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CONCEPT NOTE ON REACH OUT TO COMMUNITIES AGAINST HEPATITIS .B.VIRUS PROJECT.
Project summery
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Reach out to communities against hepatitis.B Virus is a project to be implemented by Women action for life[wacfol] an NGO operating in Bundibugyo District to improve the lives of women and  children in  bridging the gaps in the health delivery services and human rights.Wacfol aims to be  a champion of Excellency in the delivery of human rights and  health services where gaps are identified. The prevention of the spread of infectious diseases among the rural communities is one of the primary objectives of Wacfol-hence this project
The project aims to raise awareness among the communities and Health workers to be able to understand how this disease is spread, managed and prevented to reduce on its impacts and health threatening conditions that cause mortalities among the rural populations.
The basis for this concept note follows Uganda Aids treatment and information center[ATIC] report of November2009  and Bundibugyo District referral hospital monthly surveillance report of April 2010 which revealed chronicHepatitisB surface  Antigen Demonstration in about 25% of the population of Uganda and 15% among the population of bundibugyo district.
Infectious diseases such as Hepatitis B are highly contagious and able to spread rapidly from one person to another and cause high mortalities since people living with it are highly unaware until the disease progresses and reach advanced stages where it becomes hard to manage or control. At this stage patients will have developed life threatening health conditions of liver cancer, liver cirrhosis and hypercelluler carcinoma which are the primary cause of hepatitis B.motarlity.

Problem statement.
.Infectious diseases are the primary causes of  death,disability,social and economic disruption of many people in under developed countries including Uganda. This is partly due to poor health service delivery including inadequate stocks of drugs or medicines, luck of training for health care providers, poor education backgrounds and poor flow of information among the community population.
In bundibugyo, arural and mountainous district in Western Uganda, viral hepatitis B has directly impacted on families and communities because of lost productive labour force, missed education by children, poor health, house hold economic retardation and motarlities.The advance effects of this disease is most severe among the rural and the poorest populations in the district who have limited resources to survive from and with poor or no health care services according to ATIC report. In bundibugyo these groups of people are the ones living in the mountainous areas and across L.albert near the boarder with the DR.CONGO.The occurrence of this virus in these areas is said to be 13%.
The population in these areas practice primitive subsistence crop farming for their survival and occasionally visit town centers only to sell their produce surpluses and buy basic needs. Hepatitis B poses a great threat to the communities of these areas since it is spread similarly like HIV/AIDS. Its transsimission occur through blood transfusion or blood products, sexual intercourse, mother to child during birth, use of effected drug inject able materials and close contact with an effected person. People who suffer from the virus are often unaware of for several months yet they are able to pass the effect ion to others who have been negative.Un detected hepatitis B virus is the primary cause of liver cancer ,hyper cellular carcinoma among the rural population and liver cirrhosis a condition that causes death to about  79% of people who drink alcohol and other drugs. Hepatitis B may become fatal especially when it co-effects with HIV/AIDS orT.B patients, this causes high mortalities among these vulnerable immune suppressed patients.

.Project description
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This one year project will be implemented in Bundibugyo district in the sub counties of Bukonzo and Kanara sub-county rural areas where the virus occurrence rate has been found to be 13% among the population. The project will be carried out by 4 WACFOL full time qualified medical staffs and 4 UNICEF trained community health volunteers who will do mainly the mobilization of communities. The project will aim to raise awareness on viral hepatitisB disease among communities to be able to detect it and prevent its spread. The project will involve the training of about 40 health workers who will include 10 clinical officers,10  midwives  10 nurses 5 laboratory personnel and 5 dispensers on diagnosis, drug acquisition skills, treatment algorithms and model of transmission and prevention to effectively manage the disease at their health centers and also prevent infecting themselves in a two round training seminars. We shall also train 10 TBAs on how to prevent hepatitisB during tradition village deliveries. Two round  village meetings and community sensitizations and dissemination of preventive massages as learning aides shall be conducted at village levels and at health facility ART clinics to access patients with T.b  and HIV/AIDS who are at the high risk of enfect ion. The meetings or sensitizations will involve community owned resource persons, church leaders, school teachers, and the general public. Sensitizations will be carried out on early detection, prevention and transmission. The project will conduct community outreach blood screening for hepatitisB since many people are living with it unknowingily.We shall also provide community based-directly observed treatment[;CB-DOTS] to hepatitis B patients at community level and also facilitate the transportation of blood samples for examination at the virus research laboratory in Entebbe-Uganda and feed back.
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Project Goals.

-To reduce the effection  and spread of viral Hepatitis B among the rural populations.
-To prevent the progression of hepatitis B to life threatening liver cirrhosis, liver cancer and hypercelluler carcinoma among primary patients.
Project Objectives.

-To enhance the early diagnosis and treatment of viral hepatitis B among chronic patients
-To raise community awareness on viral hepatitis B.
-To improve the capacity of 40 health workers to effectively manage viral hepatitis B.
-To increase access of hepatitis B screening services by the rural population for early detection and treatment.
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.Project outcomes [Results].
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-The adverse impacts of viral hepatitis B  on the communities are reduced.
-Improved treatment, care and management for chronic hepatitis B patients both at health centers and community level.
-Reduced mortalities from viral hepatitis among patients.
-Increased awareness of hepatitisB virus among the rural communities.
-Reduced on the spread of viral hepatitis B among communities.
-Reduced co-effect ion of viral hepatitis B in HIV/AIDS and TB patients.
-Reduced effect ion in high risk groups such as health personnel ,traditional birth attendants[tbas], school children, pregnant mothers and church congregations.
Reduced replication of viral loads in patients with chronic hepatitis B
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Approach of intervention.

The project will be approached from the community level with start up preparatory and orientation meetings with district ,sub-county, and community leaders.Trainig seminars will follow immediately. Seminars will be conducted twice a year that is at the beginning of the project and in the middle of the implementation period .General community sensitizations will be held also twice in one year. During out reach community sensitizations blood screening for viral hepatitis B will be conducted and transportation of this blood to Entebbe viral research laboratory will be immediately on each day of the screening .Printed learning aides and pictures with hepatitis B prevention and transmission massages in English and in local dialics will be disseminated among communities during training seminars, community sensitizations and blood screening sessions. Directly observed treatment for hepatitis B will be conducted monthly on every Sundays. Drugs will be requisitioned from community Health centers or the district referral hospital by the project officer in time before the supply days
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Project sustainability.

-The trained heath workers and traditional birth attendants will continue to use the acquired knowledge to run the project continuously.
-Trained members of the public will continue to impress the project.
-We shall lobby ministry of health in Uganda to extend financial assistance to this project through PCH funds programme.
-Since the project is the first of its kind ,it will be impressed by the community and they will be encouraged to lobby their sub county authorities for funding of this project.
-Spirit of ownership by the project implementers and beneficiaries to continue the project.
-We shall make charity walks and fundraisings to keep the project running.
-Keeping proper books of accounts and strictly following the work plan.

Monitoring and evaluation.

Monitoring and evaluation will be done by the benefiting community, the project implementers and the local leaders to asses the project wither it achieved its objectives. This will be done through outreach supervisory visits, community meetings and project staff meetings. Evaluation will be done at the end of the project to capture the implementation layout and project design by the beneficiaries, district local leaders and representatives of the funding agency and other civil society organizations
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Project Duration.

The project will run for one year and that is ,From10- December-2010 to 10-December-2011.
Amount requested is US Dollars ………10000




Prepared by,,    WACFOL-Executive Board.
P.o box 1117, Bundibugyo-Uganda.




Contact person----Kahindo Musiime Paddy.
Title--------------Board secretary/Coordinator of projects.
Email.musiime.paddy@yahoo.com