Challenges of the Last Mile to Elimination Sample Clauses

Challenges of the Last Mile to Elimination. In 2011, MDA began in metropolitan Port-au-Prince’s six communes (Port-au-Xxxxxx, Xxxxxx, Carrefour, Cite Soleil, Xxxxxx-Ville, and Tabarre). Although the first round of MDA was successful with an epidemiological coverage of 79%, coverage has since continually declined year-over-year, now falling below the 65% coverage threshold that must be consistently maintained to achieve elimination. In addition to the urban MDA challenges listed above, funding for MDA in metropolitan Port-au-Prince (PAP) has continually declined. The initial successful MDA round in 20011/12 was funded by the CDC and UND. Afterward, the program’s budget and contributions continually declined - nearly 50% by 2014. Contributions from the 9 This year-long interruption in funding paralyzed the program, preventing MDA from being conducted in 2005. This one year of missed MDA set the progress of the program back by two years [71]. United States Agency for International Development ENVISION project helped offset funding gaps, beginning in 2006, though other funders have continued to reduce their contributions. Declining coverage and persistent transmission in PAP (among other “zones rouges”) even after ten years of MDA, has led to program fatigue among staff and participants. The causes of the continuing decline in coverage for LF-MDA in PAP remain unclear. In preparation for annual MDA implementation in 2019, MSPP and partners have now made significant commitments towards research and activities to better understand the factors that have precipitated this decline in coverage and are determined to operationalize these insights towards innovation in program design and MDA implementation to achieve the goal of LF elimination by 2020.
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