Eritrea Health Update Issue 2 No.11

Transcription

1 Issue 2 No th June 8 th July, 2007 PROFILES Eritrea Population: 3,447,060 - (1997 Projection) Number of Zobas (Regions): 6 Humanitarian Target population: 2.3 Million Main Sources of humanitarian funding: UN CERF ECHO HIGHLIGHTS Outbreak monitoring IDSR capacity building activities Results of Results of SOS in 4 sub Zobas of NRS Events: o Visit of ECHO field officer o UNSG special envoy visits Eritrea ERITREA HEALTH UPDATE ) Outbreak Monitoring: Week 25 (18 th 24 th June, 2007) Report Completeness and Timeliness Most Zobas have submitted reports up to week 23 of the year. Majority of the 242 health facilities are submitting reports on time. The national average health facility to Zoba weekly report completeness and timeliness have not changed from the previous report and remain at optimal levels of about 95% and 82% respectively (Table 1). Table 1: Cerebro-Spinal Meningitis (CSM) No new suspected meningitis cases have been reported in the last 2 weeks. The total meningitis cases so far reported in the year remain 10 with 1 death, all from Zoba Northern Red Sea and the isolated pathogen was N. meningitidis type A. Strong surveillance with monitoring of alert and epidemic thresholds will remain in place. Average Health facility to Zoba weekly report completeness and timeliness as at week 23 (4 th 10 th June, 2007) Zoba Total Population No. of HFs Timeliness Completeness Anseba Debub Gash Barka Maekel NRS SRS Total 3,447, c/o WHO, Adi Yakob street N. 173, House N. 88/89, Geza Banda, P.O.BOX 5561 Asmara, Eritrea. Tel , Fax

2 Malaria The increase in the number of cases of malaria in Anseba Zoba that was reported in the previous was issue was confirmed to be as a result of increased reporting during that week as a result of the then ongoing community sensitization. The number of cases has returned to below the 3 rd quartile threshold level (figure 1). The weekly numbers of cases at national level remain well below the third quartile threshold level as can be seen from figure 2. Diarrhoea and Bloody Diarrhoea: The weekly numbers of cases of bloody diarrhoea (shigellosis) has been approaching the 3 rd quartile threshold level at national level as seen in figure 3. This is due to increase reporting of cases from Anseba and Maekel Zobas. No outbreak has however been reported from any of these Zobas. No outbreaks of other diarrhoeal diseases were reported. Other Outbreaks: No outbreaks of other diseases have been reported in the reporting weeks. Measles Situation: No new suspected measles cases have been reported in the last 2 weeks. The total suspected measles cases for the year remain 24. These have been reported from 4 Zobas with Debub and Northern Red Sea remaining silent. All the suspected measles cases tested negative for measles IgM. Three cases tested positive for Rubella. Figure 1 Anseba Zoba: Malaria weekly trend in rd Quartile Yr Number of cases Week number 2

3 Figure 2 Eritrea: Malaria weekly trend in rd Quartile Yr 2007 Number of cases week number Figure 3 Number of cases Eritrea: Bloody diarrhoea weekly trend in rd Quartile Yr week Number 3

4 Integrated Disease Surveillance and Response (IDSR) Capacity Building Activities: Among the core functions of WHO in emergency response are information management and capacity building. Information management includes strengthening of the existing information base including complementing IDSR with Nutritional surveillance and strengthening of districts' capacities for information management. Prior to the current crisis, Eritrea had a fairly well developed Integrated Disease Surveillance and Response (IDSR) system with few identified gaps in the support functions of the strategy (training, communication and supervision). The IDSR training activities in Eritrea included the basic epidemiology course in University of Nairobi which is limited by its high cost and the few admission slots available and the IDSR modular training which is an in-country modular training program of about 1 week. The identified gaps in the IDSR modular training included the low proportion of certain categories of health workers trained, e.g. 10% for doctors (Figure 4) as well as the regional differences in the proportion of total health workers so far trained on the strategy (Figure 5). Figure 4 Eritrea:Proportion of Health Workers trained on IDSR by Category Doctors Nurses H/A Lab Others Total 4

5 Figure 5 Eritrea: Proportion of Health Workers trained on IDSR Modules by Zoba SRS, 55.7 National, 24.5 NRS, 32.2 Anseba, 59.4 Debub, 23.8 G. Barka, 30.1 Maekel, 12 IDSR Modular training and clinician s sensitization In order to address geographical gaps in IDSR training, modular courses were carried out in both 2006 and 2007, thereby increasing the cumulative number of health workers trained (Figure 6). These modular trainings were mostly carried out in disadvantaged areas. Clinicians especially doctors are the frontline health workers who have contact with patients. In order to improve the detection and reporting components of any surveillance system, awareness has to be created among these health workers. Unfortunately due to the nature of their work, it is not convenient for this category to attend the modular training sessions and therefore another strategy had to be adopted. The WHO/AFRO had developed the clinician s sensitization kit which was adapted by the country. This kit could be used to give 1 day sensitization seminar for clinicians on IDSR which suits them better. The EHA supported the introduction of this activity in 2006 resulting in sensitizing 192 frontline clinicians (Figure 6), most of them physicians not trained on IDSR. Community Sensitizations Another area of identified gap is in the community surveillance and reporting. To address this gap, community sensitization training sessions were organized to sensitize community leaders and volunteers on the surveillance and reporting of cases of priority and unusual health and nutritional conditions to health facilities. A total of 380 community members and volunteers have been sensitized so far this year. 5

6 Figure 6 Capacity Building on IDSR: Trend of Health Workers Trained on IDSR Basic Epidemiology IDSR Modular Clinicians sensitization Cumulative No Year Special Needs Derived Trainings Some of the capacity building activities carried out were based on urgent emergency needs. For example, with the report of a case of Avian Influenza in the neighboring Djibouti last year, the country was put on high alert and required some form of capacity building to look out for the diseases as well as prepare to respond. In this context, the country rapid response team was trained with the assistance of AFRO in avian influenza response including simulation exercises. In addition 34 health workers from the regions were sensitized on avian influenza with particular emphasis on surveillance. Reports of meningitis cases from the Northern Red Sea prompted the training of health workers on prevention & Control of Meningococcal Meningitis and Epidemic surveillances in Massawa from 28 to 31st May, In attendance were 34 participants including 4 doctors, 11 nurses, 7 health assistants and 2 laboratory technicians and 2 data managers among others. The objectives were to provide health workers with appropriate skills to timely identifying cases of priority diseases and use the data for action; to strengthen Zoba capacity for improved preparedness and response for highly pathogenic diseases such as meningitis, avian influenza including A(H5N1) in human, polio, and others outbreaks and to update the health workers on recommendations for treatment of bacterial meningitis in epidemic and nonepidemic situations in the African meningitis belt, surveillance issues before, during, and after a meningitis epidemic. 6

7 IDSR Training sessions in progress Results of Sustainable Outreach Services (SOS) in Foro sub Zoba (3 rd Round) and Gelalo, Shieb & Gindae sub Zobas (1 st round): In continuation of the provision of integrated outreach services to the hard to reach and mobile communities of the coastal region of Northern Red Sea with support from ECHO and UN CERF, the exercise was carried out in 4 sub Zobas in the month of May. This exercise was carried out for the 3 rd time in Foro and for the 1 st time in the other sub Zobas of Gelalo, Shieb and Ghindae. The map below indicates the geographical location of the hard to reach area of NRS Zoba in Eritrea 7

8 Map of Eritrea showing areas of SOS implementation in NRS Map Showing geographycal Location of Hard to Reach Sub Zones of NRS Shieb Foro Gindae Gelalo miles 200 The Services offered during the SOS Implementation included: Immunization services for children under two years (OPV, DPT-Hep B, and Measles) Vitamin A supplementation for children 6-59 months Health education on various areas including (EPI, Hygiene, management of diarrhoea, Care of pregnant mothers and post partum care). The exercise involved 20 teams composed of 60 health workers, 60 community health agents and community mobilizers and utilized 16 vehicles and 17 animals for transport support to the teams. The results show that the following achievements were recorded: In the hard to reach areas of the four sub Zobas, 1533 children less than 2 years of age were vaccinated with OPV3/DPT3+HepB3, 10 received OPV0 and 735 were vaccinated with OPV1. Measles vaccine was also administered to 910 children. First dose of Tetanus Toxoid (TT) vaccine was administered to 2657 women aged years and two or more doses administered to 578 women. Antenatal care was provided to 163 pregnant women, post natal care to 63 and 4890 received folate tablets. Health promotive activities were conducted in the HTR areas of the five sub zones with special focus on community health education and 4337 people attended the sessions. Vitamin A supplementation was administered to 28,005 children 6-59 months of age. 8

9 Various scenes from the integrated outreach services Events: Visit of ECHO Field Officer Mr. Yves Horent to Eritrea: ECHO field officer from the Tanzania office, Mr. possibilities and prospects for future funding. Yves Horent visited Eritrea from 3 rd to 11 th June, He visited on of the operation areas Northern Red Sea in company of Ministry of Health, During the visit Mr. Horent met with the main UNICEF and WHO officials including the WHO ECHO implementation partners in Eritrea, country representative. During the he was able especially the WHO and UNICEF. Important to obtain first hand information regarding field discussions were held with officials from operations of some of the WHO and UNICEF agencies on the humanitarian situation, ECHO activities as well as hold discussions with operations, current projects in Eritrea as well as frontline health workers. 9

10 Mr. Horent and WHO and UNICEF officials during field visit to Foro and Ghelalo in Northern Red Se Mr. Bondevik visits Eritrea: The United Nations Secretary General s Special Humanitarian Envoy to the Horn of Africa, Mr. Kjelle Magne Bondevik recently visited Eritrea. During the visit, the envoy held various consultation discussions with the humanitarian community, the UN country team and Government officials including the Ministers of. Agriculture and that of Labour. The visit was crowned with an audience with Hs Excellency, the President of the State of Eritrea. Important issues were discussed during the visit including food security and the working of NGOs 10

11 De-Briefing Session by Mr. Bodevik with the UN, Diplomatic and Humanitarian communities at the end of his visit on 22 nd June, 2007 ERITREA HEALTH UPDATE c/o WHO, Adi Yakob street N. 173, House N. 88/89, Geza Banda, P.O.BOX 5561 Asmara, Eritrea. Tel , Fax