Transcript No Slide Title

Situation analysis
Puntland State of Somalia
Garowe 28th May 2001
Agreements
• MOSA
• 2 International NGOs
• 1 National Society (SRCS)
MCH/OPD Facilities
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Bossaso
Gardo
Bender Beila
Iskushuban
Bargal
Garowe
Sinjiif
Kalabyr
Burtinle
Dangorayo
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Eil town
Qarhis
Godobjiran
Hasbahale
Galkaio
Harfo
Baadweyn
Goldogob
Jirriban
Balibusle
Districts where EPI services are
functional??????
Bari
Bossaso
Bargal
Ufein
Gardo
Alula
Kandala
Iskushuban
B/Beila
Nugal
Garowe
Eil
Burtinle
Dangaroyo
Mudug
Galkaio
Jiriban
Goldogob
Cold chain situation
Alula
Kanda
la
Bossaso
Iksuhsuban
Gardo
Bargaal
Bender/Be
yla
BARI
Garowe
Dankoroyo
Burtinle
Eyl
NUGAAL Hasbahale
Goldogob
Galkayo
50 % is working
Harfo
Bacad Weyne
MUDUG
Giriban
Cold Chain
Very low coverage
during baseline
SUMMARY
survey.
OF UNICEF EPI COVERAGE SURVEY
Drop out rate
(DPT1 DPT 3.)
Very low coverage
in Puntland.
30 % drop out
49
50
45
40
35
30
25
20
15
10
5
0
Only 21 %
of all children
immunized
46
2% of women
were provided
second dose
of TT
immunization
in 2000..
40
32
31
BC
G
+
TT
2
im
m
.
es
M
ea
sl
3
DP
T
1
DP
T
Fu
lly
ca
rd
&
BC
G
hi
s
sc
ar
to
ry
21
coverage
SUMMARY OF EPI COVERAGE SURVEY RESULTS
CONDUCTED BY UNICEF & PARTNERS IN BAIDOA TOWN
48% BCG scar shows very low
coverage in Baidoa. 6% of BCG
Drop out rate
immunization have not developed
(BCG/ DPT3) of
BCG scar.
57% in child
immunization.
50
48
36% measles immunization
resulted to conduct measles
campaigns in Baidoa District.
The results depicted very low
coverage. However 78% out 20.4%
of children were fully immunized
before one year of age.
51
25% of
women were
provided
second dose
of TT
immunization.
49.3
45
40
36
30.3
30
25
22
20.4
20
16
10
0
BCG Scar
BCG Card +
History
DPT1
DPT3
Measles
Not immunised
Partially
mmunised
Fully
immunisaed
Before one
year
TT2+
Very low coverage
during baseline
survey.
SUMMARY OF IMC EPI COVERAGE SURVEY
RESULTS IN BAY AND BAKOOL REGIONS
Drop out rate
(BCG/ DPT3) of
67% in Bay and
77% in Bakool.
35
32
30
Very low coverage
in Bay and Bakool
regions.
31
Pe r ce ntage
30
25
20
24
9% of women
were provided
second dose
of TT
immunization.
No data in Bay
IMC survey
19
13
15
15
14
10
9
10
3
5
0
BCG Scar
BCG Card + History
DPT1
DPT3
IMC Bay 2000 IMC Bakool 2000
Measles
TT2+
Very good
coverage but needs
to be sustained.
SUMMARY OF WORLD VISION EPI COVERAGE
SURVEY RESULTS IN BUALE 2000 & 2001
Good coverage of
but needs to be
increased.
Drop out rate of
69% in 2000 and
38% in 2001.
90
81
80
83
68
70
Pe r ce ntage
83
68
65 62
60
26% of women
were provided
second dose
of TT
immunization
in 2000.
No data in 2001.
42
50
40
26
30
26
20
10
0
BCG Scar
BCG Card + History
DPT1
DPT3
Measles
World vision Buale 2000 World visiion Buale 2001
TT2+
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Cold chain not functioning in certain areas
Inadequate supervision
Shortage of qualified Human resources
Few implementing partners
Existing MCH structures are not providing
EPI services on a daily bases.
• Request for supply come in late
• TOR MCH staff not well defined. (Staffing
pattern)
• Information lacking concerning
immunization schedule for mothers/
caregivers
• Lack of confidence in MCH staff
• Attitude of MCH staff towards parents,
patients etc… .
• Missed opportunities
• Availability/ use of IEC materials for MCH
centres and parents/ caregivers
• HIS system not completely understood
• Reporting not regular
• Quality/ reliability of data ?
• Motivation of staff?
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Definition of catchment areas?
target population?
Social mobilization (responsibilities)
Co-ordination between partners
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Strengthen the MCH structure
Question of Catchment population
Need for more implementing (EPI) partners
Need for transportation - resource allocation
Appropriateness of cold chain eg gas/solar
panels/electric as opposed to kerosene
refrigerators
• Need for separate budget line for EPI
implementation
• Training and follow up of EPI activities
• Monitoring and evaluation of EPI activities
• Feedback of EPI surveys
• Quality of vaccines (for purpose of
monitoring)
• Cold chain management training
• Further development of MCH standards
• Need for common EPI policy eg incentives,
motorcycles, office equipment etc
• Appropriateness of social mobilisation
strategies - Puntland version best
• Inadequate participation of international
staff in EPI (acceleration) activities
• Need for regional cold chain
• No clear roles and responsibilities of EPI
stakeholders
• Need for clear action points and
prioritisation
• Lack of EPI maintenance/replace old
equipment
• Service providers - no screening, high dropout rates, no supervision tools
• Mothers not aware of vaccination schedules
• Need to increase capacity of MCH staff
related to EPI activities
• Contraindication not clearly known to
health staff
• Missed opportunities
• Low community participation
• Inadequate cold chain
• Social mobilisation messages insufficient
• Inadequate distribution of MCH facilities
(eg in Bossaso)
• Enlarge scope of EPI partners - private,
local NGOs, MOSA
• Lack of motivation of MCH staff