Nation-wide Measles/Polio SIAs in Afghanistan, 2012
Background
The action have been prompted by the nation wide measles outbreak in 2012.
Three folds increase in the number of cases as compared with 2011
High mortality rates in initial phases (before response)
Double number of outbreaks almost in all provinces
Age-distribution of measles,2008-2011
Mapping of cases/outbreaks, Jan-June 2012
SIA Dates
Nation-wide Measles/Polio Follow up SIAs in Afghanistan, 2012SIA Dates 7-12 July 2012 (1st phase)
1-6 December 2012 (2nd phase) 18-22 November (Mop-up measles campaign in 16 districts)
Target age group
9M-10Y for measles 0-10Y for OPV
Target population (#) for Measles
5,616,580 (for Measles SIAs 1st phase) 4,279,589 (for measles SIAs 2nd phase) 106,500 (for measles mop-up campaign in 16 districts) 10,002,669 – total target
Population reached (#)
6,025,203 (Measles reported – 1st phase) 4,755,519 (Measles reported – 2nd phase) 98,778 (measles reported coverage of measles mop-up campaign) 10,879,500 – total number of children vaccinated with measles
Coverage (%) achieved
106% (measles reported coverage), 93% (PCS result) – 1st phase 111% (measles reported coverage), 96% (PCA result)- 2nd phase National coverage (all 34 provinces) based on Post Campaign
Assessment (PCA) – 94%
3rd Nation-wide Measles/Polio Follow up SIAs in Afghanistan, 2012
Number of immunization posts 1497 (fixed centers)Number of vaccination teams 17,219 (outreach/mobile teams) Total # of health workers, volunteers, supervisors, monitors and evaluators were engaged in measles SIAs
71, 872.
Other Interventions (number reached and % coverage if available)
In addition to measles vaccine, OPV was included into measles SIAs. Total # of children 0-10Y received OPV: 11,679,211 (92%) children aged 0-10Y have received a full dose of OPV.
Major national/local partners WHO,UNICEF, MOPH and all Health NGOs
Resources utilizationCost/Child immunized
So far, around $12 million spend
Challenges/Constraints
• Poor quality of district micro-plans (some provinces)• Weak strategy for remote and high-risk areas • Weak communication & social mobilization strategies• Shortage of trained health workers • Difficulty in reaching all children in problematic
provinces (Kandahar, Helmand, Farah, Zabul, Uruzgan, Badghis, Ghor, Kunar and Nooristan, Paktika, Paktya and khost); 54 districts underperformed
• Shortage of cold chain equipment • Over-reporting
Lessons learned• Early preparation and proper micro-planning is the key• Inaccurate denominator resulted in in-adequate micro-
planning including incorrect estimation of vaccine/supplies, human resource need and fund in many instances.
• Timely inventory of cold chain equipment is vital for adequate handling of vaccine and preventing shortage of vaccines at service delivery levels
• In advance identification of trained health workers and volunteers helps to timely conduct training courses
• Visiting all households for referring of children to the vaccination sites and adequate daily monitoring /reporting helps taking timely actions during the implementation
Future Plan• Local measles campaigns should be conducted
in partially covered districts to reach the un-reached children and supplement declining routine immunization coverage
• Conduct measles mop-up campaign in the districts that could not achieve 90% coverage for measles
• Implement RED strategy in all districts less than 60% coverage for EPI.
Provinces Problematic districts ( <90% SIAs coverage, <80% routine coverage, without EPI services) in need for Mop-up measles campaign, in 2013
Kandahar Maroof, Arghistan, Shorabak, Reg, Nesh, Ghorak, Khakrez, Shah wali kot
Helmand Khan Nshin, Sangin, Gramser, Deshu, Washer, Nawa Barakzai, Nawzad, Baghran, Kajaki,
Farah Poor Chaman, Gulistan, Bakwa, Bala Blook, Khaki Safid, Lash wa Joien
Zabul Daychopan, Mizan,Tarnak Wa Jaldak, ShinkayAtghar, Shamulzayi
Uruzgan Chora, Shahid Hassas, DihrawudBadghis Qadis, Jawand, Ghor Saghar, Tayawara, Pasaband, Tulak, ShahrakKunar Mrawara, Nari, Chapa Dara, NurgalNooristan Kamdesh, Waygal, Mandol, Mandol, wamaPaktika Gomal, Omna, Barmal,, Gayan, NekaPaktya Shwak, ZoormatKhost Musa Khael, SabariBadakhshan Darwaz, Jurm,
ProvincesDistricts ( <90% SIAs coverage, <60% routine
coverage) in need for Mop-up measles +pulse immunization campaign, in 2013
Additional districts coming from median coverage
Kandahar Maroof, Arghistan, Shorabak, Reg, Nesh, Ghorak, Khakrez, Shah wali kot Shah Wali Kot, Maroof
HelmandKhanshin (Reg), Sangin, Gramser, Deshu, Washer, Nawa Barakzai, Nawzad, Baghran, Kajaki,
Nahri Saraj, Musa Kala, Nad Ali, Nawa Barakzai, Sangin, Gramser, Washer
Farah Poor Chaman, Gulistan, Bakwa, Bala Blook, Khaki Safid, Lash wa Joien
Zabul Daychopan, Mizan,Tarnak Wa Jaldak, Shinkay Atghar, Shamulzayi
Uruzgan Chora, Shahid Hassas, Dihrawud Badghis Qadis, Jawand, Qala I Now, MugurGhor Saghar, Tayawara, Pasaband, Tulak, Shahrak Lal Wa SarjangalKunar Mrawara, Nari, Chapa Dara, Nurgal PechNooristan Kamdesh, Waygal, Mandol, Wama Nungaram, Du Ab, Paktika Gomal, Omna, Barmal,, Gayan, Neka Wor ManayPaktya Shwak, Zoormat Jadran, Jani Khel, Jaji Ayoub, Khost Musa Khael, Sabari KalandarBadakhshan Darwaz, Jurm, Khwahan, Ragh, Kohistan
Thank You