Kenya TRACHOMA Action Plan

Gichangi,M.,Baraza,E., Courtright,P.

Achievements of the implementations 2011-2012,a case study

A Kenya free of Blinding Trachoma

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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

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Prevalence of Trichiasis (TT)Prevalence of active trachoma (TF)

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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 TAP Executive Summary

▪ 12 pages, 8 exhibits▪ Sectionso Introductiono Current state of

trachoma in Kenyao Path to Eliminationo Case for Action

oOne-pager

oAdvocacy tool at high level of policy and development

Challenge Solution Case for action

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Overall objectives for the TAP:

Drive stakeholder alignment

▪ Bring together all interested parties in a collaborative planning process

▪ Guide country leadership in a critical evaluation of existing partner support and stakeholder activities

▪ Use Evidence to clearly highlight the gap between current efforts and those necessary to achieve 2020 elimination…survey data, clear milestones

Delineate the path to 2020

Develop messages to drive advocacy

▪ 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

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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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A partner support mapping reviewed some gaps in support for SAFE implementation against these districts

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A partner support mapping reviewed some gaps in support for SAFE implementation against these districts

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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 antibiotic1 Anticipate <10% prevalence, but prepare for 3Q11 MDA in case2 Need to decide whether to survey following IA3 Part of Baringo, unclear whether existing survey data is sufficient to support full SAFE rollout4 Beginning SAFE in 20115 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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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

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We also developed a set of short-term milestones for the next two years

All Districts

2,216

6 Districts

Trachoma Summit 2011

Not all

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Baseline Trachoma Survey Data Impact Evaluation Survey Data

District TF(%) TT() TF TTKajiado(3) 28.1 3.3 17.4 3.5Narok(2) 30.5 2.3 11.0 0.9Samburu(3) 35.0 6.0 7.4 3.4West Pokot(3) 26.6 5.6Turkana(3) 42.3 3.56East Pokot(1) 34.3 7.6Trans Mara(1) 10.6 0.9Marsabit(3) 14.1 0.68Laikipia(3) 9.5 1.1Isiolo(2) 8.9 0.6Meru North(2) 8.1 1.0Baringo(3) 6.4 5.8Moyale(1) 4.6 1.84Kyuso(2) 4.8 0.8Kitui(8) 0.8 1.4Mwingi(3) 0.5 0.1Mbeere(2) 0.1 0.4Mutomo(2) 0.0 0.4Koibateck TRA DONE, No TrachomaMakueni

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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 AFE19

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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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THANK YOU

A Kenya free of Blinding Trachoma

KENYA TRACHOMA ACTION PLAN