Tropical Health Matters

Because Akwa Ibom State is one of the seven States involved in the World Bank Malaria Booster Program in Nigeria, the Bank became aware of Jhpiego’s ExxonMobil Foundation supported work in Community Directed Interventions (CDI) to improve coverage of malaria services in seven local government areas in the State.

CDI was pioneered by the African Program for Onchocerciasis Control with Ivermectin and in the past 15 years has reached over 100,000 villages in Africa. CDI places responsibility for distribution of basic health commodities in the hands of community members who made decisions on distribution mechanism and timing and selection of volunteer community directed distributors (CDDs). The value of CDI beyond onchocerciasis control was proven through a 3-year, 7-country study sponsored by the Tropical Disease Research Program of UNDP/World Bank/UNICEF/WHO.

The World Bank included CDI as a key strategy for the additional funding provided to its seven Nigerian states.  To enable these states to deliver malaria services through CDI, the Bank encouraged the National Malaria Control Program (NMCP), one of the managers of the Booster Funds, to contract Jhpiego to provide CDI training for teams from the seven Booster states.

Two 5-day CDI took place between 22 November and 3 December 2010.  Participants included staff from each States’ Malaria Control Programs and Ministries of Health along with representatives of NGOs and consultants contracted by the states to help them implement CDI.  The Workshop was delivered in 11 main sessions as follows:

1. Overview and Objectives for Workshop on Implementing Community Directed Interventions
2. The Value of Community Involvement
3. Community Structure Networks & Organization
4. The CDI Process; Roles of Partners & Focal Persons
5. Applying CDI to Home Management of Malaria; Sample CDD Lesson on CCM/HMM
6. Applying CDI to LLINs and Vector Management
7. Applying CDI to Controlling Malaria in Pregnancy
8. Record Keeping and Reporting (M&E)
9. Supply Chain Management for CDI
10. Applying CDI to Deliver Malaria Plus Packages
11. Follow-up Activity Planning

Trainers included Bill Brieger, Jhpiego Senior Malaria Specialist; Dipo Otolorin, Jhpiego Nigeria Country Director; Bright Orji, Jhpiego Program Officer for Akwa Ibom State; Gbenga Ishola, Jhpiego M&E Officer, Nigeria; Oyedunni Arologun, Department of Health Promotion and Education, University of Ibadan; and Godwin Ntadom, National Malaria Control Program.

A total of 42 participants attended from Akwa Ibom, Anambra, Bauchi, Gombe, Jigawa, Kano, and Rivers states and 8 from the NMCP. They took part in role plays, crafting educational songs, producing sample CDD lessons and developing follow-up action plans. The NMCP will now follow-up with these states to ensure that CDI training is rolled out to the local governments, the primary health care facilities (PHCs) and ultimately the small villages, settlements, clans and hamlets in the catchment areas of PHCs. In this way prompt and appropriate malaria treatment can reach people within 24 hours and all recipients of recently distributed insecticide treated nets will hang and use them to prevent the disease.

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