to enlist the support of
the states in the implementation of RBM activities in their states.




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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
8.0         PROGRAMME MANAGEMENT
         8.1 Africa Malaria Day Celebration
AMD is an annual event in most African countries including Nigeria. In 2004, a schools essay competition was
carried out as part of the events to mark 2004 AMD. However, the winning schools were awarded their due
prizes in the 1st quarter of 2005 by the Hon. Minister of Health, Prof. Eyitayo Lambo. The winning schools went
away with 2 sets of computer and accessories donated by USAID and cash prizes and library of books
donated by BASICS.

In the year under review, the theme for the AMD celebration was “Unite against malaria” and the slogan was
“Together we can beat malaria”. These called for unity of purpose and collaboration of partners and
stakeholders especially governments at all levels (State and LGA) including related parastatals; communities
and families. The AMD 2005 Committee decided that States and major stakeholders would be actively
engaged in this year’s commemoration. The mechanism of engaging states and stakeholders were as follows:
     • National Chairman of AMD and National Programme Coordinator contacted Honourable Minister of
         Health to sensitize States with a memo and during the National Council on Health meeting.
     • Mobilization of participation in the states by Development Partners operating in such states
     • Involvement of the First Ladies of participating States and LGAs facilitated by Ministry of Women
         Affairs
     • Advocacy visits to Governors and Honourable Commissioners of Health of one State per zone by
         AMD sub-committee
     • Sharing of AMD notices and guidelines with states
     • States to list all partners both active and inactive, constraints and way forward towards RBM Forum
         formation or strengthening.
Involvement of Miss Nigeria 2005 whose agenda is “Malaria control” Special events and programmes
carried out to mark this year’s Africa Malaria Day at the national level included massive awareness
campaigns including a Media Forum hosted by the Hon. Minister of Health, Prof. Eyitayo Lambo; a Talk Show
on Radio Link, ‘Market Storm’, which was preceded by a musical float on the major streets of Abuja, Exhibition
of anti-malarial drugs and Insecticide Treated Nets, State level inauguration of RBM partners, Essay
competition, debate and drama among others. The pictures below are clips taken during the celebration.
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
Scope Of AMD 2005 Activities:
   • The scope is informed by the theme and slogan of the 2005 AMD: “Unite against Malaria”;
      “Together we can beat malaria” respectively.




Fig. 18 The Secretary of Market Women Association,                 Fig. 19 Media Forum by the Hon. Minister of
  Wuse Market, Abuja, pledging commitment to                          Health, Prof. Eyitayo Lambo, AMD 2005
  join the fight against Malaria at the 2005 AMD
     Market Campaign tagged Market Storm
                  (April 2005)




             Fig. 20 AMD Market Storm Rally                            Fig. 21 Miss Nigeria 2005 Demonstrating The
                                                                         Comfort of Sleeping Under ITN

At the State and Local Government levels, specific activities were also carried out by these
authorities in commemoration of AMD. Six states including Lagos, Nassarawa, Yobe, Sokoto, Cross
rivers and Abia were selected from the six geopolitical zones for special emphasis.
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                      Africa Malaria Day 2005
                  African Malaria Day 2005 - –
                Selected States for Focused Activities
             Selected States for Focused Activities
                                                     Sokoto

                                                                     Katsina
                                                                                        Jigawa
                                                     Zamfara                                                                     Borno
                                                                                                              Yobe
                                     Kebbi                                       Kano



                                                                                                                                              N
                                                                                                      Gombe
                                                                         Kaduna            Bauchi

                                                     Niger                                                             Adamawa           W          E


                                                                                                                                              S
                                                                                        Plateau
                                                                   FCT
                                             Kwara
                                                                         Nassarawa
                                Oyo
                                                                                                 Taraba
                                                 Ekiti
                                                                  Kogi
                                                                                                                                         Nigerian States
                                        Osun                                       Benue
                              Ogun             Ondo
                                                                    Enugu
                                Lagos
                                                         Edo              Ebonyi
                                                               Anambra                                                                            AMD 2005 focused
                                                                      Abia Cross
                                                      Delta       Imo      River
                                                                                                                                                   Other States
                                                                          Akwa
                                                      Bayelsa
                                                                Rivers    Ibom
                        200                      0                          200                           4 0 0 M i le s




Fig 22

Other states would benefit in subsequent AMD celebrations.

         8.2 Participation at the Malaria Vaccine Initiative meeting in South Africa: NMCP participated at
the Malaria Vaccine Initiative meeting in South Africa in the first quarter of the year under review. Mrs. O.
Otsemobor (AD, M&E) represented the programme at the meeting in South Africa.

        8.3 Collection and collation of Monthly Progress reports and Quarterly Plans of Action,
including Production of Annual Report: In the year under review, the programme management unit
ensured regular compilation of quarterly reports of the RBM activities for proper tracking and programme
evaluation. The maiden edition of NMCP annual report was produced in the year under review.

         8.4 Meeting to Review the Guidelines for Programme Management for Malaria Control in
African Region (Harare, Zimbabwe, June 20 – 22, 2005): WHO/AFRO organized a workshop to expose the
draft Guidelines on Programme Management for Malaria Control Managers to selected field managers who
have been involved with day to day management of malaria programmes and obtain their inputs. In addition,
documents on progress reports on implementation were shared and the areas of further support for the
country were explored. Participants were country NMCP Managers, WHO/NPO, AFRO MAL Staff, Director
(ATM), AFRO HRN/DSD, AFRO/CSR, USAID rep and Management Consultants.
The outcome of the meeting include: review and input into all the 10 chapters of the Guideline; agreed next
steps identified to finalize the Guideline up to deployment for use in the countries; national document and
progress report shared with MAL AFRO and consultative and advocacy meetings held with MAL and focal
points. Dr. T. O. Sofola represented NMCP.

          8.5 Retreat For Women and Child Friendly Health Services (WCFHS) Initiative Components
Programme Officers In The FMOH: Programme officers rendering women and child friendly services in the
FMOH were called to a 2-day retreat organized by the WCFHS initiative of the CDPA department of the FMOH
in collaboration with UNICEF on 6-9 Sept. 2005 at Shiroro Hotel, Kaduna. NMCP, as part of its efforts at
integrating with other relevant health programmes, participated at the meeting.

The Women and Children Friendly Health Services (WCFHS) Initiative was adopted in Nigeria in July 2001
following the commitment of the First Lady, Chief Mrs. Stella Obasanjo at the Vision 2010 sub-regional forum
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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
of First Ladies from West and Central African countries held in Bamako, Mali in March 2001. The overall aim is
to improve quality of health care delivery and as such reduce maternal and child mortality; which will result in
improvement in the health indices of Nigeria and contribute to the attainment of the Millennium Development
Goals (MDGs) on maternal and child health.

The objectives of the meeting were to update the knowledge of the WCFHS component programme officers in
FMOH on the current status of implementation of WCFHS in Nigeria and to brainstorm on strategies for
ensuring nationwide coverage.

Participants were drawn from NPHCDA, RH division, Nutrition Unit, NASCP, Safe Motherhood Unit,
Commodity and Logistics Management Services Division, Gender/Women’s Health and Development Unit,
Child Survival, NMCP and UNICEF. At the end of the meeting areas of collaboration between NMCP and
WCFHS were identified.

         8.6 2nd High-Level Meeting on Malaria: Scaling-up Insecticides Treated Nets: The United
Nations Fund (UNF) and the Canadian International development Agency (CIDA) convened a high-level
meeting in Geneva, June 23, 2005 to discuss the feasibility of a rapid scale-up to protect all pregnant women
and children under five children by 2010 with ITNs with an emphasis on LLINs. This 2nd meeting, held on
September 7, 2005 at Le Dauphin, Paris, was called to 1) review progress in implementing and planning rapid
scale-up of ITN coverage fro most vulnerable groups in Africa; 2) adopt a way forward on reaching annual
coverage targets through multiple approaches including financing; 3) communicate various approaches for
streamlining procurements and 4) identify sources of funding for and agree on implementation responsibilities
among partners. The Hon. Minister of Health Prof. Eyitayo Lambo and NC, NMCP represented Nigeria at the
meeting.

           8.7 Participation at ENHANSE Year 2 Work-Plan Development Retreat: NMCP participated at the
Year 2 Work-plan Development workshop organized by ENHANSE at Mic Com Golf hotel, Ada, Osun State
between 1st and 6th August, 2005.
The focus of the meeting was to reflect on the performance of the project in Year 1 to identify gaps, plan for
Year 2 and explore areas of further collaboration with their partners and the Nigerian Government.
The first two days of the meeting involved plenary presentations from ENHANSE as well as its partners –
GHAIN, Deliver, COMPASS, UNAIDS, Safe Blood etc; while the rest of the retreat was dedicated to work-plan
development. National malaria Control Program (NMCP), represented by Dr. O. B. Oresanya participated in
the first two days of the workshop. Key areas of ENHANSE collaboration with NMCP in Year 2 were
                wider dissemination of the policy in collaboration with NMA, Paediatric Association of Nigeria
                    etc
                Strengthening of Non Governmental organizations to address Child Survival issues.
                Support the implementation of the Global Fund grant
                Follow up on the media training
                Training of Program Managers on Advocacy skills.

         8.8 Global Partnership Support For Health Management Information Systems (HMIS)-Health
Metrics Network (HMH): Mrs. O. O. Otsemobor attended a one day workshop on Global Partnership Support
For Health Management Information Systems (HMIS)-Health Metrics Network (HMH) Support held at the
Arcade Club Suites, Abuja. The objectives of the workshop were to apply standardized self-assessment tools
towards identifying area of strength and weaknesses and to develop funding proposals directed at addressing
the weaknesses.
The support is to last for five years (2006-2010). A proposal for a total sum of US$ 500,000 was prepared for
support for the year 2006.

          8.9 Partners’ Meeting for New Direction for Child Survival: Child Survival Unit of the CDPA
department of the FMOH held a meeting of partners at RockView Hotel, Wuse II, Abuja on 8 th - 9th November
2005 to brainstorm on issues related to child survival and chart a new course for this strategy in Nigeria.
Component programmes in the FMOH offering child-related services like nutrition, breast feeding, NASCP,
NPHCDA, Adolescent Sexuality, school health, were at the meeting. Other participants were NEPAD,
ministries of information and Education and development partners.
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    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
A draft Child Health Policy and draft Integrated Child Survival and Development (ICSD) Strategic Frame work
and Plan of Action were presented at the meeting to enable component programmes t make in-puts. The Child
Health Policy was developed in May 2005. It applies to persons who fall within the 0 -18years age bracket i.e.
neonates, under 5s, School-age children and adolescents and the overall goal of the policy is to improve the
survival and development as well as ensure protection and participation of the Nigerian child.
The role of NMCP was stated in the document as collaboration with ICSD in building capacity for disease
management and prevention); partnership building; advocacy and social mobilization; monitoring and
evaluation, and operational research; in-service training; availability and use of PPDs in HFs and
communities.

           8.10 Roll Back Malaria Annual Review Meeting: The Roll Back malaria annual review meeting was
initiated last year with the aim of building the capacity of Programme Managers and sharing ideas to learn best
practices and proffer way forward for Programme implementation. It also facilitates effective and efficient
coordination of the Malaria Control Programme nationwide. The 2005 Annual Review meeting held in the
quarter under review on Nov. 28 – 29, 2005 at Hotel Presidential, Port-Harcourt. The focus of this year’s
meeting were to 1) review progress made on RBM activities in the States in the past one year, 2) familiarize
the Programme managers with the new anti-malarial treatment policy, 3) strengthen data management,
reporting and implementation of strategic plan at the State level and 4) orientate Programme Managers on
new concepts in Programme management using AFRO guidelines. The Hon. Minister of State for Health,
Chief (Mrs) U. J Esuene was the Special guest of Honour who also declared the meeting open. The Rivers
State Governor was ably represented by the Hon. Commissioner for Health Dr. Eyinda. Other participants at
the meeting included the National Coordinator, NMCP, Dr. T. O. Sofola, Programme Managers from 35 States,
representatives of country WHO and AFRO, ENHANSE, COMPASS, DFID, YGC, Rivers State Art and Culture
group, Drug manufacturing companies, other private sectors and members of staff of NMCP etc. The
workshop featured paper presentations, exhibitions, brainstorming and plenary sessions. At the end of the
two-day meeting, a communiqué was issued. It was agreed that the 2006 annual review meeting will be
hosted by Kano State.




9.0 GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA: MALARIA GRANT
ACTIVITIES
The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) was set up to provide additional source of
assistance to countries in their fight against these three killer diseases.

Nigeria, through an existing and functional country coordinating mechanism (CCM) secured the two GFATM
grants for malaria in 2004; Round two and Round four grants of $20.9 and $20.47 million for the first two years
respectively, the Principal recipient of the grant being Yakubu Gowon center and the Sub-recipient Federal
ministry of Health.

The key objectives of the two grants were to procure and distribute 1,743,480 LLINs to 1,162,386 under five
children and 581,194 pregnant women within 2 years and ensure re-treatment of the nets; procure and
distribute 16.1 million doses of Artemisinin Based Combination Therapy (ACTs) to under five children for
treatment of malaria within 2 years; provide 1 million doses of IPT to 500,000 pregnant women using SP
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
through public/private sectors; to procure, distribute and increase informed demand for ACT through IEC/BCC
and advocacy activities targeted at care givers, train National, state and LGA health workers on RBM
interventions, procure and distribute motor cycles, computers and accessories to all LGA s of the benefiting
states aid appropriate communication/reporting of activities.

          9.1 Procurement of RBM Commodities: In the year under review, 500,000 Doses of SP were
procured and distributed to 12 States; 2.5 million doses of ACTs were procured from Novartis through WHO
and distribution plan has been made. Orders have also been made for 250,000 Long Lasting Insecticidal nets
from A – Z Textile Mills, Arusha , Tanzania.

          9.2 New RBM Secretariat: The RBM Secretariat took possession of the new office accommodation
secured through the Global Fund in the 3rd quarter of the year under review. The office is located on the 2 nd
floor of Yobe House, 1st Avenue, in the central district area of Abuja. The relocation to this more spacious office
has immensely boosted the productivity of the RBM team in Nigeria.

          9.3 Procurement of Office Equipment: Also, one desk top computer and accessories were
distributed to the Global Fund assisted states, including one motorcycle each to the LGA to facilitate timely
data collection from health facilities. Office equipment were procured and installed at the RBM
secretariat and some selected states.

         9.4 Training: National Sensitization of Tertiary level health care providers on the new National
Antimalarial policy was carried in Abuja in the 2nd quarter of the year under review and a sensitization meeting
of State Policy makers (Hon Commissioner for Health, Permanent Secretaries, Directors of Primary Health
Care and Disease Control) was held during the 48th National Council for Health at Benin Edo State on May
5th 2005 (2nd Quarter). This was later cascaded down to the states and LGAs in the six geopolitical states of
the federation in the 3rd Quarter of the year. Plans are also underway to train health workers on Drug
Management, role model mothers on Home Management of malaria and M&E officers on the use of M&E
softwares.

         9.5. Meetings: several meetings were held at the instance of the Global Fund




10.0          CAPACITY BUILDING
Highlighted below are the activities carried out by NMCP in the area of capacity building in 2005. The activities
were supported by various partners.

           10.1 Training on IPT and Malaria in Pregnancy in North West Zone: This training was carried out
on 6th-8th January in the northern zone of the country by UNICEF.

         10.2 Training Workshops on the Effective Management of Malaria: in the year under review, a
national orientation workshop targeted at the Tertiary Level Health Care Personnel was held at Nicon Hilton
Hotels Abuja, on 26th April 2005. The objectives of the workshop were to sensitize policy makers on the new
Anti-malarial Drug Policy change, orientate participants on effective management of malaria using Artemisinin-
Based Combination Therapies and to update the participants on the Roll Back Malaria Initiative in Nigeria.
Subsequently, a National Facilitators Workshop to re-orientate the National facilitators on prevention and
management of malaria, train new facilitators and field test the developed training manuals was held at Top


     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
Rank hotel, Enugu from 23rd -26th May 2005. The aim of the workshop was to build capacity of Health Care
Providers at the various levels.

         10.3 Sensitization Workshop on Management of Malaria: Later on in the course of the year, a
step-down training on the management of malaria was conducted on 29th August – 2nd September 2005 in 18
States of the country. The participants at the training were Secondary health workers at the state level and
primary health care providers at the LGAs. A total of about 4,000 health workers were trained. The training
was supported through the Global Fund. It is expected that this training will be scaled up to the other states in
the coming year.

        10.4 Result-Based Management (RBM) Training organized By the Canadian International
Development Agency (CIDA): The Canadian International Development Agency (CIDA) is the project arm of
the Canadian government charged with the responsibility of implementing Canadian Aid Programmes in
developing countries.
A two-day training session was organized from May 31 – June 1, 2005 at Nigeria Canada Cooperation Office,
Wuse II Abuja for the partners in the School of Health Technology project, which is being sponsored by CIDA,
and other stakeholders. The objectives of the meeting were to familiarize the participants with the context and
rationale for RBM and elicit a better understanding of the policy, principles and characteristics of RBM.
Participants were drawn from the benefiting states (Bauchi and Cross River), Federal Ministry of Health,
United Nations Fund for Population Activities (UNFPA) and National Primary Health Care development Agency
(NPHCDA).
The participants were introduced to the Logical Framework Assessment format. A Canadian consultant, Mr.
Ron Titus conducted the training sessions. Dr. O.B. Oresanya represented FMOH.

          10.5 Orientation Workshop on Malaria Costing Tool: The FMOH, in collaboration with WHO
organized a training workshop on Malaria Costing Tool for NMCP staff and State Programme Managers in July
2005 at Hamdala Hotel, Kaduna. This was a 3-day workshop carried out in two phases; 17 th – 21st July and
27th – 29th July, 2005. Overall, 37 States Programme Managers and 20 NMCP Officers were trained.
Facilitators were drawn from WHO Nigeria and Harare. The objective of the training was to contribute to the
strengthening of capacity for decision making and planning for scaling up malaria control interventions in
Nigeria. During the training, some gaps were identified, especially with respect to dissemination of information
from NMCP to the states as regards current trends/development in malaria control. These gaps are to be
addressed at the Annual Programme Managers’ meeting holding next quarter in Port Harcourt.




A cross section of the participants at the training                    A Group Photograph of Participants taken
         on Malaria Costing Tool.                                       after the Costing Tool Training, Kaduna.


         10.6 Orientation of NMCP Staff on the Use of Portable Scanning Machine: NMCP staff were
introduced the use of a portable scanner, a pencil-like device procured for tracking the utilization of malaria
commodities at the LGA level, at a one-day orientation workshop at Yakubu Gowon Center, Asokoro on 27th
July, 2005. The facilitator was a YGC consultant on M&E from Germany. The tracking forms filled out by the
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
recipients of the commodities (ITN or ACT) will be scanned using the portable scanner at the health facility
level in the LGA. The device is then taken to the State Malaria office on a monthly basis for the data collected
to be down loaded into the computer to be forwarded to the YGC at the national level.

         10.7 International Training on Management of Malaria: The Government of Thailand granted two
fellowships to the Government of the Federal Republic of Nigeria to participate at an International Training
Course on the Management of Malaria from 26 September – 7 October 2005 at Mahidol University, Bangkok,
Thailand. The aim of the fellowship awards was to promote Thailand’s role in Academic Collaboration in the
African region under the South-South Cooperation for relief of malaria problems and also to establish a
network for collaboration among third world countries.
The objectives of the Training were to support effort in solving the problem of malaria disease, especially
malaria in the Africa Region and to establish human resources to relieve malaria problems in the countries in
Africa. Apart from Nigeria, 9 other African countries and some bordering Asian countries were invited for the
training. However, countries that participated were Nigeria, Sudan, Tanzania, Burkina Faso, Uganda,
Madagascar, Kenya, Indonesia, Burton, Japan, India and Australia.
Four Medical doctors involved in malaria control activities were nominated for the award (two State Malaria
Programme Managers and two Medical officers from the National Malaria Control office) out of which two were
selected by the Thailand Government. The beneficiaries of the fellowship awards were Dr. Olusola Oresanya
(NMCP) and Dr. Adedayo Adeyanju (Ondo State Malaria Programme Manager).

         10.8 International Training on Malaria and Planning its Control: Three members of Staff of the
NMCP; Dr. Saddiq Ibrahim, Miss Nneka Ajagbulu and Mr. Banjo; attended a six-week International course on
Malaria and Planning its Control at Nazareth, Ethiopia. The course commenced on 26th September 2005.

           10.9 Training Of National Programme Officers On The Use Of Computer Software: With the
increased momentum of Roll Back Malaria activities in Nigeria, a lot of data on Disease Management and
Disease Prevention is being generated at the various levels of Government, Research and other Health
Institutions. A five-day training workshop sponsored by GFATM was carried out at Crystal Palace Hotel, Abuja
on the 19th – 23rd December, 2005. Participants comprised of NMCP Staff, Epidemiology Division staff and
facilitators were drawn from Health Planning and Research Department of FMOH and ENHANSE. The
objectives of the training were to: update knowledge of participants on RBM implementation in Nigeria
       To orientate Malaria Programme Managers and Monitoring and Evaluation Officers on the Monitoring
           And Evaluation of RBM
       To introduce and stream line data collection instruments and methodology
       To develop and establish cycles for data collection and dissemination
       To train officers on the use of portable scanning machine for data collection on RBM from LGAS to
           RBM M&E database
       To train M&E officers, Programme Managers at state and LGA levels on the use of Health Mapper,
           Epi Info, SPSS, GIS graphics, excel, access.

A total number of 20 officers, comprising 4 from M&E, 5 Case Management, 2 ITN and others were trained.

         10.10 Training of Health Personnel and Students of Higher Institutions of Learning: The Training
Unit of the NMCP based in the Lagos office engaged in various activities in the year under review including
training of Health Personnel and operational research in collaboration with the Nigerian Institute of Medical
Research in the area of vector mapping and use of Polymerase Chain Reaction in the identification of
Anopheles Gambiae complex. Various cadres of Health personnel were trained including MPH students from
the College of Medicine, Idi-Araba, Olabisi Onabanjo University Ago-Iwoye; Public Health Nurses and
Environmental Health Officers from the various schools of technology.
The core modules of the training included Epidemiology of malaria, Malaria Entomology, Malaria Parasitology,
Malariometric survey including entomological survey and the RBM Initiative. Other areas covered were
diagnosis of malaria, Case management and the new anti-malaria drug policy, Malaria in Pregnancy, Malaria
Prevention, malaria Prevention Vectors of medical importance, IVM, Community Mobilization and BCC. Field
visits were made to Badagry for malariometric surveys and there after laboratory sessions were conducted in
order to carry out identification exercise for the parasite and the mosquito vectors.
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
The table below shows a summary of the number of trainees by institution, category and duration of training.

Table 2:
S/N No. of              Institution                                       Category                   Duration of Training
    Students
1      30               University of Lagos, Idi-Araba, Lagos.  Master of Public 31st Jan – 4th Feb. 2005
                                                                Health (MPH)
2      20               Olabisi Onabanjo University Ago-Iwoye MPH                    14th – 18th March 2005
                        Ogun State
3      16               Nigerian Army Medical Corps             Environmental        14th Mar – 20th May 2005
                                                                Health Officer
4      18               School of Nursing, Akure                Public Health Nurses 26th Jun 2005
5      28               School of Health Technology Ilese, Ogun Environmental        27th Jun – 8th Jul 2005
                        State                                   Health Officers
6      9                Medical Training School, NNS Quorra, Environmental           11th Jul – 5th Aug. 2005
                        Naval base, Apapa.                      Health Officers
7      76               School of Health Technology Ilesa, Osun Environmental        1st – 12th Aug. 2005
                        State                                   Health Officers
8      47               School of Health Technology Ondo State Environmental
                                                                Health Officers
9      6                Industrial attachment students from 300 level industrial Oct. – Dec. 2005
                        University of Benin.                    attachment students
10     1                IT Student : Bayero University, Kano    IT Student           2 weeks




11.0           RESOURCE MOBILIZATION
        11.1 Stakeholders meeting on 5th Round for Global Fund: A Stakeholders’ Consensus Meeting
on Round 5 Global Fund Grant was held 20th – 23 rd march 2005 at Top Rank Hotel. Afterwards, NMCP
convened a proposal writing meeting at Top Rank Hotel where the various units had inputs into the proposal. A
Consultant was hired to fine tune and finalize the proposal. Final Malaria component of the proposal has since
been submitted to CCM

         11.2 World Bank Booster Program for Malaria Control in Africa: Donors Conference
A two-day conference of donors on the Booster Program for Malaria Control in the Africa Region of the World
Bank, was held on September 8-9, 2005 at the World Bank’s Paris offices. The Conference objectives were to
stress the need for better coordination and harmonization of resources around common malaria control
strategies and outcomes for each country and to call for significant mobilization of resources for countries to
scale-up their malaria control efforts for impact. At the end of the meeting, it was agreed that:
         3.3.1 Control of malaria is a big problem that requires big solutions
         3.3.2 Strong Partnership and Harmonization is Needed for Results
         3.3.3 There is a need for stronger emphasis on monitoring and evaluation for results.
         3.3.4 The design of the Booster Program for Malaria Control in Africa will involve no new
                  structures
         3.3.5 There is a need to mobilize the resources of and collaborate more effectively with the
                  Private (including NGO) sectors.
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     NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
       3.3.6 Design of Global Subsidy for Artemisinin-based Combination Therapies
The meeting was attended by the Hon. Minister of Health and the NC, NMCP.

          11.3 Hosting of the World Bank Mission on Malaria Booster Program: Sequel to the request
made to World Bank for support for malaria control earlier on in the year, a World Bank mission visited Nigeria
in September 2005. The team, which comprised of Dr. Eva Jawaran, Dr. Suprotik, and other staff of the World
Bank office in Nigeria, were hosted by the HMH, DPH, NC, DHPR and RBM partners. The mission explained
that the World Bank Booster program is a 10 year plan with US$ 600 to 700 million to be provided for a 3-year
intensive phase to rapidly achieve set targets for malaria control through aggressive vector control and case
management. The project cycle was described as involving 1) Identification – the mission 2)Pre-appraisal -
environmental assessment 3) institutional arrangements 4) Appraisal – finalize costing and institutional
arrangements 5) Negotiations – draft contracts ready 6) Presentation to the World Bank board 7) Grant/Credit
effectiveness 8) Disbursement.
The mission further submitted that a Country Partnership Strategy (CPS) was developed in conjunction with
the Finance Ministry which explains the relationship between the country and World Bank in all sectors and
that priority is given to MDGs after identifying lead NEEDS states through the benchmarking process. The
mission was however unsure of the nature of the support at this stage but noted that this would be would be
decided after consultations with all parties involved whether it is going to be a grant, credit or mixed.




12.0          PARTNERSHIP




     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
          Fig. 23

The RBM in Nigeria has a virile team of partners of diverse backgrounds but acting in concert to achieve
common goals. This partnership is at the moment strong and well coordinated at the national level and efforts
are being made to strengthen same at the sub-national levels.
In the year under review however, NMCP held regular meetings with her programme partners on monthly
basis while the National Malaria Control Committee (NMCC) also met quarterly.

          12.1List of RBM Partners by category

   Partners                                                 Area of work
    1. WHO                                                  Technical support, M&E, Capacity building,
                                                            Advocacy
    2.  UNICEF                                              EPI, Nutrition, RBM
    3.  UNDP                                                Development Malaria
    4.  World Bank                                          Supports RBM
    5.  USAID                                               Poverty alleviation
    6.  DFID                                                RBM, Health
    7.  COMPASS                                             RBM, RH
    8.  JHPIEGO                                             Case Management
    9.  HARVESTFIELD                                        ITNs
    10. NetMark                                             ITN dealer
    11. ENHANSE/POLICY PROJECT                              Policy
    12. VESTARGARD                                          ITN
    13. MAC                                                 Case Management, MIP
    14. CIDA                                                Health and environment
    15. PMG-MAN                                             Manufacturing
    16. DANGOTE Group                                       ITN
    17. CHI (ITN)                                           Insecticide
    18. SYNGENTA                                                      “
    19. MSF                                                 Community malaria
    20. Futures Group
    21. SUNFLAG                                             Bed-net manufacturer
    22. Parastatals:
            a. NPHCDA,
            b. NAFDAC,
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
             c. NPI
             d. SON
  23.   Health Departments:
             a. Planning and Research, FMOH.
             b. Hospital Services and Training, FMOH
             c. Food and Drugs (FMOH)
             d. Community Development and Population Activities (Reproductive health)
  24.   Non-Governmental Organizations:
             a. Society for Family Health (SFH)
             b. Malaria Society of Nigeria
             c. Interphase
             d. Malaria Care Organization in Africa (MACAO)
             e. CHESTRAD International
             f. Malaria Parasite: Africa Fights Back etc
  25.   Oil Companies:
             a. Exxon-Mobil
             b. AGIP
             c. Chevron
  26.   Research / Academic Institutions:
             a. NIMR
             b. NIPRID
             c. Malaria Research Group, IMRAT, Ibadan
  27.   Professional Bodies:
             a. NMA (Nigerian Medical Association) and others: Pharmacists, Nurses, etc
             b. Association of General Medical Practitioners (private sector participants)




13.0         CHALLENGES
   _______________________________________________________________________________________________________________

  NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
The major challenges in RBM implementation include the following:

13.1. The huge burden of malaria problem
    • Malaria still ravages the entire population with high mortality amongst children under five years and
        pregnant women.
    • Knowledge about malaria in the rural communities is still poor.
    • There is high resistance of the parasite to the 1st and 2nd line anti-malaria drug
    • Poor treatment seeking behavior among the people.
    • Enormous resources are required to scale up ITNs intervention as preventive measure against
        malaria due to the large size of the Country.

13.2. Programme Management issues at all levels
    • Capacity building for implementing ITNs is inadequate
    • Re-treatment continues to be a major issue in effective ITNs implementation at community level.
    • Lack of consistent, standardized and technically accurate messages targeted at correcting
         misconceptions and beliefs associated with the causes, management and prevention of simple and
         severe malaria to families, community members, health care providers in communities and health
         workers.
    • Lack of trained personnel to carry out M&E activities at state and LGA levels
    • Inability of states to use data to inform project planning and implementation
    • Irregular reporting from the state.
    • Different planning/project cycles use by states.
    • Data collection at state level done by different units leading to fragmentation of data.
    • Lack of printed Policy / Guideline for malaria Programme management
    • Training manuals are updated and due for printing.
    • Delayed submission of reports by the state Programme Managers to the M&E Unit.
    • Possible gaps in the transition stage from CQ and SP
    • High cost and non-availability of local manufacturers of ACTs.

13.3. Limited resources:
    • There are limited resources to scale up the tested ITNs intervention in all LGAs and communities in
         Nigeria as the demand increases. Total ITNs required for IMPAC is 15 million but current pledges and
         funds available are less than 2 million.
    • Poor commitment of Partners to funding M&E network meeting.
    • Low support from Partners and government institutions.
    • Lack of funds to carry out BCC activities. There was difficulty in sourcing for funds for development of
         RBM Communication strategic document.

13.4. Poor Logistics:
    • ITNs availability in peri-urban and rural areas hampered by weak distribution channels/network. Weak
        distribution logistics also affect public sector ITNs provision. In addition, ITNs operation is limited by
        low public financial budgets and lower releases, and inadequate donor support. Similarly, private
        sector investment is low because of low demand.
    • Local ITNs distributors are not making enough profits to invest in sustaining and developing
        distribution channels.
    • Delayed supply of RBM commodities for programme implementation.

13.5. Poor Political will at the State and LGA levels:
    • Commitment at state and LGA levels still low in spite of MOU signed. There is low level of
        participation, with little provision of ITNs for IMPAC implementation at state and LGA levels.


13.6. Administrative Issues
     _______________________________________________________________________________________________________________

    NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
  •    Lack of sufficient equipment e.g. Computers, UPS, stabilizers, In-focus, photocopying machine, file
       cabinets, printing machines etc to enhance activities within the units.
  •    Lack of Data entry clerk and statistician in the M & E unit.
  •    Lack of running cost to purchase consumables




14.0       WAYFORWARD
   _______________________________________________________________________________________________________________

  NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
•    Awareness creation on the problems of malaria in Nigeria
•    More community participation in RBM activities.
•    Rapid scaling up of ITN coverage for impact through synergy with measles campaign.
•    Advocacy at all level of Governance to support malaria control activities in Nigeria
•    More commitment in terms of funding, manpower, materials is needed on continuous basis to ensure
     that the Abuja targets are met.
•    There is need for operational research on the best distribution mechanism/ channels for ITNs.
•      Rolling out of already developed consistent, standardized and technically accurate malaria
     messages targeted at correcting misconceptions and beliefs associated with the causes,
     management and prevention of simple and severe malaria to families, community members, health
     care providers in communities and health workers.
•    Resources, particularly funds from partners should be well coordinated.
•    There is need to empower NGOs/ community members to have access to re-treatment kits at
     affordable prices at as when needed.
•    Fast track the local production of ACTs so as to reduce the cost of the drugs and enhance
     acceptability.
•    More intensive capacity building of the RBM Staff of the various units at the National level is critical to
     the success of the global malaria control initiative.
•    Updated National Treatment Policy and training manuals should be printed and disseminated.
•    Private sector participation in scaling up of ITNs should be harnessed.




 _______________________________________________________________________________________________________________

NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
15. ANNEXES
Annex I

COMMUNIQUE ISSUED AT THE INTERRACTIVE MEETING BETWEEN PMG of MAN AND FEDERAL
MINISTRY OF HEALTH AT THE NIGERIAN INSITUTE FOR MEDICAL RESEARCH
ON 24TH JANUARY 2005.

Malaria still constitutes a serious public health problem in Nigeria. It is responsible for 60% outpatient visit to
health facilities, 30% childhood death, 25% of death in children under one year and 11% of maternal death.
The financial loss due to malaria annually is estimated to be about by 132billion Naira in form of treatment
cost, prevention, loss of man-hours etc.

The FMOH, based on the results of the Drug Efficacy Studies carried out in 2002 on Chloroquine and SP,
which indicated that these two drugs were no longer efficient for national first line use; and result of the
efficacy trials on two Artemisinin based combination therapy -Artemether + Lumefantrine & Artesunate +
Amodaquine, which showed 87-100% efficacy in the six geopolitical zones, decided on a policy change as
regards the first line of drug for malaria treatment.

A one-day interactive meeting was therefore held with the PMG of MAN to:

 •    To intimate the PMG of MAN on the updated anti-malarial treatment policy and discuss the process of
      change
 •    To clarify issues related to the policy change and role of PMG of MAN
 •    To solicit the cooperation of PMG of MAN in the successful implementation of the policy.

At the end of the meeting, it was resolved that:

     1. The issue of resistance to the current first line drugs (Chloroquine and Suphadoxime –
        Pyrimethamine) for malaria treatment was generally agreed on
     2. The need for a policy change was said to be long overdue, however, the change should be an
        ongoing, gradual process.
     3. The current DTET on ACTs is acceptable but needs to be expanded on especially in the area of
        pharmacovigilance.
     4. The efficacy of ACTs was undisputed; however, there were concerns about the availability and
        affordability.
     5. Zero percent tax relief on imported raw materials for ACTs and the finished products was
        recommended.
     6. The government (the three tiers) should make funds available to patronize local manufacturers by
        procuring drugs from them.
     7. The Government (the three tiers) should support efforts to source raw materials so that the drugs
        would be affordable.


Communiqué Committee Members:

     1.   Dr. T.O. Sofola                                    -National Coordinator, RBM (FMOH)
     2.   Dr. O. B. Oresanya                                 -RBM (FMOH)
     3.   Mrs. Osaretin Jaiyeola                             -PMG of MAN
     4.   Nnamdi Okafor                                      -PMG of MAN




      _______________________________________________________________________________________________________________

     NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
                                     Annex 2: SUMMARY REPORT OF STATE RBM ACTIVITIES IN NIGERIA

STATES          POPULATION          NO. OF CASE MGT                           IPT                                            BCC                      PARTNERS             M&E                   REMARKS
                                    LGA/                                                    IVM / ITNs
                                    WARD                                                    ENV.MGT

ABIA            2.5M                17 in each      LGA procure drugs e.g.    Non           -28,000 distributed.             IEC through jingles in    SMOH/               Checklist
                                    LGA             CQ      &     SP  and                                                    State Radio / TV on      HEALTH               developed by          No    operational
                                                    distribution.                           No treatment centre              Env. Mgt & vector        NET/SFH/HSDP         SMOH/Basics           Research carried
                                                                                            -Capacity building to Health     Control. Distribution    11/UNICEF/ADB        on Mal. Mgt /         out
                                                                                            workers, mothers & caregivers,   of posters pamphlets     /LGAs/Red            ITNs use
                                                                                            clearing of refuge and drains    to Health Workers,       Cross/Girls’
                                                                                            by SEPA                          PMVs mothers and         Guide/Min. of
                                                                                                                             caregivers.              Information/Terti
                                                                                                                             Celebration of AMD,      ary         Health
                                                                                                                             Advocacy Visits to 17    Institutions
                                                                                                                             LGA Chairmen, HOD
                                                                                                                             (Health), Health of
                                                                                                                             Serv, Secretaries of
                                                                                                                             LGAs and LGA
                                                                                                                             Programme
ADAMAWA         4.1M                                -                         105 doses     435 ITNs distributed round the   -Promotion of ITNS –     UNICEF, FMOH,        Supervision with      No    operational
                                                                              of      IPT   state.                           435                      LGA                  the use of            Research carried
                                                                              distributed   IRS carried out and monthly      -IRS                                          checklist       and   out
                                                                                            Environmental Sanitation.                                                      report format.
                                                                                                                                                                           and provision of
                                                                                                                                                                           Feedback to the
                                                                                                                                                                           health facility
AKWA IBOM       3.5M                31              -No drug procurred        Individual    -Promotion of ITNs distributed   TV        Programme      AFRICARE,            Data collection       No    operational
                                                    -Training of Health       purchase      29,500 ITNs                      carried,         IEC     FMOH, LGA            from          DSN     Research carried
                                                    Personnel’s carried out                                                  materials are almost                          officers              out
                                                                                                                             ready.
                                                                                                                             Hon. Commissioner
                                                                                                                             granted TV interview
                                                                                                                             to     mark     AMD
                                                                                                                             celebration




             _______________________________________________________________________________________________________________

            NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
ANAMBRA       5.1m                21              Drug       distribution   Individual   -35,580 ITNs distributed.           Advocacy visits to         •Syngenta         -Data collection   No    operational
                                                  through    Pry        &   purchase     Retreatment          Programme      the          Principal     /Juhel            from       DSN     Research carried
                                                  Secondary HFs                          carried out in HF, LGA and          Secretary to the           Pharm./Neimith    officers   using   out
                                                                                         household levels                    Governor .                 Pharm./PSN,       checklist.
                                                                                         -Seminars for Professionals         Celebration of AMD         Anambra
                                                                                         (Env. Health officers)                                         chapter, MMA
                                                                                                                                                        Anambra
                                                                                                                                                        Chapter,

                                                                                                                                                        women

                                                                                                                                                        organization in
                                                                                                                                                        the church

                                                                                                                                                        Catholic/Anglic
                                                                                                                                                        an. Sickle cell
                                                                                                                                                        club, Ghains
                                                                                                                                                        project/Gates
                                                                                                                                                        malaria
                                                                                                                                                        partnership.

BAUCHI        4.3m                20              C. Q. (PPD and others).   348 doses    IRS carried out                     Jingles          on        UNICEF, WHO,      Regular            ,,
                                                  2. Fansidar (SP)          of     IPT   23,800 ITNs distributed             mosquitoes/ITNs use        COMPASS,          monitoring     &
                                                  3. Cortecxin              distribute   Environmental          sanitation   -    Drama on ITNs         SFH, MAHEMA,      Evaluation using
                                                                            d
                                                  4. Quinin                              carried out, Clearing of gutters    - Radio and TV             RAHAMA            IMPAC
                                                                                                                             discussion           on                      monitoring and
                                                                                                                             malaria disease and        WOMEN CO-         feedback given
                                                                                                                             its prevention.            OPERATIVE         to the 20 LGAs
                                                                                                                               -     Community          SOCIETY
                                                                                                                                     mobilization.
                                                                                                                               -     AMD
                                                                                                                                     Celebration
                                                                                                                               -     Advocacy
                                                                                                                                     visits        to
                                                                                                                                     district head




           _______________________________________________________________________________________________________________

          NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
BENUE       4.2m                23              Cortecxin distributed to              PROMOTION OF ITNs                  Yet to be done   PATHS (DFID)    Monthly              ,,
                                                tertiary hospitals                    n-       Distribution of 14,560                                     Collection     of
                                                                                      retretable/long lasting                                             Data.
                                                Home Management of                      -    Indoor           Residual                                    Supervision of
                                                uncomplicated malaria                        spraying (IRS) activities                                    LGA activities
                                                encouraged                                   have commenced
                                                                                        -    Monthly Environmental                                        Prevalence     of
                                                                                             sanitation                                                   cases          in
                                                                                        -    Erosion           Control                                    November.
                                                                                             activities
                                                                                        -    Passing of Sanitation                                        2000     severe
                                                                                             Authority Bill                                               malaria cases
                                                                                                                                                          reported     in
                                                                                                                                                          children      <
                                                                                                                                                          5years

                                                                                                                                                          Mortality cases
                                                                                                                                                          highest         in
                                                                                                                                                          <5yerrs.
BORNO       3.3M                                -Doses of cotexin                     -48 000 ITNs distributed           -Celebrate AMD   UNICEF, FMOH,   -Use checklist       ,,
                                                distributed                           -Carry out indoor residual                          LGA             for supervision
                                                -200 Health workers
                                                trained
DELTA       3.8M                25 LGA          -150 Health Workers                   85 000 ITNs distributed                             AFRICARE,                            ,,
                                                trained.                                                                                  FMOH, LGA




         _______________________________________________________________________________________________________________

        NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
CROSs
RIVER
             2.8M                                Chloroquine,
                                                 Amodiaquine.
                                                                             33,762
                                                                             doses
                                                                                           Spraying of Establishments,
                                                                                           Local Governments quarters
                                                                                                                             IEC materials to
                                                                                                                             secondary Schools.
                                                                                                                                                       WHO,               Supervisory
                                                                                                                                                                          activities  with
                                                                                                                                                                                              ,,

                                                 Artecom procured for        distributed   sprayed on a cost recovery                                  UNICEF,            the use of
                                                 distribution to the LGA     .             basis.                            Regular           IEC                        checklists,
                                                 through            direct   Implemen      Workshop on Environmental         materials    to    the    Interpha           Report format.
                                                 purchase.                   ted      as   management                        Media.                    se
                                                 50%        subsidy    for   Directly      Advocacy visits to Nigeria                                                     Poor feedback
                                                 antimalaria                 Observed      Navy, Airforce and Army on        Fliers & posters          Healthca           due to delay
                                                                             Therapy.      Env. Mgt.                         distributed during the                       logistics.
                                                                             Training                                        AMD
                                                                                                                                                       re
                                                                             of Health     Training of PHC Workers                                     Foundatio          Monthly      data
                                                                             workers       Orientation workshop on ITNs      School         Essay                         collection    and
                                                                             Health        and the role of women in          Competition               n                  collation
                                                                             Integratio    Prgramme implementation           Advocacy           to     RBM
                                                                             n Project.    Meeting with the Governor and     churches,     Media,
                                                                             Heads of      policy makers in the State.       Uniformed Forces,         NGO
                                                                             ANC                                             Civil         Society
                                                                             trained on                                      Organizations             Network,
                                                                             IPT                                                                       Africare,
                                                                             100%                                            Radio Talks & TV
                                                                             subsidy                                         programmes                SFH,
                                                                                                                                                       EHCAP
EBONYI       2.1M                                -Distributed Cotecxin       -20,760       -Distributed 13,600 ITNs           -      TV                CEPHADS, APF,      Liase with DSN      ,,
                                                 free to H/Fs on new         doses of      -Collaborate with Ebonyi State            programme         SMLAS, FMOH,       officers for Data
                                                 concept                     SP drugs      Env.      Protection    Agency            on IRS            LGA                collection
                                                 -Train H?Ws on new          distributed   (EBSEPA) to maintain clean          -     Advocacy
                                                 concept of interventions    to H/F        environment.                              Visit to LGA
                                                                                                                                     Chairman
                                                                                                                               -     Celebration of
                                                                                                                                     AMD
EDO          3.2M                                - Training     on   new                   -18,600 ITNs distributed to H/F   -Community                Africare (Heath    Monthly   data      ,,
                                                 concept                                   at LGAs                           Mobilization              integrated         gathering
                                                                                           -30 Houses 10/ward fumigated      -Hold           regular   project)           through   DSN
                                                                                           -Monthly Env. Sanitation          meetings with Health                 -       officers
                                                                                           -Larviciding of dump sites,       educators at LGA          HSDP
                                                                                           burrow pit.                       level                                -
                                                                                           Petroleum oiling of pits and      -Advocacy visit to        RHS
                                                                                           draininges                        Traditional Rulers,                  -
                                                                                           -Clearing of Drainages            Opinion       Leaders,    Frequency     of
                                                                                                                             Members of the            meetings:
                                                                                                                             House of Assembly         quarterly
                                                                                                                             and               Hon.               -
                                                                                                                             Commissioner         of   Donors:- WHO
                                                                                                                             Health                    Training
                                                                                                                                                                  -
                                                                                                                                                       HSDP Training

          _______________________________________________________________________________________________________________

         NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
EKITI       2.2M                                Drug         distribution   230,842       Retreatment         Programme                                           Celebration   of   ,,
                                                through Health Facility     doses of      carried out in Ekiti West LGA                                           AMD.
                                                                            SP            IN April
                                                                            distributed




ENUGU       3.7M                17              Drug distribution thru’     175,000                                       Health Educ. Of          FMOH, WHO,                        ,,
                                                Pry & Sec HFs               SP                                            RBM in Churches,         UNICEF, WHO,
                                                                            distributed                                   Schls,     Age-grade,    PIA
                                                                            thru’ HFs.                                    Mrkts,communities
                                                                                                                          Suicide road show
                                                                                                                          campaigns & jingles
                                                                                                                          on roads, mrks
                                                                                                                          square.
                                                                                                                          Radio Media Link
                                                                                                                          Phoning prog. Radio
                                                                                                                          & TV messages &
                                                                                                                          advertisement      on
                                                                                                                          use of ITNs, IPT,
                                                                                                                          IMPAC & other RBM
                                                                                                                          intervention,
                                                                                                                          Inclusion of ITNs in
                                                                                                                          bride price.
                                                                                                                          Use of poster, fliers,
                                                                                                                          bill board & town
                                                                                                                          crier      in     the
                                                                                                                          dissemination       of
                                                                                                                          RBM messages &
                                                                                                                          educ.
                                                                                                                          Celebration of AMD.
                                                                                                                          17 day Advocacy
                                                                                                                          visits to        Chief
                                                                                                                          Executives of the
                                                                                                                          state & LGAs & Hon.
                                                                                                                          Members of House
                                                                                                                          of           Assemble
                                                                                                                          Chairmen,        HOD
                                                                                                                          (Health),




         _______________________________________________________________________________________________________________

        NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
FCT          1.5M                61              Quinine distributed thru’   IPT yet to    56,230 ITNs, 3000 LLITN            -celebration of AMD      FMOH,               Tracking of ITN      ,,
                                                 drug Revolving Scheme       commenc       supplied by RBM Partnership,       -Advocacy            /   COMPASS,            use supervisory
                                                 in most sec HF.             e in FCT.     SFH,       COMPASS,        total   Sensitization to Area    UNICEF              visits to Area
                                                 -cotexin supplied to HF     -SP           distributed is 58,230;retreated    councils and policy                          councils.    To
                                                 from stock supplied by      distributed   =41,360                            makers                                       check
                                                 FMOH                        thru’ HF      Space spraying in partnership                                                   programme
                                                                             Quantity?     with      FCTA      Agriculture                                                 implementation.
                                                                             -Abaji        Secretariat
                                                                             Area
                                                                             Council
                                                                             offers free
                                                                             treatment
                                                                             to
                                                                             pregnant
                                                                             women
                                                                             using
                                                                             what?
IMO          3.7                                 -Distributed     1,076      Distribute    -34,175 nets distributed so far                             Nigeria Christian   M&E      Officers    ,,
                                                 doses of PPD & 7200         d 29,680      -Carry out IRS in selected                                  Hospital, Aba,      work with DSN
                                                 doses of cotecxin           doses of      schools, quarters, hospitals &                              Antimalaria &       officers collects
                                                 tablets                     SP            Secretariat                                                 AIDs Club           data on monthly
                                                 -Traning of H/Ws                          -Monthly     Env.     Sanitation                                                basis.
                                                                                           exercise
JIGAWA       4.5M                27              - Training done on new      25,470        -19,434 ITNs distributed                                    PATHS, WHO,         M&E       officers   ,,
                                                 concept of Malaria          doses of      -Practice IRS with equipments                               UNICEF, FMOH,       work with DSN
                                                                             SP            -Carry out House to House                                   LGA                 officers for data
                                                                             distributed   inspection                                                                      collation       on
                                                                                           -Involve Professionals in Env.                                                  monthly basis.
                                                                                           manipulations

KADUNA       5.6M                23              -Training   on     new                    -81,040 ITNs distributed                                    UNICE{F,            M&E       officers   ,,
                                                 concept of malaria                        -Carry out IRS                                              WHO,                work with DSN
                                                                                            in 9 General Hospitals                                                         officers for data
                                                                                                                                                                           collation       on
                                                                                                                                                                           monthly basis.
KANO         8.3M                                -Training   of Health       37,070        -54,000 ITNs distributed                                    Compass,PATH        M&E       officers   ,,
                                                 Workers      on  new        doses of      -Carry out IRS                                              S,UNICEF,WHO        work with DSN
                                                 concept                     SP            -Monthly Env. Sanitation and                                ,Society     For    officers for data
                                                                             distributed   proper waste disposal                                       Family Health       collation       on
                                                                                                                                                                           monthly basis.
                                                                                                                                                                           Using checklist




          _______________________________________________________________________________________________________________

         NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
KEBBI       3.2M                                -Train 270 H/Ws           -Distribute   -28,200 ITNs distributed           TV       &      Radio   HSDP11,         M&E       officers   ,,
                                                                          d       SP,   -Monthly    Env.      Sanitation   discussion        on    UNICEF, WHO,    work with DSN
                                                                          doses not     carried out                        malaria prevention &    FMOH, LGA       officers for data
                                                                          known                                            Home Mgt.                               collation       on
                                                                                                                           AMD Celebration                         monthly basis.
                                                                                                                           Advocacy visit to
                                                                                                                           Chairman       House
                                                                                                                           Committee on Health
                                                                                                                           & 7 LGAs Chairmen
KOGI        300,7415                             -    Sp & Cq still in    10    000     -28000 ITNs distributed            -Celebrate AMD          FMOH,    LGA,                        ,,
                                                      use                 doses of      -Waste treatment                   -Advocacy visit         FAITH   BASE
                                                  -   700        Health   Supplied                                         -Television &Radio      ORG
                                                      workers trained                                                      discussion
KWARA       2.3M                16              -Use ACTs distributed     -    Uses     -56,800 ITNs distributed                                   HSDP,UNICEF,    M&E       officers   ,,
                                                through the Essential     IPT but       -Monthly    Env.      Sanitation                           FMOH            work with DSN
                                                Drug project              doses not     carried out                                                                officers for data
                                                -250 H/Ws Trained         stated                                                                                   collation       on
                                                                                                                                                                   monthly basis.




         _______________________________________________________________________________________________________________

        NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
LAGOS       15M                 20 LGAs         Chloroquine, SP, in         101, 129       23, 600 ITNS distributed by the                                                 Checklist      for   The State needs
                                                Combination therapy.        doses of       RBM Unit..                                                   Preparatory        Storage              rapid scaling up in
                                                Artesunate                  Sp                                                                          Plan with the      facilities.          the areas of
                                                /Amodiaquine                distributed    6,100 LLINs distributed by                                   WHO Malaria                             Monitoring     and
                                                Amodiaquine /SP             to all HF      COMPASS/SFH                                                  focal Person in    Monthly       data   Evaluation to be
                                                100% Subsidy                in       the                                                                the State for      returns.             able to capture the
                                                Drugs procured by           State.         11,511 sold      by   LESMAC(                                MIP research.                           RBM activities at
                                                State Pharmacy dept         IPT is by      CSOs)                                                                           Reporting format     the state and LGA
                                                and distributed to HF       health                                                                      Protocol   being   redesigned.          level.
                                                using a requisition         facility       50,000 by Netmark through                                    drafted.           Assisted      by
                                                system.                     based          discount vouching                                                               COMPASS M &
                                                                            DOT            985 re-treatable kits sold                                                      E Specialist
                                                                            100%           100% subsidy by State, 80%
                                                                            subsidy        by SFH and 50% by LESMAC                                                        Gross     under
                                                                                           CPHs                                                                            reporting

                                                                                           Monthly          Environmental                                                  Lack of skills
                                                                                           Sanitation                                                                      and knowledge
                                                                                                                                                                           in       data
                                                                                           Collaborative activities with the                                               management
                                                                                           Ministry of Environment
                                                                                                                                                                           Received and
                                                                                                                                                                           distribute     20
                                                                                                                                                                           motorbikes to
                                                                                                                                                                           LGA         RBM
                                                                                                                                                                           Officers for data
                                                                                                                                                                           collection

                                                                                                                                                                           RBM       Office
                                                                                                                                                                           strengthened
                                                                                                                                                                           with Computer
                                                                                                                                                                           System

                                                                                                                                                                           Need
                                                                                                                                                                           assessment of
                                                                                                                                                                           the          PHC
                                                                                                                                                                           system.
NIGER       3.7M                25              -Training carried out for   IPT            -257,075 ITNs distributed           -        1        day-   UNICEF, FMOH,      M&E       officers   ,,
                                                H/Ws, CBO & NGO             carried        --Carried out IRS in selected       Advocacy/sensitizati     LGA,               work with DSN
                                                -150 Caregivers on new      out     but    areas                               on for 20 LGA            SYNGENTA           officers for data
                                                concept                     doses not                                          Chairmen in oct.                            collation       on
                                                                            stated                                             -Television     drama                       monthly basis.
                                                                                                                               “Kara o le” anchored
                                                                                                                               by HCH.
OGUN        3.3M                                                                                                               Advocacy and social                                              ,,
                                                                                                                               mob. To 16 LGAs
                                                                                                                               -celebration of AMD


         _______________________________________________________________________________________________________________

        NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
ONDO          3.4M                                -Sp and Al in use            25     000    28 500 ITN distributed            -Celebrated AMD          UNICEF                                ,,
                                                  -25 health workers           IPT                                             -Advocacy        visit   _FMOH
                                                  trained                      supplied                                        carried out
                                                                                                                               -Essay competition
                                                                                                                               -TV and Radio
                                                                                                                               discussion
OSUN          3.2M                                -250 H/W Trained             -carry out    -10,000 ITNs distributed                                   FMOH, LGA        M&E       officers   ,,
                                                  -Uses ACTs                   IPT,          -Channel canals constructed                                                 work with DSN
                                                                               doses not                                                                                 officers for data
                                                                               stated                                                                                    collation       on
                                                                                                                                                                         monthly basis.
OYO           5.1M                                -Cq & Sp still in use        IPT in use    -3 935 ITN distributed            -Celebration of AMD      UNICEF, FMOH,    Proper       M&E     ,,
                                                  -330    000         health   but     no    -Monthly          environmental   -Advocacy        visit   LGA              carried out with
                                                  personnel                    doses         sanitation                        carried out.                              use of checklist
                                                                               stated                                          -IEC         material
                                                                                                                               distributed
PLATEAU       3.5M                17              -Training    of   Health     37,170        -70, 000 ITNs distributed                                  UNICEF, WHO,     M&E       officers   ,,
                                                  Workers                      doses of                                                                 SHDP,       EU   work with DSN
                                                                               SP                                                                       Prime, FMOH,     officers for data
                                                                                                                                                        LGA, UNFPA,      collation       on
                                                                                                                                                        CEDAR, Carter    monthly basis.
                                                                                                                                                        Foundation,
                                                                                                                                                        Rotary Club
RIVERS        4.7M                23              -Training of      Health     259,622       -19,420 ITNs distributed                                   NDAY,            M&E       officers   ,,
                                                  workers                      doses of      -Monthly          Environmental                            GOLBTECH,        work with DSN
                                                  -use of ACTs                 IPT           sanitation carried out                                     HEALTH NET,      officers for data
                                                                               distributed                                                              AFRICARE,        collation       on
                                                                                                                                                        WOMEN ORG        monthly basis.
SOKOTO        3.4M                                -Training carried out        No            ITNs distributed (quantity not                             UNICEF, HSDP,    M&E       officers   ,,
                                                                               informatio    stated)                                                    FMOH, LGA        work with DSN
                                                                               n on IPT                                                                                  officers for data
                                                                                                                                                                         collation       on
                                                                                                                                                                         monthly basis.




           _______________________________________________________________________________________________________________

          NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005
TARABA       2.3M                16              -170 Health Workers       26,704       -13,300 ITNs distributed         Awareness creation                        M&E       officers   ,,
                                                 Trained                   doses of     -Monthly Env. Sanitation         on clean                                  work with DSN
                                                 -       Still Uses        IPT                                           Environment.                              officers for data
                                                 monotherapies                                                                 -    Meeting                        collation       on
                                                                                                                                    with                           monthly basis.
                                                                                                                                    religious
                                                                                                                                    and
                                                                                                                                    traditional
                                                                                                                                    leaders.
                                                                                                                               -    -celebrati
                                                                                                                                    on        of
                                                                                                                                    AMD
                                                                                                                               -    Mobilizati
                                                                                                                                    on
                                                                                                                                    campaign
                                                                                                                                    s to 9
                                                                                                                                    LGAs
YOBE         2.3M                13              -Distributed guidelines   -234,000     -Spraying of gutters, 7          -Radio jingles, Press     Harvestfeild,   Checklist    for     ,,
                                                 for case management       doses of     Boarding schools, 3 major town   conference,         TV                    regular
                                                 of malaria                Distribute   prisons and 9 Government         programme,                                collection     of
                                                                           d to 17      quarters                         Celebration of AMD                        data on all
                                                                           LGAs         -Committee of sanitation                                                   malaria cases.
                                                                                        -Clearing of gutters




          _______________________________________________________________________________________________________________

         NATIONAL MALARIA CONTROL PROGRAMME/FMOH/2005 ANNUAL REPORT/CREATED JAN. 2005

								
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