Guinea Worm Eradication Program (GWEP) Technical Advisor-ETHIOPIA

TERMS OF REFERENCE – TECHNICAL ADVISOR

A. Work with the Guinea worm eradication Program Manager (PM), Senior Technical Advisor (STA) if present, and with The Carter Center Senior Country Representative (SCR) to Ethiopia, as well as with Ministry of Health (MOH), and Gambella State Health authorities to perform, as appropriate, the duties listed below.

1. Obtain geographic coordinates (using GPS units) of the location of the villages/localities reporting cases of GWD during. Report the geographic coordinates to the national EDEP secretariat for preparation of new or update of existing operational maps.

2\. Review the clustering of villages/localities reporting cases of GWD to determine the number of sub-districts defining clusters, following the norms established by these programs for number of villages and non-village areas to be supervised by a volunteer/focal person, and for a Field Officer (FO).

3\. Work with Senior Project Coordinator (SPC) to determine the number of FOs, Supervisors, and Village Volunteers (a male and a female volunteer, whenever possible) needed to cover each of the defined zones to implement interventions against GWD.

4\. Work in collaboration with the PM, relevant Officers, and SCR to develop training guidelines and schedules to improve the skills of field officers, supervisors and community leaders/village health committees. Train FOs and Supervisors on technical matters and norms of the integrated program, including definitions of Guinea worm rumors, suspects, and cases/infections and Guinea worm endemic villages, the interventions against GWD including health education, behavior change communication , social mobilization, surveillance (including use of case/animal infection registers, and monthly reporting) containment of transmission from cases and infections of GWD, distribution, use and care of cloth and pipe filters, ABATE Larvicide application, interventions related to domesticated animals, on the use of supervisory check lists, and on the use of forecasting line lists for endemic villages to help time the applications of ABATE Larvicide, the distribution of filters, etc.

5\. Where applicable, develop work plans with the FOs, FCs, BCC Officer, Program/Assistant Entomologist(s), and Program/Assistant Veterinarian to improve surveillance, consistent application and monitoring of interventions, community mobilization and behavior change communication/health education on consistent tethering of dogs/cats, and proper care, and regular treatment of unsafe water sources.

6\. Train Supervisors, FOs, and Village Volunteers/Focal Persons on how to establish an effective dialogue with GWD endemic communities to explain what GWD is, how it is transmitted, how it can be prevented, and to let the entire community know what the EDEP will do to empower them to take action to prevent transmission of GWD, while at the same time convincing residents that their active positive participation is needed to stop transmission, i.e., by preventing anyone with an emerging Guinea worm from entering sources of drinking water, and by always filtering all drinking water and caring for the filters provided.

7\. Supervise the training of Focal Persons/Volunteers by FOs to ensure the quality of the training and conveyance of the appropriate messages and techniques to the trainees.

8\. In coordination with the GWEP team develop an annual plan of action and budget for the needs of the endemic area of assignment and develop a plan for the use of resources in consonance with the seasonal needs of the EDEP. Submit and discuss this plan with PM and TCC CR for their recommendations and approval.

9\. Assess the sensitivity of the surveillance system for cases of GWD in endemic villages/localities. Determine whether the village-based surveillance is being conducted daily (active), and whether there are the required personnel and resources to detect 100% of all cases/infections of GWD within 24 hours of Guinea worm emergence. Check that all entries in the village case register are properly recorded. Where the surveillance system is not active and/or not completely sensitive, recommend immediate action steps the EDEP supervisor needs to take to correct flaws in the system, and help implement these.

10\. Ascertain whether there is compliance with the international definition of a case/infection of dracunculiasis and with the standards for containing transmission from each infected person/animal. Determine if a) endemic villages have the necessary resources (village volunteers, filters, medical kits, etc.) to contain every case/infection in the village and non- village areas, and b) transmission from infected persons/animal is indeed fully contained. In endemic villages where cases are not being detected and contained within 24 hours of worm emergence, recommend the implementation immediate action steps to correct these deficiencies, and help implement these.

11\. Assess the frequency and quality of supervisory visits to the village volunteers, including the use of a supervisory checklist and that the volunteers know what they need to do, are doing it, and are satisfied with the working relationship with their supervisor. Take immediate action steps to correct any deficiencies noted about the frequency and or quality of supervisory visits. Provide regular supervision, evaluation and on-the-job training to program assistants, field officers, supervisors and other actors in community-based health care as appropriate.

12\. Evaluate the frequency, quality, and penetration of BCC messages and social mobilization events about GWD and the prevention. Where inadequate, assist FOs, volunteers, and relevant stakeholders to improve the quality of participatory health education activities at the village level. Promote the need for political and community leaders and community members to take action to eradicate GWD.

13\. Become informed via civil authorities, partners, or other stakeholders implementing, monitoring and evaluating public health emergency management (PHEM) surveillance system in their respective locations.

14\. In areas where ABATE® Larvicide is being used: assess the frequency and quality of applications in sources of drinking water used by endemic villages, by checking the records, including the calculation of water volume, and whether ABATE® Larvicide crews are using “forecasting” to time the applications of ABATE®. Inquire as to the rationale for the particular selection of sources of drinking water being targeted for treatment with ABATE® Larvicide. Recommend immediate action steps to correct any deficiencies in the application or the strategy for use of ABATE® Larvicide and help implement these.

15\. Assess whether line-listings of GWD endemic villages (arranged in descending order of cases reported in the previous year and showing the number of cases reported, number of households, number of filters distributed, % coverage of households with filters, number of ponds, number of ponds treated, numbers of functioning boreholes/hand-pumps, etc.) are being used to monitor the status of interventions and as an advocacy tool for providing safe sources of water to these villages. If not, help supervisors prepare such listings and educate them about the advantages of using these to monitor interventions and of updating such line-listings monthly and posting them at the district and area level offices. Ascertain whether the data from the previous year showing cases reported by month is being used to forecast the timing of interventions in each of these villages, including health education, social mobilization, the distribution of filters and the treatment of ponds with ABATE® Larvicide. Check a sample of households to ensure that filters are available, being used, undamaged, and whether additional new filters need to be distributed. A