Uganda Phase Two

National Workshop in April

National Workshop in April On Tuesday and Wednesday April 20th and 21st, Dr Narcis Kabatereine convened the 5th workshop on the National Programme for the Control of Bilharzia and Intestinal Helminths. This workshop was held to consider the successes and difficulties encountered during the pilot phase, and to finalise plans for the launch of the second implementation phase of the control programme. In attendance were the District Director of Health Services (DDHS), the District Vector Control Officer (DVCO), the District Director of Education (DDE), and the District Inspector of Schools (DIS) from each of 20 Districts.

Image: Dr Sam Okweri (left) opened the workshop and the Hon. Fred Omach MP (right) addressed the audience.

The workshop was opened by Dr Sam Okweri, Commissioner in the Ministry of Health, and addressed by Dr Dawson Mbulamberi, Assistant Commissioner for Vector Control. The Honorable Fred Omach, MP for Jonam County in Nebbi District addressed the audience and urged the District Health Officers not to delay this important treatment programme.

Pilot phase evaluation and lessons learned

The processes of sensitization, training, health education, drug delivery, recording and reporting of data were evaluated in detail, district by district by Dr Ambrose Onapa and Dr Richard Ndyomugyenyi. They considered that the pilot phase was a success in all districts with coverage of the target population in the range 60% - 90%, and in some districts communities and school children coverage was excellent (over 90%). However they reported that in most districts it took several months to reach the target population in the communities. The worst coverage and slowest distribution occurred in districts where sensitization of the local senior political and civic leaders had been less than satisfactory. These individuals, if not convinced of the value of the programme, could and did slow down implementation by delaying distribution of funds.

A second point of breakdown was with end user compliance. Some teachers and Community Drug Distributors (CDD) failed to pass on the information on the diseases and the drugs given at their training. If end users (children and their parents and communities) were not properly informed, they feared that there would be serious side effects, and were even suspicious of the free treatment being offered. It was recommended that at all training workshops, teachers and CDD’s be urged to pass n the reasons for the free treatment, and the dangers from infection.

A third point for the programme coordinator to consider was the demand for some level of incentives by teachers and Community Drug Dispensers. It was agreed that meal allowance during training and tee shirts would be all that would be required.

Selection of 2004 target populations

Each district leader proposed the next sub-county for treatment, and presented his budget for approval. It was agreed that all residents within 5 km of the Lakes would be treated. However in villages situated more that 5 km from the Lake, prevalence levels in schools would be checked prior to presumptive treatment to determine that prevalence merited mass treatment.

Drug distribution

At the end of the meeting 1.5 million tablets of praziquantel and 0.5 million albendazole tablets were distributed to the twenty districts so that the second implementation round could start. District officials were also provided with new registers and manuals for training. The target for 2004 is to treat 1.5 million people, with 1 million new people being reached across the 20 districts, and a re-treatment for the 0.5 million already treated once in 2003. The aim is to deliver the treatment within 2 months of this workshop.