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APPLYING LESSONS LEARNED TO FOLLOW-UP CAMPAIGNS, NIGERIA

APPLYING LESSONS LEARNED TO FOLLOW-UP CAMPAIGNS, NIGERIA. A presentation @ 8 th Annual Meeting of Partners for Measles Advocacy. Washington DC, USA By FMOH/NPHCDA - Dr. Emmanuel. I. Odu. Nigeria Political Map. Admin Levels. Country State LGA Ward Community. North West. North East.

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APPLYING LESSONS LEARNED TO FOLLOW-UP CAMPAIGNS, NIGERIA

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  1. APPLYING LESSONS LEARNED TO FOLLOW-UP CAMPAIGNS, NIGERIA A presentation @ 8th Annual Meeting of Partners for Measles Advocacy. Washington DC, USA By FMOH/NPHCDA - Dr. Emmanuel. I. Odu

  2. Nigeria Political Map Admin Levels Country State LGA Ward Community • . North West North East North Central South East South West South South

  3. Administrative coverage results of measles Catch-up Campaign, 2005/2006; Nigeria. North – Dec 2005 South – Oct 2006 Overall coverage; 83% Overall coverage; 95.3% < = 84% 85 – 94% 95 – 100%

  4. SUMMARY FEATURES OF MEASLES CATCH-UP CAMPAIGN, NIGERIA; 2005/2006

  5. Measles trends, 2005-2008, Nigeria Measles catch up campaign in Southern states Measles catch up campaign in Northern states 2007 2008 2005 2006

  6. Age & vaccination status of confirmed measles cases, Nigeria, Jan – Jul 2008 (n=8,887)

  7. Surveillance • Measles case-based surveillance implemented in all states. • Good performance • rate of suspected measles cases reported with blood specimens >3 / 100,000 population, of which • >95 have had blood specimen collection, and results available.

  8. Zonal location of Measles Labs; Nigeria Measles lab

  9. Lesson learned – 1 • Government Funding. Readiness of government to provide funds. • PhasedImplementation ensured optimum use of limited skilled personnel • Partnership. Technical resources in-country partners & Support international partners, including Measles Partnership – Valuable. • Involvement of other Ministries, Religious, Traditional & Community leaders – helpful. • Use of Volunteers helpful.

  10. Lesson Learned – 2: • Controversial population estimates • Planning. Commenced late; more time needed for micro-planning and verification • Procurement of vaccine not ‘bundled’ created logistic problems. • Delays in clearing & forwarding • Training. Quality decreased on cascading to operational levels. • Duration of implementation. Five days were not sufficient.

  11. Lesson Learned – 3: • Timing of implementation. Rainy season in the south; affected vaccination activities & quality of supervision. • Late release of funds by partners. • Mobilization messages not focused on fixed post vaccination. • Coordination. Weak coordination capability at LGA level. • LLINs Integration; concept and practice need to be managed well. • Mop-up Plans. Necessary to have contingency (Mop-up) plans. • Gains registered after the catch-up campaign were not sustained throughout the country due to failure to achieve reasonable RI coverage levels.

  12. 2008 Follow-up Campaigns

  13. Goal Contribute to Measles Mortality reduction by by building on the gains of 2005 and 2006 catch-up campaigns Objective to Vaccinate 95% of all children aged 9 – 59, months in Nigeria, against Measles (regardless of their previous immunization status) by December 2008. To use the opportunity to deliver other CS interventions. Scope: 36 states plus FCT Goal and Objectives

  14. Interventions • Measles Vaccine: Children aged 9-59 months irrespective of previous immunization status (target coverage 95%): target population 25,348,212. • Oral Polio Vaccine (OPV): Children aged 0-59 months irrespective of previous immunization status (target coverage 95%): target population 29,821,426. • Vitamin A Supplementation: Eligible Children aged 6-59 months (target coverage 95%): target population 26,839,285.

  15. Roles & Responsibilities; Key Stakeholders.

  16. Planning • Commenced early, 2006 Census figures used. • National POA developed > 1year ahead • National Budget prepared > 1 year ahead • Partners mobilized • International Support; MP

  17. Activity Timelines, IMC 2008; Nigeria.

  18. Timing of Implementation & Evidence

  19. Communication/IEC • POA distributed to stakeholders • States informed • Consultative Meetings – North & South • Information sharing • Views/inputs • IEC materials finalized. • Mobilization messages address fixed posts. • social mobilization messaging for the different target groups clarified

  20. Training • Training materials and schedules are standardized for the operational levels to ensure that content and messages do not get diluted while cascading, • Lessons from previous measles SIAs are incorporated at all training levels • Mapping • part of the training and micro-planning exercises, • vaccination teams understand the operational use of these maps • to delineate their catchment areas, • for community mobilization purposes and • For Monitoring & Supervision • National & Zonal TOT for Micro-planning - conducted

  21. Logistics/Cold Chain • Procurement of Vaccines (MV, OPV) by FGN. • ‘Bundles’ MV, Sufficient quantities ordered • Expected Date of Delivery • 15/10 (for North) • 24/10 (for South) • Vitamin A – available. • Syringes/Needles being cleared at the ports. • Cold Rooms & Dry Stores (National, Zonal States, LGAs). • Waste Mgt options being explored and included in Micro-plans. • Distribution Plan – in place.

  22. M & E • M & E tools finalized and harmonize for the various interventions at different levels • With instructions on their use. • Training on supervision and operational support for supervision duly included in implementation training. • Strategy in place for monitoring of zero dose measles vaccine recipients outcome for • advocacy • programmatic use for strengthening RI • Planning, Implementation & Monitoring/Supervision Templates/Forms - finalised.

  23. Implementation • Phased. Duration – 5 days. • Scheduled for Dry Season (Nov/Dec) in both North & South. • Intervention to delivered at fixed Posts. • Supervision highly prioritized. To be addressed during implementation training. Active participation by LGA team • Supervisors/Monitors to be used extensively. • Nationwide Distribution of LLINs suspended, possibility of distributing in 2-3 States, final decision to be reached.

  24. Conclusion • The Catch-up campaign implemented in Nigeria 2-3 years ago achieved significant impact on measles morbidity & mortality, in view of low disease incidence post-SIA. • Outbreak events affected unvaccinated Children < 5 Yrs. • Gaps in routine vaccination of recent birth cohorts • Gaps in campaign coverage. • Campaign coverage gaps to be eliminated with mop-ups. • Follow-up campaign to contribute to RI Strengthening. • We so value and count on your support & advice for which we ‘say thank you’.

  25. THANK YOU

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