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Boosting EPI Coverage in Puntland: Challenges and Solutions

Dive into the EPI coverage survey results in Somalia's Puntland region and explore challenges like cold chain issues, low community participation, and the need for more implementing partners. Discover potential solutions to enhance coverage and effectiveness.

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Boosting EPI Coverage in Puntland: Challenges and Solutions

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  1. Situation analysis Puntland State of Somalia Garowe 28th May 2001

  2. Agreements • MOSA • 2 International NGOs • 1 National Society (SRCS)

  3. Bossaso Gardo Bender Beila Iskushuban Bargal Garowe Sinjiif Kalabyr Burtinle Dangorayo Eil town Qarhis Godobjiran Hasbahale Galkaio Harfo Baadweyn Goldogob Jirriban Balibusle MCH/OPD Facilities

  4. Districts where EPI services are functional??????

  5. Cold Chain Cold chain situation Alula Kandala Bossaso Bargaal Iksuhsuban Gardo Bender/Beyla BARI Dankoroyo Garowe Eyl Burtinle NUGAAL Hasbahale 50 % is working Goldogob Harfo Bacad Weyne Galkayo MUDUG Giriban

  6. Very low coverage during baseline survey. Drop out rate (DPT1 DPT 3.) 30 % drop out SUMMARY OF UNICEF EPI COVERAGE SURVEY Very low coverage in Puntland. 2% of women were provided second dose of TT immunization in 2000.. Only 21 % of all children immunized

  7. 48% BCG scar shows very low coverage in Baidoa. 6% of BCG immunization have not developed BCG scar. Drop out rate (BCG/ DPT3) of 57% in child immunization. The results depicted very low coverage. However 78% out 20.4% of children were fully immunized before one year of age. SUMMARY OF EPI COVERAGE SURVEY RESULTS CONDUCTED BY UNICEF & PARTNERS IN BAIDOA TOWN 36% measles immunization resulted to conduct measles campaigns in Baidoa District. 25% of women were provided second dose of TT immunization.

  8. Very low coverage during baseline survey. Drop out rate (BCG/ DPT3) of 67% in Bay and 77% in Bakool. SUMMARY OF IMC EPI COVERAGE SURVEY RESULTS IN BAY AND BAKOOL REGIONS Very low coverage in Bay and Bakool regions. 9% of women were provided second dose of TT immunization. No data in Bay IMC survey

  9. Very good coverage but needs to be sustained. Drop out rate of 69% in 2000 and 38% in 2001. SUMMARY OF WORLD VISION EPI COVERAGE SURVEY RESULTS IN BUALE 2000 & 2001 Good coverage of but needs to be increased. 26% of women were provided second dose of TT immunization in 2000. No data in 2001.

  10. 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

  11. 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… .

  12. 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?

  13. Definition of catchment areas? • target population? • Social mobilization (responsibilities) • Co-ordination between partners

  14. 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

  15. 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

  16. 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

  17. 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 drop-out rates, no supervision tools

  18. 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

  19. 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

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