Preventive Health Services Directorate

1. Preventive Health Services Directorate By Dr Pinyi Nyimol DG Preventive Health Services MoH/RSS December 4th, 2013

2. Introduction The directorate’s departments: Environmental & Occupational Health (E&OH); Epidemics Preparedness & Response(EP&R); Eye Care(EC); Guinea Worm Eradication programme (SSGWEP); HIV/AIDS/STIs;

3. Introduction Cont. Malaria Control Programme (NMCP); Neglected Tropical Diseases (NTDs); Non-Communicable Diseases (NCDs); and TB, Leprosy & Buruli Ulcer;

4. Directorate' Mandate • Development and provision of policies, guidelines, protocols and standards • Coordination and management of programmes, projects and responses to control

5. E&OH Main achievements: Development and printing of Medical Waste Management Plan (MWMP), Medical Waste Management guidelines and policy; Installation of incinerators in six hospitals and; Training of incinerator operators in three hospitals

6. E&OH Challenges: Lack of staff Lack of financial recourses

7. EP&R Main achievements: IDSR annual review meeting held in November; Weekly review meeting and monthly health cluster meetings to update surveillance situation is being held and; Coordination of outbreaks or emergency response activities at all levels ensured.

8. EP&R Cont. Main achievements: At least one hundred and twenty health workers (120), trained to detect, verify and respond to public health events Ten State Surveillance Officers (SSOs) trained and mentored on data analysis, interpretation and dissemination through DHIS

9. EP&R Cont. • IDSR reporting tools and support supervision checklists to health facilities produced and disseminated: • Weekly IDSR reporting form – 3000 pcs • Case Based Investigation form – 3000 pcs • Outpatient Register – 5000 pcs • Supervisory register – 3000 pcs

10. EP&R Cont. Main achievements: Two supervisory visits to Upper Nile and Western Equatoria states conducted Assessment and report on introduction of Integrated Community Based Disease Surveillance (ICBDS) in priority counties completed Six SSOs and twenty CSOs trained as TOTs on ICBDS

11. EP&R Cont. Challenges: Lack of resources (financial) Communication Insecurity

12. Eye Care Main achievements: Attended the first scientific conference of the College of Ophthalmology for Eastern Central and Southern Africa at Kigali, Rwanda Paid three supervisory visit to the states (NBG,WBG and Warap), through WHO Support

13. Eye Care Cont. Procurement of a laptop and heavy duty printer (three in one) through WHO Support; Conducted three meetings with eye care providers (NGOs); Conducted two Radio talks show with eye Radio and Miraya for awareness creation and; Conducted one TV show for awareness creation

14. Eye Care cont. Challenges: lack of human resources lack of consumables Issues of training

15. SSGWEP Main achievement: Cases reduced from 521 in 2012 to 115 in 2013 Challenges: Insecurity - Jonglei state Inaccessibility due to floods and poor roads especially, Jonglei state

16. HIV/AIDS/STIs PMTCT Guidelines updated and validated; TOTs on PMTCT/EID conducted; Dissemination workshop on the WHO new Consolidated Guidelines conducted and; Test, Treat and Retain (TTR) assessment and report presented in August 2013

17. HIV/AIDS/STIs Cont. A scale up plan for PMTCT is in its final stages of development, through UNICEF support.  Staff of the department participated in Casablanca, Morocco in September, 2013 and Accra, Ghana November, 2013 in a workshop on WHO new guidelines

18. HIV/AIDS/STIs cont. learning visit paid by the department to Uganda for a PMTCT/EID; The department in partnership with ICAP-Columbia University carried out supportive supervisory visits to Bentiu, Renk, Aweil, Yambio and Bor; Three monthly, HIV TWG meetings were conducted

19. HIV/AIDS/STIs cont. Lack of resources ( human and financial )

20. NMCP Main achievements: Malaria case management training in 9 states conducted. A total of 360 were trained, 40 health workers per state; 20,290 ACT distributed to health facilities that submitted an emergency request and; 7,314 RDTS distributed to HFs

21. NMCP Cont. Main achievement: A total of 2,580,148 LLIN By July 2013, distributed to CES, EES Lakes, Jonglei; NBG and Upper Nile; 26,800 LLIN were distributed as emergency response and; The final vector susceptibility study protocol submitted to the Global Fund

22. NMCP Cont. Main achievement: • MIS is going (Data collected); • The Therapeutic Efficacy Study to monitor the effectiveness of ACTs has been embarked upon in late August and is ongoing in Kator Payam in Juba County and; • Supportive supervisory visits conducted in CES.

23. NMCP Cont. Challenges: NMCP being a third party in receiving the global fund money; MIS funds managed by different partners have made the implementation difficult; Lack of human resources.

24. NTDs Nodding Disease: Main achievements: CDC conducted case control study to establish risk factors for Nodding Disease in South Sudan in 2011 In July 2013 Documentary on Nodding Disease was conducted by Journalists from Austria.

25. NTDs Cont. Dutch government sent researchers to investigate the nodding disease and see possibility of establishing research center; OVCI has planned to support victims of nodding syndrome with epileptic drugs

26. NTDs Cont. Onchocerciasis: Training of Trainers conducted in Wau, Aweil, Rumbek and Bor. Mectizan distributed to Jonglei, UN, EE, CE, Warrap, WBG, NBG and Lakes states.

27. NTDs cont. Trachoma: Baseline survey to start in January, 2014 in UN, Jonglei, Lakes, EE and C E States; Plans: NTD strategic planning in February 2013

28. NTDs Cont. Mapping of NTDs: LF, STH Schistosomiasis, Nodding Disease, Onchocerciasis and Trachoma Challenges: Lack of funds

29. NTDs Cont. MSF-H is supporting MTH to control Kala-azar epidemic; Supplies were sent to MTH, with support of WHO and MSF-H and; Kala-azar assessment (Community screening in Upper Nile and Jonglei) is on-going with supported of MSF-H and Med-air.

30. NTDs Cont. Challenge: Lack of resources(human and financial)

31. NCDs Main achievements: Procurement of furniture and equipments, through WHO Support; Awareness raised among population on Diabetes and Hypertension Challenges: No staff Lack of financial recourses

32. TB, L & BU Main achievements: Four (4) quarterly state level review meetings conducted 16 laboratories engaged in external quality assurance (EQA) 32 samples sent to Nairobi, Kenya for culture and Drug Sensitivity Test(DST) against a quarterly target of 28

33. TB, L& BU Cont. Main achievements: Project on-going (over 200 patients lost to follow currently retrieved and re-started on treatment) Five days refresher training on TB and TB/HIV management for 60 clinicians in Bentiu, Bor, Kuajok, Malakal and Rumbek (12 in each), Conducted

34. TB, L & BU Cont. Challenges: Low coverage of TB services (DOTS coverage); Inadequate number of health staff ; A limited laboratory network including lack of a reference laboratory; No Programmatic Management of Multi Drug Resistant TB (PMDT) is in place.

35. TB, L & BU Cont. Challenges: Inadequate community involvement in TB; High defaulter rate especially in urban centers (>10%); Inadequate implementation of TB/HIV activities and; Limited integration of TB activities into PHC and the general health system.

36. Thanks “Prevention is better than cure” pinyiupur@yahoo.com 0955604020