Planning for the implementation of best practices in the 2010 Measles SIAs, Ethiopia

1. Planning for the implementation of best practices in the 2010 Measles SIAs, Ethiopia � � � � � � Neghist Tesfaye(MD,MSc) Federal MoH, Ethiopia July 2010

2. Outline Background Measles coverage and epidemiological situation Workshop on best practice SIAs Ethiopia SIA Experience Inclusion of best practices into SIAs planning Status of preparation Opportunities and challenges

3. Ethiopia: Background

4. Reported measles cases and measles vaccination coverage, 1990-2008, Ethiopia

5. Phased Measles SIAs 2002 - 2009 Administrative coverage from the 2007 � 9 follow-up SIAs Catch-up SIAs 2002-2005 6 months � 15 years Follow-up SIAs (first cycle) 2005-2006 6 months � 5 years Follow-up SIAs (second cycle) 2007-2009 6 months � 5 years of age

6. Confirmed measles cases. Ethiopia. (2006 � May 2010)

7. Measles Outbreaks - 2010 Vaccination status of confirmed measles cases. January � May 2010 Confirmed Measles cases January - May 2010

8. Measles SIAs �Best Practices� workshop A consultative meeting to identify best practices to improve the outcome of the measles SIAs in 2010

9. What are best practices? A technique or methodology that has been proven, thru experience and research, to reliably lead to a desired result A practice that produces results without using inordinate resources, in full or in part, and that can be useful in providing lessons learnt

10. Ethiopia SIAs Experience-Planning and Training Strengths- mobilization of staff is easily facilitated Participatory (partners, local leaders etc�) Weaknesses- Late identification of areas �missed� by microplanning (camps, federally administered areas) Not initiated early enough in the preparatory phase because of lack of funding, overlapping priorities, etc Best Practices identified Timing of micro-planning exercises and training sessions Involvement of local administrators in planning process

11. Ethiopia SIAs Experience - Logistics Strengths Utilization of locally available alternatives to overcome logistics challenges Good collaboration of partners, NGOs and private sectors Weakness Late collection and distribution of inputs in some zones Best Practices identified Micro-planning starting from kebele level to assess logistics needs and opportunities Packaging of inputs for distribution to operational level

12. Ethiopia SIAs Experience - Social Mobilization Strengths Use of local media, word of mouth communication and village-criers The active participation of political and opinion leaders Weakness Quality and distribution of IEC materials Best Practices identified Multi-channel messaging approach FGDs and KAP studies to tailor messaging Door-to-door canvassing in some areas

13. Ethiopia SIAs Experience-Monitoring and Evaluation Strengths established data recording system participation of all stakeholders Weakness Problem in data quality, esp the accuracy of denominators Best Practice Identified Documentation and analysis of supervisory findings at all levels Independent SIAs monitoring

14. Inclusion of best practices into the SIAs planning and implementation

15. Measles SIAs- 2010 Target: 9.04 million children aged 9 - 47m in 8 Regions (91.8% of population) Dates: 22 - 25 October Budget: US$ 5.6M Operational costs US$ 3.3M Bundled vaccines USD 1 per child Integrated interventions Vitamin A OPV De-worming Nutritional Screening

16. Inclusion of Best Practices Into the SIAs preparations A National task force led by the DG of Health Promotion and Disease Prevention Directorate, FMoH taking care of the coordination of preparation Weekly meetings Linkage to ICC Three technical working groups reporting to the task force MoH and partner members Best practices incorporated into the revisions of the: Macroplan Field guide Training documents Supervisory and monitoring tools and formats

17. Key areas of emphasis in the SIAs Contributions towards improving the routine immunisation system Identify weak performing areas and provide focused support for planning and implementation Specific strategies for populations with difficulties to access services, different lifestyle etc Careful monitoring and evaluation of SIAs Independent monitoring, RCM, post-SIAs coverage surveys, Evidence based approach to social mobilisation messaging

18. Timeline of activities

19. Status of preparation Micro-planning Starting at kebele level (lowest level) in all 8 Regions on 19 July 2010 To be compiled by mid-August Orientation of microplanning facilitators (July 14-15) to support zonal MP activity SIAs field guide being updated

20. FGD and KAP studies to be conducted by mid August Social mobilization tools and guidelines to be finalised Training materials to be updated SIA Monitoring and Evaluation Checklists and monitoring tools being finalised Logistics Procurement of vaccine and other supplies underway Development of distribution plan underway

21. M & E: Independent monitoring to be done systematically Supervision tools being refined Protocol for post-SIAs survey being developed Indicators identified for evaluating �different aspects of the best practices� Documentation of the process and outputs

22. Funding for 2010 Measles SIAs

23. Opportunities High level political will and leadership Motivation created by best practice concept High level of cooperation between immunization partners Presence of �health extension workers�

24. Gaps/ Challenges Persistent security problems in some areas, esp in Somali Region Raising adequate operational funding from local sources and disbursing funds on time Adequate documentation of the process

25. Next Steps Complete the macro-plan : end July Complete the logistics distribution plan: end July Complete micro-planning exercises: mid August Finalise guidelines, tools and materials: late August Document progress and challenges Advocacy with Regional governments: late August Local resource mobilization

26. Ameseginalehu!