Bringing Health to Idjwi: Partnership to Reduce NTDs

Photo Credit: Mo Scarpelli / The End Fund & Amani Global Works

Commitment to Action

Bringing Health to Idjwi: Partnership to Reduce NTDs

Commitment by

Amani Global Works

In 2015, Amani Global Works committed to decrease the prevalence of three Neglected-Tropical Diseases (NTDs), intestinal worms, schistosomiasis, and lymphatic filariasis, through the treatment of at-risk communities on the island of Idjwi, located in the Democratic Republic of Congo. The program adopts a comprehensive approach, including Mass Drug Administration, a school WASH program, and a bed net distribution program. With the help of 500 recruited and trained community health workers, this program will be implemented to treat virtually all 250,000 inhabitants of Idjwi across three years. Simultaneously, Amani Global Works will educate the community and health providers on NTD treatment and prevention.

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Overview

Summary

Commitment

Bringing Health to Idjwi: Partnership to Reduce NTDs

Launched

2015

Est. Duration

3 years

Estimated Total Value

$939,983

Region

Africa

Countries

Democratic Republic of the Congo

Commitment by

Amani Global Works

Partner(s) of the Commitment Maker(s)

The End Fund, Vitol Foundation, The Walker Family Foundation, Segal Family Foundation, The Greenbaum Foundation

Details

Amani Global Works commits to decrease prevalence of soil-transmitted helminths (STH) or intestinal worms, schistosomiasis, and lymphatic filariasis (LF) through treatment of up to 100% of at-risk communities on the island of Idjwi, and educate the community and health providers on NTD treatment and prevention. The program adopts a comprehensive approach to address these NTDs through a Mass Drug Administration (MDA), a school WASH program, a bednet distribution program, and additional capacity building activities.

Community-directed MDA: This intervention will be designed and implemented to treat virtually the entire population for the three diseases prevalent on Idjwi. It will build on the community health worker (CHW) network that has been established within the North Idjwi administrative region and be expanded to cover South Idjwi as well. In total, 200 community health workers from the northern parts of Idjwi will be trained, and 300 new CHWs from the southern parts will be recruited and trained. CHWs will conduct two MDA campaigns for STH, schistosomiasis and LF every year, along with follow ups for the next three years. This network will work in teams of three to reach every household and administer the drugs using a Direct Observation of Treatment (DOT) approach. To support these campaigns, Amani will create posters, booklets and radio spots to promote for awareness and mobilization.

School WASH: Commencing in year two of the initiative, a school WASH project will be progressively rolled out to all 187 schools on the island. This project will be focused on educating students about disease transmission and is essential to preventing and controlling NTDs. These initiatives include promoting face and hand washing, the use of soap, and ensuring there are well-maintained latrines and clean water sources near the community. For this program, 81 officials (two kings, six catchment chiefs, 72 village chiefs at the territory administrator) and one representative from each of the 187 schools will be trained on NTD and WASH programs.
Sleep Safe: There is scientific evidence that the transmission of LF can be interrupted by the systematic use of bed nets. Therefore, in program year two, a behavior change campaign and bednet distribution program, led by Against Malaria Foundation, will be undertaken across all the islands villages.

Health Capacity Building: A NTD task force for Idjwi will be formed and will be responsible for the development of an annual plan, the establishment of the process for drug procurement and the request of the necessary drugs to the ministry of health. An NTD coordinator, a monitoring and evaluation director, and a fund-raising director will be hired. In addition, 106 Clinicians and 22 Laboratory technicians will also be trained on clinical and laboratory diagnosis of the three common neglected tropical diseases in Idjwi.

Amani Global Works will implement the program with technical assistance and program management support from The End Fund.

Q4 2015
-Conduct an assessment trip to Idjwi
-Conduct school mapping in Idjwi
-Conduct NTD mapping to identify sentinel sites
-Recruit 12 people for the NTD Task Force

Q1 2016
-Train Community Drug Distributors
-Train clinicians on Schistosomiasis, STH and LF
-Hold first NTD Task Force Meeting and develop the annual plan
-Hire the NTD coordinator
-Begin distributing bednets

Q2 2016
-Conduct supervision of a third of the 72 villages to ensure that villages have been treated

Q3 2016
-Hold NTD Task Force meeting
-Conduct refresher training of community drug distributors
-Conduct MDA
-Train teachers on preferred School WASH practices
-Distribute Hand Washing Kits to schools

Q4 2016
-Conduct supervision 10 schools to ensure good WASH practices
-Hold NTD Task Force meeting

Q1 2017
-Conduct supervision of sentinel sites
-Hold NTD Task Force meeting
-Conduct refresher training of community drug distributors
-Conduct MDA
-Conduct supervision 48 villages during the MDA campaign
-Conduct refresher training for teachers on preferred School WASH practices
-Conduct supervision of 40 schools for WASH practices

Q3 2017
-Conduct refresher training of community drug distributors
-Conduct MDA

Q1 2018
-Refresher training of community drug distributors
-Conduct MDA

Background

The Democratic Republic of Congo (DRC) is a priority country in global efforts to control and eliminate Neglected Tropical Diseases (NTDs). It is recognized by the World Health Organization (WHO) as one of the countries with the highest NTD disease burden in Sub-Saharan Africa. As part of the efforts to address this issue, the Ministry of Health collaborated with CNTD Liverpool in 2014 to conduct a mapping exercise of the two DRC provinces: North and South Kivu. The mapping showed a 39.3% prevalence lymphatic filariasis (LF) and a 6% prevalence of schistosomiasis. NTDs occur in areas with limited access to water and sanitation, and where hygiene practices and health infrastructure are limited.

Within South Kivu is the island of Idjwi, which has approximately 250,000 inhabitants and is isolated without access to appropriate health care. Findings from mapping conducted by the End Fund in 2013 indicated that 90% of school-age children are infected with STH, and there is a 6% of prevalence of schistosomiasis and a 13% prevalence of LF.

Amani Global Works has been working on Idjwi island for five years, where it has set up a hospital and trained 200 CHWs who provide a continuum of care for patients outside of the hospitals walls. Amani works to reduce discrimination against pygmies by providing equal access to all health programs. Idjwi has never had a comprehensive NTD program.

Partnership Opportunities

Amani Global Works and its partner END Fund are planning to scale the WASH component of the NTD program to more communities. Amani and END Fund are currently implementing WASH activities in schools throughout Idjwi, engaging the broader community through education and access to clean water.

Amani Global Works and End Fund are also interested in partners with media expertise to highlight this program, the first of its kind in Idjwi Island.

Amani is an implementing partner on Idjwi Island and would be happy to share best practices from this commitment.

Progress Reports

May 2016

The successful implementation of the first of its kind program on neglected tropical diseases (NTD) in the region focused on the following priority interventions during the first year of the commitment.

At the outset of implementation, Amani Global Works (AGW) developed a "Task Force", led jointly by AGW, the Minister of Health, and a technical steering committee. The task force was composed of 18 people representing Idjwi, the South-Kivu province, as well as local World Health Organization (WHO) and UNICEF delegations.

In order to develop and employ evidence based programming, AGW mapped two of three prevalent NTDs in Idjwi, Soil-Transmitted Helminths (STH) or intestinal worms, and Schistosomiasis. AGW tested 480 pupils from 30 schools in Idjwi, 15 in the north and 15 in the south. Results of the mapping exercise showed a prevalence of more than 80% of STH and 9% of Schistosomiasis, compared to 90% STH and 6% schistosomiasis found in a 2014 mapping of four schools located in south Idjwi.

Subsequently, AGW trained 23 laboratory technicians, 23 head nurses and 13 physicians operating in Idjwi on the diagnosis and management of NTDs and related health issues. Additionally, AGW trained all the village chiefs, catchment chiefs, the two kings, and the territory administrator in Idjwi on NTDs and the importance of their involvement to control and eliminate NTDs. AGW also trained 500 community health workers (200 in north Idjwi and 300 in south Idjwi) and their 12 supervisors on the management of NTDs, drug distribution, and referral services for people suffering from drug side effects.

Following the mapping exercise and the various trainings, AGW conducted its first mass drug administration (MDA). The MDA reached 231,330 (or 89% of the popuation) people with treatment for STH (intestinal worms), 131,698 (or 51% of the population) people with treatment for lymphatic filariasis, and the remaining will be treated in July during the second mass drug administration which will reach an estimated 80% of the population, concluding the first year of the commitment. During this time, at least 80% of the targeted population will be treated for schistosomiasis (bilharzia).