Eritrea Health Weekly Update 9 th to 15 th October, 2006

Transcription

1 Eritrea Health Weekly Update 9 th to 15 th October, 26 HIGHLIGHTS Weekly outbreak Monitoring WCO Meets to Develop Strategies HH/C-IMCI Survey Findings Weekly Outbreak Monitoring Week 41 (9 th to 15 th October, 26) The latest data is from week 39 of the year 26 (25 th to 1 st October). Report Completeness/Timeliness: Table 1: Average Health facility to Zoba weekly report completeness and timeliness as at week 39 (25 th 1 st October, 26) Zoba Total Population Number of HFs Timeliness Completeness Anseba 539, Debub 891, Gash Barka 666, , NRS 541, SRS 78, Total 3,353, The average health facility to Zoba report timeliness as at the end of week 39 was 76.78%, less than a percentage point increase from the previous week s 76.36%. The report completeness has not changed and remains at 95.28%. All Zobas have reached over 85% report completeness. Gash Barka and Southern Red Sea Zobas, which have not improved the report timeliness, still remain the greatest challenges. These two Zobas have difficult terrains. CSM: No new cases were reported in week 39. Last Report was in week 15 of the year (1 16 April, 26). Total cases reported this year were 22 and 3 deaths from 6 districts.

2 Malaria: Malaria reported cases are still below the 3 rd quartile threshold level at national level for all Zobas that reported as at week 39. Diarrhoea and Bloody Diarrhoea: The number of reported cases weekly has not crossed the third quartile threshold at national level in week 39. In Zoba Anseba however, the third quartile threshold for week 39 was exceeded (Figure 3). The cause of this will be investigated. No outbreaks of other diarrhoeal diseases were reported. Other Outbreaks: No outbreaks of other diseases have been reported during the week. Measles Situation: The measles situation has not changed in week 39. The total suspected measles cases reported by all Zobas as at week 39 are 91 cases. Two cases tested positive for measles in Zoba Gash Barka so far. Figure 1 Eritrea: Weekly trend of malaria in 26 number of cases week number 3rd Quartile Yr 26 Eritrea Health Weekly Update 19 th Issue

3 Figure 2 Eritrea: Weekly Trend of Bloody Diarrhoea in 26 Number of Cases Week NO 3rd Quartile Yr 26 Figure 3 Zoba Anseba: Weekly Trend of Bloody Diarrhea in 26 Number of Cases Week No 3rd Quartile Yr 26

4 WCO Meets to Develop Strategies for the Next Few Months The WHO Country Office held an in-house meeting on Thursday October 12, 26 to develop strategies for emergency response for the next few months. The meeting discussed report of EHA induction briefing held in Mombassa as well as report of nutrition management training held in Arusha, Tanzania. Eritrea was represented at both international workshops. The strategy meeting recognized two important areas as crucial for the coming months of which resource mobilization is one. The second area is holistic approach to management of malnutrition at community level. At the meeting it was resolved that two necessary steps needed to be taken: 1. To hold a retreat in Keren this week to develop project proposal was the first resolution. 2. To develop a strategy to integrate community component of nutrition management with the community IMCI approach. Other important next steps include follow up trainings at Zoba level, introduction of the new growth standards and establishment of 1 sentinel sites for nutritional surveillance. Members in discussion at the meeting

5 Findings of the HH/C-IMCI Released As pointed out in our last issue the MOH along with its partners has conducted a survey last August to evaluate the effectiveness and importance of House Hold/Community IMCI (HH/C-IMCI) and consequently promised that we would present the findings of the survey in this week s issue. The objective of the survey was to track the HH/C-IMCI pilot project s progress using KPC questions linked to benchmark indicators project monitoring. Moreover, it aimed at comparing the findings in the villages implementing C-IMCI and control villages, and help build consensus between local partners and stakeholders on scaling-up strategy. The survey took 3 household each from C-IMCI implementing villages and control villages. The questions asked in this survey were related to breastfeeding and infant/child nutrition, childhood immunization, water and sanitation, care seeking behaviours related to fever, diarrhoea and ARI, adoption of protective behaviours for malaria, and knowledge of protective behaviours for HIV. The findings of the survey follow. Child treatment and care The survey revealed that the villages in which C-IMCI is implemented fared slightly better than the control villages on child spacing. In the villages with C-IMCI 74.8% children aged between -23 months were born at least 24 months after the previous surviving child, where as in the control villages the percentage is 73.7%. Infants should be breastfed exclusively for 6 months and complementary feeding should be introduced at 6 months. Besides, children should be taken to complete a full course of immunization before their 1st birthday. Regarding these, the survey has found that 54.1% children in the age range between -6 months were exclusively breastfed during the last 24 hours in the villages with C- IMCI whereas only 47.6% in the control villages received the exclusive breastfeeding. However, the survey uncovered 8.3% children in the age -11 months were breastfed with in the first hour after birth in the control villages, 1.6% greater than the villages with C-IMCI. Furthermore, 75.5% children aged months were fully vaccinated before one year of age in the villages with C-IMCI making them 12.1% higher than those from the control villages. Water supply and hygiene One of the basic hygiene rules is to dispose faeces safely and wash hands after defecation and before handling foods. Strangely enough, 64.4% mothers of children in the age between -23 months from the intervention areas said that they washed their hands with soap or ash before food preparation before feeding children after defecation or attending a child who has defecated, about 4% less than from the control villages.

6 However, speaking of safe sources of drinking water- piped water, public taps, protected dug well- it was found out that in the intervention areas 71.4% respondents use improved source for drinking water more than 1% greater than in the control group. Malaria and HIV prevention Children living in malaria-endemic areas can be protected helping them sleep under ITNs. One of the questions asked in the survey was if the mothers own ITNs and use them or not. In the intervention villages it was found out that 75.5% mothers with children aged -23 months reported that they owned bed nets in the house and 8.3% children slept under insecticide-treated bed nets the previous night. In the contrary, 73.9% mothers from the control villages said that they own bed nets and 18.1% children from the control villages slept under insecticide-treated bed nets the previous night. On the issue of maternal knowledge of HIV risk reduction, 88.7% mothers from the intervention villages cited at least two known ways of reducing the risk HIV infection, about 4% higher than the ones from the control villages. Recognition and home management of diseases When asked if the mothers know at least two signs of childhood illness that indicate the need for treatment 76.4% mothers from the intervention villages said they do while 74.6% from the control villages said they do. Beside, 25.3% from the villages with C-IMCI had children who received increased fluids during an illness in the past two weeks, compared to only 2.2% from the control villages. Seeking advice or treatment When children get seek they should be continuously fed and be given more fluid. What is more, parents need to recognize when sick children need treatment out side the home and seek advice with out killing much time. Following the advice given by the health workers could be vital for the child s health. In the intervention areas, 42% and 54% respondents said that they sought advice or treatment for community health worker and health facilities respectively. Whereas respondents from the control villages 91% said they sought help from health facilities or centers and 3% each from community health workers and traditional practitioners. In the villages with C-IMCI about 33% of the respondents admitted that they sought treatment in less than 48 hours when they noticed the child had cough and fast breathing, whereas only about 13% respondents from the villages without C-IMCI said so. To treat cough and fast breathing 31.8% respondents from the intervention villages replied that they have given antibiotics where as only 17.7% respondents from the control group used antibiotics.

7 Time between noticing respiratory problems and seeking treatment 1 5 C-IMCI Villages No C-IMCI Villages <48h >48h For a child s diarrhoea about 83% of the parents from the villages with C-IMCI responded that they get treatment from someone outside the home while only about 57% parents from the control villages did so. Moreover, to treat diarrhoea 62.5% of the respondents from the intervention areas said they gave ORS to treat diarrhoea compared with only 47.1% from the control villages. In the conclusion of the survey it was explicated that men also need to actively involve themselves in child care and reproductive health in order to make HH/C-IMCI a success. Moreover, if this and similar interventions are to be successful better coordination with programs of environmental sanitation and nutrition at the community level is needed. Further qualitative research related to Health Seeking Behaviours need also to be undertaken, the finding of the survey pointed. The enumerators eliciting responses from Community members