Health cluster Lessons Learned

Workshop

21st May 20152pm WHO conference room

Expanded Program on Immunization

StrengthsBefore TC Pam Immediately after

(first 72hrs)Emergency phase (72hrs to 6 weeks)

National Vaccine Supply and Cold Chain System was functional

EPI unit working with WHO/UNICEF in focusing to strengthen RI and cover the immunity gap for Measles with SIA campaign and new vaccine introduction (IPV Rubella).

NDMO has prepositioned gasoline

Pool of nurses in the country

NGOs on the ground Microplans, tools, CCE Inventory available

Good coverage in 2014 due to implementation of RI strengthening activities.

No vaccine damages: Immediate assessment & actions in cold room; power restored in <48Hrs: -Flooded area cleaned up; -generator, cold room were fixed; -Passive containers, conditioned ice packs were secured for vaccine storage

Pool of resources MOH, UNICEF,WHO, NDMO (financial, TA, gasoline)

Procured 10 KVA generator and 3 stabilisers

Power Grid resumed 1week post TC Pam

MOH commitment, Partners Support & Coordination-Emg Measles campaign started on 5th day in Evacuation centers and cont

-other services (timely arrival of supplies) integrated: VAC, Deworming, MUAC, IYCF, HW w/soap

-Cold chain vaccine mgt orientations for vaccinators- Microplanning, RCA - Intensify AFR

Surveillance

Weakness

Before TC Pam Immediately after (first 72hrs)

Emergency phase (72hrs to 6 weeks)

Staffing: -No national cold chain officer & technician

-Weak routine outreach public health service delivery ( less HR, vaccine stock outs in remote health facilities, low provincial public health management ) causing low routine coverage and immunity gap for measles ( PV, Tanna )

Lack of functional VPD surveillance No Cold Chain contingency plan at almost all levels

Power grid not restored

No gasoline for the standby generator; low access to daily supply of gasoline x 1 week

Cold room not meeting WHO PQ standards

Lack of stabilisers for Ice Lined Refs

Low HR capacity

Power restored only after 1 week Cold Room Building and space not meeting global standards

Solar refs installations not disaster resilient

Lack of hired MOH vaccinators to conduct campaigns

Inadequate routine community based mobile outreach services

Health facilities lack vaccinators

Recommendations – moving forward

Before TC Pam Immediately after (first 72hrs)

Emergency phase (72hrs to 6 weeks)

Develop contingency plans for cold chain/vaccine management at all levels esp central store

Secure sustainable and predictable funding and implement routine community based mobile outreach vaccinations integrating essential population based services

Analyse immunization program management by province/HFs and develop equity focused microplan ( vulnerable high risk areas)

Follow EVMA standards on contingency planning, and implementation for disasters

Update National cold chain inventory according to recent global standards; procure additional equipment

Implement Measles Campaign Plan with Budgets during Emergencies

Ensure Cluster Assessment tools include adequate Cold chain variables

Ensure quality supervision and monitoring during measles campaign

Continue best practices e.g. good partners collaboration, MOH commitments