Transcript Kenya Action Plan Gichangi,M.,Baraza,E., Courtright,P. TRACHOMA

A Kenya free of Blinding
Trachoma
Kenya TRACHOMA Action Plan
Achievements of the implementations 2011-2012,a case study
Gichangi,M.,Baraza,E., Courtright,P.
Before 2004:Trachoma Suspected in 18 Districts :
First Trachoma Baseline Survey of 6 districts: June 2004,integrated into Eye
care plan 2005/2010
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Kenya National Plan for Elimination of Trachoma : 2008-2015
Plan towards elimination 2015
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Situation of Trachoma in Kenya :2010
Prevalence of active trachoma (TF)
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Prevalence of Trichiasis (TT)
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Genesis of the Trachoma Action Plan (TAP) template:
2010 GET 2020 meeting…. 14th Global Alliance
Excerpt of preliminary minutes from April 2010 GET2020 meeting
…. to help countries focus on the 2020
elimination goal
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Trachoma action plan template Pilot:
Kenya; March 2011
Objectives for the TAP pilot
Using Kenya as an Example:
▪
To develop a concise high-level strategic document(tool) to complement
KNPET(2008-2015).
1. Create comprehensive set of information and view of the current
state of trachoma in Kenya (Survey data, Suspected endemic
districts, Resource needs, Opportunities, Lessons learnt)
2. Visualize the path to elimination
3. Join the two to show how we get to elimination (road map)
Then(Ultimately)
▪
Refine and improve the TAP template for eventual rollout to all endemic
countries
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Trachoma action plan template Pilot:
Kenya; March 2011
Government involvement /Consent and Leadership
Developed with involvement of all key stakeholders
NGDOs,
Field Implementers( from districts),
Local technical advisors(UoN).
Technical Support from ITI.
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The process resulting in two highly useful documents that
we are using a variety of settings
Trachoma Action Plan
▪
▪
12 pages, 8 exhibits
Sections
o Introduction
o Current state of
trachoma in Kenya
o Path to Elimination
o Case for Action
TAP Executive Summary
o One-pager
o Advocacy tool at high
level of policy and
development
Challenge
Solution
Case for action
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Overall objectives for the TAP:
Delineate the
path to 2020
Develop
messages to
drive advocacy
Drive
stakeholder
alignment
▪ Use Evidence to clearly highlight the gap between
current efforts and those necessary to achieve
2020 elimination…survey data, clear milestones
▪ Clearly articulate the actions and resources
needed to achieve 2020 elimination ,rationalized
by economic loss to disability/return on
investments, MDGs and country development
agenda e.g. Vision 2030 for Kenya
▪ Bring together all interested parties in a
collaborative planning process
▪ Guide country leadership in a critical evaluation of
existing partner support and stakeholder activities
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REVIEW AFTER ONE YEAR OF IMPLEMENTATION
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A partner support mapping reviewed some gaps in
support for SAFE implementation against these districts
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Working Draft - Last Modified
Printed
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A partner support mapping reviewed some gaps in
support for SAFE implementation against these districts
TVM-AAA123-20110309-
Working Draft - Last Modified
Printed
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A partner support mapping reviewed some gaps in
support for SAFE implementation against these districts
TVM-AAA123-20110309-
Working Draft - Last Modified
Printed
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The district level calendar aligned our stakeholders on how
to get to elimination, district by district…
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Note: IA= Impact Assessment, the A part of SAFE defined as Mass administration of antibiotic
1 Anticipate <10% prevalence, but prepare for 3Q11 MDA in case
2 Need to decide whether to survey following IA
3 Part of Baringo, unclear whether existing survey data is sufficient to support full SAFE rollout
4 Beginning SAFE in 2011
5 Need to show funding for logistics to get antibiotics
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… and helped prioritize our approach for suspected but
unsurveyed Districts
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Working Draft - Last Modified
Printed
Note: IA= Impact Assessment, the A part of SAFE defined as Mass administration of antibiotic
1 Likely only 50% of Mwingi, Koibatek, Makueni, Trans-Mara, Kitui, and Mbeere
McKinsey & Company | 5
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We also developed a set of short-term milestones for the
next two years
All Districts
2,216
6 Districts
Not all
Trachoma Summit
2011
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Baseline Trachoma Survey Data
Impact Evaluation Survey Data
District
Kajiado(3)
Narok(2)
Samburu(3)
West Pokot(3)
Turkana(3)
East Pokot(1)
Trans Mara(1)
Marsabit(3)
Laikipia(3)
Isiolo(2)
Meru North(2)
Baringo(3)
Moyale(1)
Kyuso(2)
Kitui(8)
Mwingi(3)
Mbeere(2)
Mutomo(2)
Koibateck
Makueni
TF
17.4
11.0
7.4
TF(%)
TT()
28.1
3.3
30.5
2.3
35.0
6.0
26.6
5.6
42.3
3.56
34.3
7.6
10.6
0.9
14.1
0.68
9.5
1.1
8.9
0.6
8.1
1.0
6.4
5.8
4.6
1.84
4.8
0.8
0.8
1.4
0.5
0.1
0.1
0.4
0.0
0.4
TRA DONE, No Trachoma
TT
3.5
0.9
3.4
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MDA in Kenya
DISTRICT
BASELINE
PREVALENCE (%)
MDA COVERAGE
PREVALENCE
AFTER
INTERVENTION (%)
TF
TT
Round 1 Round 2 Round 3 TF
TT
GREATER NAROK
30.5
2.3
83%
74%
63%
11.0
0.9
KAJIADO
28.6
3.3
91%
75%
83%
17.4
3.5
SAMBURU
35.0
6
82%
83%
7.4
3.1
WEST POKOT
26.1
5.6
68%
-
-
-
-
EAST POKOT
34.3
19
61%
-
-
-
-
TURKANA
42.3
8.7
71%
-
-
-
-
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FACIAL CLEANLINESS AND ENVIROMENTAL IMPROVEMENT
F and E(in all districts)
The results of F and E interventions though not stated are complex
and are best done at impact assessment(not done in 2011/12).
Some interventions currently going on include:
1.Water provision- bore holes-Water and Irrigation Ministry
2.CLTS-Community Led Total Sanitation-Community Health
Impact assessments:-Narok(2010)
1. Reduction in TF prevalence from 30.5% to 11%
2.Increase in clean faces from 46% to 57%
These are outcomes of AFE
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Situation of Trachoma in Kenya 2012
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CONCLUSION
The Kenya Trachoma action Plan (Template)
achieved the objectives of :
 Providing a clear road map , with clear milestones
towards elimination, based on information
Advocating especially to development partners on the
benefits of elimination of Trachoma, resulting to
significant support, and improvement in Trachoma
situation in Kenya.
Aligning the Trachoma Stakeholders with the needs
Providing the Country leadership with a tool to monitor
the elimination process.
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PROPOSAL
The Pilot Tested TAP Template should be
refined (include F and E components) for
use in other countries to realise the 2020
Elimination Target.........Its real
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KENYA TRACHOMA ACTION
PLAN
A Kenya free of Blinding
Trachoma
THANK YOU