Week-28 Ending 15 July 2018

Transcription

1 Somalia eekly Update eek-28 Ending July

2 Summary highlight VDPVs from environmental samples No new cvdpv2 isolate. The date of collection of most recent positive environmental sample was on th May No new cvdpv3 isolate. The date of collection of most recent positive environmental sample for cvdpv3 in Somalia was on 19th April In, a total of 10 cvdpv2 and seven (7) cvdpv3 viruses have been isolated from environmental samples compared to two (2) VDPV2s and 0 VDPV3 in There are four (4) environmental sites in Somalia, all of which are located in Banadir region (Mogadishu) VDPVs from human samples Two (2) suspected PVs isolated from two (2) Contact samples collected from L. Jubba and M. Shabelle VDPV2: A total of 2 VDPV2 were isolated from human in Somalia. hile one is an AFP case with coinfection (cvdpv2 & cvdpv3) reported from Bulloburti districts of Hiran region in Central zone, the other VDPV2 is isolated from a contact sample from Dolo in South zone VDPV3: Eight (8) VDPV3 were isolated from Human samples in. Isolates are from two (2) AFP cases (1 is a coinfection), four (4) contacts and two (2) community samples Cases are distributed across access-compromised areas of South and Central zones of Somalia No reporting of a new positive human cvdpv2 or cvdpv3 samples this week; the date of onset (collection) of most recent positive human sample for cvdpv2 was on 29 th May from a contact sample in Gedo region, Dolo town in South Somalia

3 mopv2 campaign in Central and South of Somalia synchronized with Kenya & Ethiopia BDB DNS ELB HUD RBD JD ABD ADD BLB DSB GLS GUR BDB BLH BRD DLO EL GBH LUQ BBT BLT AFM KIS Campaign conducted and successfully concluded in the 6 targeted regions from July. Post campaign IM and LQAS monitoring is in progress starting from July 14th and will continue until July th. Intra-campaign IM coverage data shows overall coverage is 98% (0-11 months=99% & months=98%) according to finger marking. Most districts have achieved > 95% coverage. Final coverage data and exact number of Children will be shared soon. Preliminary data: Percent of children vaccinated by age group and total Preliminary data: % of HHs aware about the campaign 9 95% % % 1 75% BDB DNS ELB HUD RBD JD ABD ADD BLB DSB GLS GUR BDB BLH BRD DLO EL GBH LUQ BBT BLT AFM KIS BAY BKL GDD GDO HRN LJB Total % Children 0-11 Vaccinated % Children Vaccinated % Children total Vaccinated BAY BKL GDD GDO HRN LJB Total

4 Both No sample collected due to flooding of sewage vdpv2 Summary Environmental Samples and Lab Classification Epidemiological eek- Epidemiological eek- District Name of Sites Date of Establishme nt J. 04 J. 11 J. J. 25 F. 01 F. 08 F. F. M. M. M. M. M Ap. 05 Ap. 12 Ap. 19 Ap. 26 Ma y 03 Ma y 10 Ma y Ma y 24 Ma y 31 Jun e 7 Jun e 14 Jun e 21 Jun e 28 Jul y 05 Jul y 12 Jul y 19 Jul y 26 aberi 21October 19 Sept. Shangani Urobo Sept. Hamere woini Hodan Kawma Egy. Hospital 21 Sept. 23 Nov. Legend 1 Not scheduled 6 Sabin 11 PV1+cVDPV2 2 Pending 7 NPENT + Sabin 12 Sent for sequencing 3 Negative 8 cvdpv2 13 Scheduled but not collected 4 NEV 9 PV1 14 Sabin 2 5 NPENT 10 PV3 Sabin + NPEV + NEV

5 SIA Activity Calendar Apr Dec. Activity Target area Date Status NID 1 bopv Somaliland and Puntland 30 Apr- 03 May Done NID 1 bopv South and Central Except Banadir, Lower and Middle Shabelle 5-8 May Pending Third response round mopv2 Campaign Banadir, Lowe Shabelle and Middle Shabelle 5-8 May Done R 1 synchronized mopv2 Campaign (with Ke, ET) South and Central regions without Banadir, Lower and Middle Shablle regions synchronized with Kenya response campaign 9-12 Jul Done Small scale bopv Response Banadir, Lower and Middle Shablle regions 23 Jul Pending R 2 synchronized OPV2 Campaign (with Ke, ET) South and Central regions with out Banadir, Lower and Middle Shabelle regions synchronized with Kenya response campaign 4 8 Aug. Pending R 1 bopv synchronized Ke & ET R 2 bopv synchronized Ke & ET All 19 regions in Somalia (2,499,010) 3-6 September Pending All 19 regions in Somalia (2,499,010) 1-4 Oct Pending

6 Part I AFP Surveillance

7 eek-28 Somalia eekly EPI/POL Update Epidemiological Curve 01 January 14 July Pending Lab Pending ERG Discarded Compatable PV avdpv VDPV2 VDPV3 Graph no. 1

8 Table no.-1 Total Total Total eek-28 Somalia eekly EPI/POL Update eekly AFP cases reported by Provinces, - Somalia. (cases are distributed across weeks based on date of onset of paralysis). PROVINCE BANADIR GALGADUD M. SHABELLE L. SHABELLE HIRAN BARI NUGAL MUDUG TOGDHER GALBEED SANAQ ADAL SAHIL SOOL LOER JUBA BAY GEDO MIDDLE JUBA BAKOOL Total Somalia Four (4) new AFP cases were reported last week bringing the total AFP cases reported in to 7 from 19 regions, compared to 195 AFP cases from 19 regions at the same time point in. Silent (not reporting) for > 8 weeks Reported AFP cases Community Samples collected in silent regions Community Samples collected but regions not silent

9 Table no.-2 eek-28 Somalia eekly EPI/POL Update Classification of AFP cases by status ( & ) Chart no Discarded 29 In process (lab) 0 PV 7 AFP cases reported in 29 Pending 0 Pending ERG 0 Compatible 1 cvdpv2 0 Pending ITD 1 cvdpv3 ZONE PROVINCE Discard Pendin ed g Total Discard ed VDPV Pendin g Total BANADIR GALGADUD CENTRAL HIRAN L. SHABELLE M. SHABELLE BARI Puntland MUDUG NUGAL ADAL GALBEED Somaliland SAHIL SANAQ SOOL TOGDHER BAKOOL BAY SOUTH GEDO LOER JUBA MIDDLE JUBA Grand Total

10 eek-28 Somalia eekly EPI/POL Update Annualized NP-AFP Rate by Zone, Surveillance Indicators by Zone and Region Central Puntland Somaliland South Total Somalia Annualized NP-AFP rate by accessibility status Graph no In-accessible Partially Acceessible Accessible Somalia Graph no. 3 Map no. 1 Map no. 2

11 eek-28 Somalia eekly EPI/POL Update Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, Map no /1 districts reported at least 1 AFP case since the first week of Of the 102 districts reporting AFP cases in, 94 have annualized NP-AFP rate above 2 per 100,000. In addition, 100 districts have stool adequacy rate of above 8 The remaining 13 districts have not reported any AFP case in ; However, no district in Somalia has been silent for more than 52 consecutive weeks 12% (n=2/) inaccessible districts and % (n=11/75) of accessible districts did not report AFP cases in. All the partially accessible districts have reported at least 1 AFP case Map no. 4

12 eek-28 Somalia eekly EPI/POL Update Distribution of NP-AFP cases and zero-dose cases vs accessibility of districts AFP cases were reported from all zones, regions, and accessible and inaccessible parts of the country Geo-code information was collected from 64% of AFP cases reported in Of the zero-dose AFP cases reported in, 10 were reported from inaccessible districts, eight (8) from partially- accessible districts and two (2) from accessible districts Map no. 5 Map no.6

13 eek-28 Somalia eekly EPI/POL Update 300 Number of NP-AFP cases reported across years during the same period (13-) by zone CENTRAL PUNTLAND SOMALILAND SOUTH SOMALIA Central and Somaliland have reported lower number of AFP cases compared to the number of reported in during the same period. A total of 213 additional community samples were collected from Central zone from healthy children in this year to compensate the low AFP reporting. Active case search in Hospital and community also continued.

14 BANADIR GALGADUD HIRAN L. SHABELLE M. SHABELLE BARI MUDUG NUGAL ADAL GALBEED SAHIL SANAQ SOOL TOGDHER BAKOOL BAY GEDO L. JUBA M. JUBA eek-28 Somalia eekly EPI/POL Update Early case detection within 7 days from onset of paralysis at zonal and region levels- Notification within 7 days, Zonal Notification within 7 days, Regional % % 1 1 CENTRAL PUNTLAND SOMALILAND SOUTH SOMALIA CENTRAL PUNTLAND SOMALILAND SOUTH TOTAL 95% (n=9/7) cases reported in were notified within 7 days of onset of paralysis. Eight AFP cases (three (3) from Bay, two (2) from Lower Jubba, one (1) from Middle Jubba, one (1) from Middle Shabelle and one (1) from Sanaaq regions had delayed notification).

15 # AFP cases NP-AFP Rate # Cases with Adequate Specimen Cases pending lab results Cases with lab. result. Cases with stool in good cond. % Cases with stool in good cond. # of samples with NP-EV Isolated % Samples with NP EV Isolated # cases with Sabin like virus Isolation % of cases with S L Virus Isolation eek-28 Somalia eekly EPI/POL Update Summary of AFP surveillance key indicators by Zone, ZONE % Stool Adequacy % Inv. within 48 hours % Notification within 7 days Central % 98% 98% % 5 1 Puntland % 4 % Somaliland % % 1 3% South % 88% % 0 Total % 99% 95% % 10 7% Table no.-4

16 eek-28 Somalia eekly EPI/POL Update ZONE PROVINCE Regional U Pop. CENTRAL Summary of AFP surveillance key indicators by Province, Expected # of AFP cases as of this eek Number of AFP cases reported NP-AFP Rate % Stool Adq. % inv. within 48 hrs. % Notif. within 7 days % Stool condition % Samples with EV isolated % cases with SL isolated # Cases with late 60 days followup BANADIR % 0 GALGADUD % 9% 0 HIRAN % 0 LOER SHABELLE % 8% 0 MIDDLE SHABELLE % 92% 92% 5% 0 BARI % % 0 MUDUG % 0 NUGAL % 0 ADAL GALBEED % 1 SAHIL SANAQ % 33% 0 SOOL TOGDHER BAKOOL BAY % 79% % 1 GEDO % 25% 1 LOER JUBA % 1 MIDDLE JUBA % 0 SOMALIA 636, % 99% 95% 7% 7% 7 PUNTLAND SOMALILAND SOUTH

17 eek-28 Somalia eekly EPI/POL Update ZONE # AFP Cases # CONTACTS Summary of key AFP surveillance indicators for contacts, # Contact samples with Lab result Average contacts per cases % contacts < 5 age % Contact collected within 7 days of AFP notified % Contact with stool in Good Condition # Contact pending lab results # Specimens with NPEV isolated % Specimens with NPEV Isolated # Contacts with Sabin virus isolated Central % 9 7% Puntland % 6 8% Somaliland % 5 5% South % 4 4% Somalia % 24 6% Summary of Community Samples collected in from silent districts, Egyptian hospital and inaccessible districts Zone Pending Negative NPENT PV 3 Sabin PV 1 Sabin & PV3 Sabin PV 1 Sabin VPV3 SL2 Grand Total PUNLAND SOMALILAND CENTRAL SOUTH Grand Total Of the total 346 community samples collected from healthy children in, 49% (n=8) and 51% (n=8) were from access-compromised areas Table no.-5 % contacts with Sabin like virus Isolated

18 Prop. cases notifed by eek-28 Somalia eekly EPI/POL Update Distribution of AFP cases by source of case notification, 9 8 Source of AFP cases notification by Zone Zone Number of VPVs Number of cases reported # of cases Notified by VPV Proportion of cases reported by VPV CENTRAL PUNTLAND % 3 % SOMALILAND % 1 Central Puntland Somaliland South Somalia VPV HFs Other Key: 1. VPVs: Village polio volunteers 2. HFs: MCH, Hospitals and Private clinics 3. Others: community members, district field assistants, traditional healers SOUTH % Total Somalia % Table no.-6

19 eek-28 Somalia eekly EPI/POL Update AFP cases by specific sources notification, NOTIFIED BY VACCINATORS AND TRADITIONAL HEALERS 250 NOTIFIED BY COMMUNITY AND VOLUNTEERS 300 NOTIFIED BY HEALTH FACILITIES CAMPAIGNS DISTRICT FIELD ASST DPO NID VACCINATOR TRADITIONAL HEALER CH COMMUNITY HOUSEHOLD VOLUNTEERS HEALTH POST HOSPITAL MCH PRIVATE CLINIC PRIVATE PHARMACY

20 eek-28 Somalia eekly EPI/POL Update Distribution of AFP cases by lifestyle, age group and sex, % 1 Distribution of AFP cases by Life style per zone Nomadic Rural Urban % 1 Distribution of AFP cases by Age group Graph no.-10 Graph no.- 11 Graph no <5 Yrs 5 Yrs % 1 Distribution AFP cases by Sex Female Male Of the 7 AFP cases reported in, 44% (n=77) and 38% (n=68) came from urban and rural populations respectively. Nomadic communities account for only % (n=32). 72% (n=127) of cases are aged less than 5 years. 51% (n=90) AFP cases are female.

21 eek-28 Somalia eekly EPI/POL Update AFP surveillance indicators by district accessibility status, Accessibility # of districts U- Pop in this area # of AFP cases Reported # of Cases reported by VPVs % of Cases NP AFP reported rate by VPVs Number of cases with lab result % of Stool adequacy % inv. ithin 48 hrs. % of Notif. within 7 days % Specimen s with NPEV % cases with Sabin like virus Inaccessible 619, % % 12% Partially accessible 23 1,7, % % 9 6% 3% Accessible 75 4,024, % % 101% 98% 7% 1 National 1 6,364, % % 99% 95% 7% 7% Despite accessibility challenges, majority of indicators are above global standards Table no.-7

22 eek-28 Somalia eekly EPI/POL Update AFP surveillance indicators by population lifestyle, Accessibility % of < populati on in the area # of AFP cases Reporte d # of Cases reported by VPVs % of Cases reported by VPVs NP AFP rate Number of cases with lab result % of cases with lab result within 14 days % of Stool adequacy % inv. ithin 48 hrs. % of Notifie d within 7 days % Specim ens with NPEV % cases with Sabin like virus Nomadic % 94% 91% 4% Rural % % 9% 5% Urban % % 99% 99% 95% 8% 9% National % % 98% 99% 95% 7% 7%

23 eek-28 Somalia eekly EPI/POL Update Validation and zero dose investigation of AFP cases, AFP Cases Validation Zero Dose Investigation Zone # of AFP cases Reported # of AFP cases Validated % of AFP cases Validated Zone # of Zero dose AFP cases Reported # of Zero dose AFP cases investigated % of Zero dose AFP cases investigated Comment Central % Somaliland % South Zone % Puntland % Central % 2 from accessible and Somaliland remaining from accesscompromised South Zone % areas Puntland Grand Total % Table no.-8 Grand Total 8 Table no.-9 Of the 7 AFP cases reported in, 59% (n=104) were validated by the RPOs. Of the 104 AFP cases validated, (n=75, n=, n=11) were from accessible, partially accessible and inaccessible districts respectively There were zero OPV dose AFP cases reported in, out of which 8 (n=/) were investigated

24 eek-28 Somalia eekly EPI/POL Update Tracking lab results of AFP cases Total AFP cases 7 Tracking AFP with stool specimens AFP cases with stool specimens AFP cases without stool specimens cvdpv2 7 0 cvdpv3 Other viruses ith lab results Enroute In the lab neg st in lab en route cvdpv2 cvdpv3 SL EV -ve

25 eek-28 Somalia eekly EPI/POL Update Sample source # Specimen collected Lab performance indicators for AFP surveillance in Somalia, # Specimen with culture result # Specimens pending lab result # Specimen with culture result within 14 days % of specimen with culture result within 14 days Number of specimen with NPEV % of specimen with NPEV Number of cases with Sabin isolation % of Cases with Sabin isolation Cases % 21 7% 10 7% Contacts % 29 7% 24 6% Total % 50 7% 34 6% Table no.-10

26 eek-28 Somalia eekly EPI/POL Update Median and average number of days from onset of paralysis to final lab results - Date of onset Date of Notification Second stool collected Specimen reached to Lab Primary Culture result ITD result Median: 3 days Average: 3.53 days Median: 2 days Average: 1.89 days Median: 3 days Average: 3.8 days Median: 11 days Average: 11.7 days 1 day Date second stool collected Median: days Average: 22 days Date final ITD results Chart no. 2

27 eek-28 Somalia eekly Polio Update Village polio volunteers weekly house to house visit and number of AFP cases notified, July January Feberuary March April May June July Aug Sept Oct Nov December Central No. of AFP No. of HH No. of HH cases visited visited notified No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of No. of HH AFP cases visited notified No. of AFP No. of HH cases visited notified No. of No. of HH AFP cases visited notified No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notifie d Central , , , South , , , Puntland , , Somaliland , ,7 2 8, Total

28 eek-28 Somalia eekly Polio Update Routine immunization services, status of cold chain & vaccine stocks in AFP surveillance sites, July Region Expected weekly AFP sites visits Health facility have a routine EPI service AFP sites with EPI service and functional cold chain Health facility have EPI vaccine available Health facility have IPV vaccine available No No. % No. % No. % No. % Nugal % % Bari % 32 94% % Mudug % 38 97% 38 97% 24 63% Galbeed % Sahil Sanag % Sool % Awdal % Togdher % Middle Shabelle % Hiran % 5 23% Galgadud % 58% % Banadir % 25 36% 67 96% 64 96% Lower Shabelle % 53% Middle Juba % Bakool % % 11 25% 10 91% Gedo % 95% Bay % % Lower Juba % 8 27% Somalia % % % 400 9

29 Part II Fever and rash surveillance

30 eek-28 Somalia eekly Polio Update Epi-curve on suspected measles cases by week, Somalia (-) (n=7498) (n=5657) Series (n=23,353) (n=6613)

31 Total Total eek-28 Somalia eekly Polio Update Fever and rash cases reported through the AFP surveillance system, July Region Fever and Rash Cases by weekly Nugal Bari Mudug N/East Zone Galbeed Sahil Sanag Sool Awdal Togdher N/est Zone M/ Shabelle Hiran Galgadud Banadir L/Shabelle Central Zone Middle Juba Bakool Gedo Bay Lower Juba South Zone Grand Total

32 Campaign (2-6 Jan) Campaign (11- March) eek-28 Somalia eekly Polio Update Campaign (11- March) Campaign (11- March) Trends of reported fever and rash cases by zone in, - Source: AFP Surveillance Reporting System Puntland Somaliland January February March April May June July AUG Sept. Oct. Nov. Dec Central January February March April May June July AUG Sept. Oct. Nov. Dec South January February March April May June July AUG Sept. Oct. Nov. Dec Data shows there is a steady decline of suspected measles reported after the measles mass immunization conducted in January in Puntland and March in central, south and Somaliland

33 eek -21 Somalia eekly Polio Update Fever and rash cases reported, July Source: AFP surveillance reporting system Age-wise distribution of fever and rash cases reported by AFP surveivallance system during Zone-wise cases of fever and rash reported by AFP surveillance system in Yrs10+, 798, 12% 5_9yrs, 1055, % <1yr, 1078, % _4 yrs, 3769, 56% Central North East North est South Total Somalia

34 eek-28 Somalia eekly Polio Update Measles mass immunization in Somalia, Nationwide campaign targeted to vaccinate all children from 6 months to 10 years of age; based on epidemiology. 83% of cases were under 10 years of age % 92% 95% 94% 93% 4.7 million children were targeted in all accessible and partially accessible districts of the country 4.4 million children were vaccinated (94% coverage) Independent monitoring data shows 94% of the children were reached with measles vaccination during the campaign dates % 1 centeral Puntland Somaliland South Grand National Total

35 Part III Population Immunity

36 eek-28 Somalia eekly EPI/POL Update Maps showing accessibility and security/ risk level, Somalia Source: UNDSS Map no.10 Map no.11

37 eek-28 Somalia eekly EPI/POL Update Zone CENTRAL PUNTLAND SOMALILAND SOUTH SOMALIA Summary programmatic features and initiatives in Somalia by accessibility Accessibility Number of Population AFP active VPV Settlement Under Years Surveillance sites TPVP Accessible 2,475 2,419, Inaccessible 984 5, Total 3,459 2,936, Accessible 1,2 459, Inaccessible Total 1,2 459, Accessible 3,435 1,469, Inaccessible Total 3,435 1,469, Accessible 2,234 1,040, Inaccessible 1, , Total 3,782 1,499, Accessible 9,364 5,388, Inaccessible 2, , Total 11,896 6,364, Note: the data are preliminary and U population is estimated from Surveillance historical data and U5 SIA data and are being reviewed.

38 Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses Table no.- % Zero doses eek-28 Somalia eekly EPI/POL Update Transit Points Vaccination activities using bopv - July January February March April May June July Zones CENTRAL % % % % % % % PUNTLAND % % % % % % SOMALILAND % % % % % % % SOUTH % % % % % % % SOMALIA % % % % % % A total of 1,232,390< 10 years individuals were vaccinated week 27,. Among them 12,552(1%) were vaccinated for the first time

39 eek-28 Somalia eekly EPI/POL Update Immunity Profile of NP-AFP cases and Contacts 13- Immunity Profile of NP-AFP Cases and Contacts combined Months, 13- Immunity Profile of NP-AFP Cases 6-23 Months, 13- Immunity Profile of NP-AFP cases 6-59 Months by Zone, Immunity Profile of NP-AFP cases 6-23 Months by Zone, % Graph no Dose 1-3 doses 4-6 doses 7+ doses % zero dose AFP cases reported in from inaccessible and partially accessible areas of South (n=13) and Central (n=7) zones. 6 AFP cases with zero doses reported in are in the age group of 6-59 moths and the remaining 5 AFP cases with zero dose are out of the 5-59 months age group dose 1-3 doses 4-6 doses 7+ doses Graph no % dose 1-3 doses 4-6 doses 7+ doses Graph no % Graph no Dose 1-3 Doses 4-6 Doses 7+ Doses 6 4

40 eek-28 Somalia eekly EPI/POL Update Immunity profile of NP-AFP cases and Contacts combined by Zone 12- SOMALILAND CENTRAL % % dose 1-3 doses 4-6 doses 7+ doses 0 dose 1-3 doses 4-6 doses 7+ doses SOUTH Graph no.-24 PUNTLAND Graph no % % dose 1-3 doses 4-6 doses 7+ doses 0 dose 1-3 doses 4-6 doses 7+ doses Graph no.-26 Graph no.-27

41 Part -IV Routine Immunization

42 BCG P-1 P-3 Measles OPV-3 IPV BCG P-1 P-3 Measles OPV-3 IPV BCG P-1 P-3 Measles OPV-3 IPV BCG P-1 P-3 Measles OPV-3 IPV Routine Immunization coverage by zone, Somalia -(1st quarter) (1st Q) PUNTLAND SOMALILAND SOUTH CENTERAL SOMALIA

43 Somalia Monitoring chart % Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Sum of Pent Sum of Penta Sum of Measles Sum of Montly target on surval% 8% % 25% 33% 42% 5 58% 67% 75% 83% 92% Sum of P-1% 5% 1 % % 25% 3 36% 41% 47% 53% 6 66% Sum of P-3% 5% 1 14% % 23% 27% 32% 36% 41% 46% 51% 56% Sum of Measles% 4% 8% 12% % 21% 25% 3 35% 39% 42% 46% 5

44 Somalia Monitoring Chart % Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Sum of Pent Sum of Penta Sum of Measles Sum of Montly target on surval% 8% % 25% 33% 42% 5 58% 67% 75% 83% 92% Sum of P-1% 6% 12% % 23% 29% 34% 42% 48% 54% 61% 67% 75% Sum of P-3% 5% 1 % % 25% 29% 34% 39% 45% 51% 56% 63% Sum of Measles% 4% 8% 13% % 22% 27% 32% 37% 42% 47% 53% 6

45 Somalia Monitoring Chart % 1 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Sum of BCG Sum of Pent Sum of Penta Sum of Measles Sum of Montly target on surval% 8% % 25% 33% 42% 5 58% 67% 75% 83% 92% Sum of P-1% 7% 13% % Sum of P-3% 6% 11% % Sum of Measles% 6% 12% %

46 eek-24 Somalia eekly EPI/POL Update C4D and Cold Chain Management

47 eek-28 Somalia eekly EPI/POL Update C4D Updates (1) Timelines of major activities SN Activities Dates Participants Places 1 Training of trainers' sessions -19 June RSMCs and DSMCs Mogadishu 2 Cascade training sessions June CMs Various districts Orientation session for 3 religious leaders June NIAG Members Mogadishu 4 Local cross border meetings June Local leaders of neighboring countries Border districts Radios & TV stations 5 Radio and TV broadcasts July Media Agency LTA in all 6 regions 6-12July Joint CMs teams Border districts 6 House-to-house sensitization 5-12July CMs Other districts 7 Launching ceremony 08 June MoH

48 C4D Trainings sessions conducted for the outbreak response campaigns Training participants 1 st round mopv2 2 nd round mopv2 Campaigns 3 rd round mopv2 IPV campaign Synchroniz ed mopv2 campaign # RSMCs trained # DSMCs trained # CMs trained # NIAG members trained # Post campaign Supervisors & Monitors trained

49 Families awareness Level in South Central Zone (3 Regions): mopv-2 Campaigns 9 98% 9 93% % 1 Source: Post campaign IM Data Campaign-1 Campaign-2 Campaign-3

50 1% 1% 2% 2% 2% 2% 2% 2% 2% 2% 2% 2% 3% 2% 2% 1% 1% 2% 2% 2% 3% 3% 3% 3% 3% 3% 3% 3% 4% 4% 4% 4% 5% 5% 5% 5% 6% 6% 6% 5% 5% 5% 4% 5% 4% 3% 4% 4% 6% 7% 7% 8% 8% 11% 11% 12% % 19% 3 Missed Children per District (mopv2 Campaigns) 35% 3 25% % % 1 5% Source: Post campaign IM Data Campaign-1 Campaign-2 Campaign-3

51 7% 6 69% 74% 77% 76% 75% 99% 95% 99% 91% 96% 94% 99% 88% 94% 96% 94% 9 97% 95% 98% 93% 97% 98% 97% 93% 89% 91% 96% 96% 96% 96% 99% 98% 96% 97% 96% 98% 95% 98% 99% 96% 99% 95% 99% Parents Awareness per District % 1 Source: Post campaign IM Data Campaign-1 Campaign-2 Campaign-3

52 Religious & Fatigue related refusals among total refusals per District Religious refusals Fatigue Refusals ARSHEIKH MAHADAY BALAD JOHAR ANLAEIN AFGOI MARKA Abdiaziz Heliwa Yaqshiid Karaan Daynile Howlwadag ar Dhigley Hodan aberi H/Jajab H/weyne Dharkenley Madiina Shangaani Bondhere Shibis 12% 19.4% Source: Post campaign IM Data Campaign-3 Campaign-2 Campaign-1 ARSHEIKH MAHADAY BALAD JOHAR ANLAEIN AFGOI MARKA Abdiaziz Heliwa Yaqshiid Karaan Daynile Howlwadag ar Dhigley Hodan aberi H/Jajab H/weyne Dharkenley Madiina Shangaani Bondhere Shibis 27% Campaign-3 Campaign-2 Campaign-1

53 Social Health workers / Radio (%) Television (%) Religious and Megaphone / PA Other (%)* Social Health workers / Radio (%) Television (%) Religious and Megaphone / PA Other (%)* Social Health workers / Radio (%) Television (%) Religious and Megaphone / PA Other (%)* 8 6 Performance of C4D activities - NIDs (IM) Parents Awareness Information Sources 96% 95% 92% 6 4 % 4 % Feb Apr Dec Feb- Apr- Dec- 6.0 Missed Children 6 Reasons for Missed Children 5.% 5 57% % 44% 34% 38% 32% 2.0 % 24% 0.0 Feb Apr Dec 1 % 9% N/Available Team Performance Refusal Feb- Apr- Dec-

54 eek-28 Somalia eekly EPI/POL Update Vaccines and Cold Chain Management All mopv2 vaccines for the June synchronized campaign received in Mogadishu The CEEOP operational deployment plan was completed and shared with UNICEF supply division and GAVI. GAVI promised to share Somalia s new decision letter where all cold chain equipment will be procured in year one Routine immunization vaccines required till year end estimated and procurement process ongoing

55 NB: Vaccine wastage rate reduced from 7% in round one to 6% in round two as per admin data 55

56 The END