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  1. Afghanistan Successes & Challenges Ministers of Health Meeting Geneva Feb 04, 2005

  2. Current Epidemiological Status and the role recent developments on the PEI

  3. NSL1 NSL3 1999 P1 & P3 Poliovirus Isolates 1999, 02 -2004 2002 NSL1= 5 NSL3= 5 NSL1= 32 NSL3= 18 2004 2003 NSL1= 2 NSL3= 2 NSL1= 5 NSL3= 3

  4. Non-Vacc 1-3 4-6 7+ Vaccination Status Of Polio, Compatible & Non-Polio AFP Cases age 6-23 & 24-59 months, 02-04* 6-23 months 24-59 months * Data as of JAN,3

  5. SIAs – Quantity and Quality

  6. SIAs conducted during the year 2004 in Afghanistan and Pakistan Pakistan Afghanistan SNID NIDs NIDs

  7. SIAs Planned in the 1st half of year 2005 for Afghanistan and Pakistan Pakistan Afghanistan SNIDs NIDs NIDs

  8. 95-100 90-94 <90 PCM Assessment Coverage (NID Average) District Wise Mar-Apr and Aug-Sep Rounds 2004 August & September March & April Average Percentage Not included in Post Monitoring

  9. Qualitative Improvements • Increased female participation from 9% in year 2003 to 25% in 2004 • Strengthened and structured monitoring and post SIA assessment • Increased efforts to revisit district and sub-district micro plans • Concerted efforts to get new partners on board

  10. Coverage of Marginalized Groups Vaccination Team for IDPs/Nomads

  11. Area of Maximum Focus&Special Measures Taken Southern Region Area of indigenous endemicity

  12. 1-3 4-6 7+ <95% >95% Areas not included PCM Assessment Coverage NIDs- Southern Region - 2004 March NID April NID August NID November NID September NID

  13. Specific Measures Undertaken During 2004 • Introduction of District Support Teams in the highest risk districts • Daily review meetings at Province & District levels • Establishment of Polio Control Room at Kandahar • Reaching 50% of clusters in each district for Post NID assessment

  14. Programme Strengths& Remaining Challenges

  15. Programme Strengths • Sustained Political Commitment at the highest level • Well-coordinated team effort by MoPH/WHO/UNICEF and other stake holders • Innovative strategies to overcome challenges • Well-trained and dedicated field staff • Strong 3rd party field monitoring of SIAs • Cross border consultation with Pakistan • Acceptance at the community level

  16. Challenges • Continue being innovative in difficult to reach areas • Maintaining high quality SIAs consistency in the coming rounds • Maintain highly sensitive AFP surveillance throughout the country • Increase and sustain routine EPI coverage

  17. The role of recent developments on Polio Eradication Initiative PEI and the new Afghanistan

  18. Facilitative factors BPHS program: Improved routine EPI coverage, due to better detection, supervision, and coordination GAVI input and strategy: improved EPI by targeting hard to reach areas Reconstruction of clinics: Brought routine EPI to areas previously served with much difficulty by outreach teams. Greater involvement of women health workers in Polio SIAs Challenges Multiplicity of health providers Fast expansion of service with few trained heath staff Inadequate capacity of MoPH to coordinate all of the available inputs and to monitor the quality of outputs Returning refugees and the annual movement of nomads The role of recent developments on Polio Eradication Initiative

  19. Actions to improve the enabling environment for PEI • Strengthen the MoPH capacity to coordinate effectively the inputs of donors and to monitor the process and outputs of NGOs, especially related to HMIS, Informatics, Transportation, decision making and Policy Formulation. • Conduct advocacy workshops with the aim of raising awareness about PEI among NGOs and their supporting donors so that every NGO’s contract will have a clear reference to cooperation with all involved in PEI.

  20. Specific Measures to Reach the Goal • Message from the President • Specific directives to all the Provincial Governors • Special programmes and public Service Spots on Radio and TV • Spot monitoring of the campaigns by senior MoPH officials

  21. Conclusion

  22. Conclusion • Afghanistan remains committed to achieve eradication of polio • Polio eradication remains the highest priority for the Ministry and the Government of Afghanistan • Would thank donors for their generosity and confidence in Afghanistan and would look forward to their continued support

  23. Conclusion • Despite major achievements, the programme remains fragile. Continued external support to the programme will be critical to achieve objectives • Building the stewardship capacity of the MoPH is highly needed