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Kabatereine Narcis. AFRICAN SCI CAPACITY BUILDING ADVISOR BASED IN UGANDA. NEED FOR IMPROVING IN-COUNTRY CAPACITY FOR BETTER DELIVERY. Some of my roles. As SCI Capacity building advisor and as a member of WHO/Geneva WG for Capacity building, I participate in:

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Kabatereine narcis

Kabatereine Narcis

AFRICAN SCI CAPACITY BUILDING ADVISOR BASED IN UGANDA

NEED FOR IMPROVING IN-COUNTRY CAPACITY FOR BETTER DELIVERY.


Some of my roles

Some of my roles

As SCI Capacity building advisor and as a member of WHO/Geneva WG for Capacity building, I participate in:

Identifying existing efforts and gaps in CS and Prioritize needs in order to accelerate rate of scale –up of country programmes,

I participate in training consultants who train country staff’,

I train country staff as SCI Capacity building Advisor or on behalf of WHO.

Examples of existing CS courses include:

NTD Programme Managers Course

M&E course

Working on district managers training course

As a Member of WHO/RPRG, reviewing progress of country NTD Programmes and advise on way forward.


Kabatereine narcis

WHY IN-COUNTRY CAPACITY BUILDING?

According to WHO targets: By June 2015, Mapping of PC-NTDs should be completed in all countries.Elimination should be achieved by 2020


According to existing data on global preventive chemotherapy
According to existing data on global preventive chemotherapy,

Approximately additional 350 million people per year must be reached by 2015

  • Requiring global rate of 8 to 10 million new treatments per month

  • This is not being reached at

  • The current treatment rate.

Current and projected proportion of people (2008-2020) receiving PC for at least one disease among LF, SCH and STH out of the estimated number of people requiring PC (excluding India and Bangladesh)



P c ntd mapping status
PC NTD Mapping Status

Schistosomiasis

Not Started (7)

Partially mapped (15)

Complete mapping (23)

Confirmation mapping (1)

Not Applicable (2)

Not AFRO



Other areas that urgently require capacity building include

Other Areas that urgently require capacity building include CHEMOTHERAPY :

Epidemiological survey skills

Financial management skills

Social science skills

Training of health workers on health centre based disease management


For elimination we need more sensitive diagnostic tools
For Elimination, We need more sensitive diagnostic tools CHEMOTHERAPY

  • Eg. Kato Katz method for S.mansoni diagnosis is not adequately sensitive

  • CCA has been shown to be more sensitive in a multi-country SCORE study.

  • Uganda and Rwanda are currently re reassessing schistosomiasis distribution using CCA

    • and capacity building is needed to scale-up use of CCA for re-evaluation in elimination phase in many other countries.

      .

    • CCA can be used as an RDT to improve facility based schistosomiasis managemen.


Kabatereine narcis

CAPACIITY BUILDING NEEDED FOR MONITORING IN MOST COUNTRIES CHEMOTHERAPY

Coverage monitoring

  • Geographical coverage

  • Epidemiological coverage

  • Programme coverage

Process monitoring

  • Drug procurement and management

  • Monitoring of side-effects

  • Quality of drug distribution

  • Training of teachers and CDDs

  • Health education

  • Political and financial support

  • Advocacy and publicity

  • Inter-sectoral collaboration, e.g. WASH

Impact monitoring

Prevalence and intensity of infection

Micro/macro haematuria stool

Anaemia

Growth

Clinical complications

Educational achievement

Cost-effectiveness


Ultrasound clinical examination of schistosomiasis
ULTRASOUND & Clinical examination of schistosomiasis CHEMOTHERAPY

Ultrasound examination

  • WHO guidelines

  • portable machine Aloka SSD-500


Training in integrated vector management ivm
Training in integrated vector management CHEMOTHERAPY (IVM)

  • Vector identification

  • Pesticide handling and management

  • Insecticide applications

  • Environmental Impact assessment

  • Insecticide resistance management

  • testing impact of pesticide applications etc..


Timely data retrieval and reporting
Timely data retrieval and reporting CHEMOTHERAPY

  • Timely data retrieval from the field is a problem due to inadequate logistics or demand for incentives by volunteer drug distributors.

  • However, some electronic tools eg smart phones have been tested and they work and such training is important.


Kabatereine narcis

Way Forward considering sustainability CHEMOTHERAPY

There is need to;

  • shift from disease-specific to intervention-specific approaches

  • It is important to synergize control efforts with existing health systems

  • especially with successful in country disease control channels eg, ITN.

  • Strengthen partnership and NTD coordination at National and district levels,

  • Strengthen health facility based disease management.

    Capacity building needed at country level for all these issues.



Kabatereine narcis

Malawi: Over 40 Technicians trained and they have completed CHEMOTHERAPY

Schisto / STH Map.

Mapping done

By the trained

Local Techncians


Kabatereine narcis

Rwanda: 64 technicians recently trained and are CHEMOTHERAPY

re-mapping using both CCA and Kato Katz to produce a map for elimination phase.




Main challenge

Main Challenge coverage

To promote country ownership

even when CS gap exists,

it may not be attended to

until the country feels it as a priority.

Hence CS scale-up rate is slow.


Kabatereine narcis

Thank you … coverage