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Situation analysis

Situation analysis. Puntland State of Somalia Garowe 28th May 2001. Agreements. MOSA 2 International NGOs 1 National Society (SRCS). Bossaso Gardo Bender Beila Iskushuban Bargal Garowe Sinjiif Kalabyr Burtinle Dangorayo. Eil town Qarhis Godobjiran Hasbahale Galkaio Harfo

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Situation analysis

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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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