INTRODUCTION
As a global effort on polio eradication initiative, out of estimated 350,000cases since 1988, over 99% have decreased, to 22 reported cases in 2017. And the polio eradication teams on the ground at national, regional, and global level are actively response to the detected wild and vaccine derived polio virus outbreak in north-east Nigeria, specifically in Borno state. The regional outbreak response is being coordinated within the context of the broader humanitarian emergency affecting part of the region.
The government of Nigeria has declared the outbreak to be a national public health emergency for the Lake Chad sub region.
The purpose of conducting mOPV2 implementation is to achieve sustainable interruption of cVDPV2 and other child killer diseases from the LGA by administering 2 drops of potent mOPV2 orally to the children between the age of 0-59month and that of under one year with other antigen. These include improving routing immunization coverage, surveillance and effective case management this report contain pre-implementation, implementation, post implementation outcomes, challenges, weakness, strength, recommendation/way forward, it also include details and analysis of data generated during the period of implementation in the LGA.
BACKGROUND INFORMATION
KagaLGA is among the twenty seven LGAs in Borno state with its HQs at Benisheikh town which is approximately about 380kms away from the state capital (Maiduguri). The LGA (Kalabalge) has Ten political wards namely Balge,Jilbe(A), Jilbe(B),jarawa,Kala,Kumaga, Rann (A) Rann(B),Sabkara,Signal,S
The LGA has Two (2)As Temporary Due to Inscurity HFs, all were providing RI services. Also the LGA shares boundaries with Konduga, Damboa, and damaturu. The LGA has Total population 9787, OPV TP is 9580, LGA also has four wards that are HTR; these are ,Rann and --------r. And it has two typical seasons which is wet and dry season with rocky and dry sandy.
However, the majority of the inhabitants are Kanuri, and other minority tribes such as hausa, fulani,Shuwa Arab, and respectively. The mainly spoken languages were Kanuri&hausa while English language served as an official language. The source of water supply in the areas are boreholes and wells, national grid is the LGAs power supply not fuction. The predominant occupation of the people is farming and rearing of animals and few civil servants are found in the LGA.
ROUNTIN IMMUNIZATION (RI)
The LGA has about Two (2) HFs, all HFs were providing RI services.And is conductingR.I fixed and outreach service in all the ward within LGA. 10 health facilities rendering RI Services andthis are the list of Health facilities conducting R I service and Immunized of penta1,penta3, Measles and opv3 by HF in 2021.
AFP SURVEILLANCE
The local government area Ba Ngumdo and ADSNO with the assistance of focal site in kaga local government area, there was active surveillance In the L.G.A, and 3 case of AFP reported and result shows negative. And Also the LGA has sex (6) focal site.
PRE IMPLEMENTATION
PLANNING MEETING
STF arrived the LGA on the 15/12/2020 LGA teams were briefed and updated on the exercise.Cold Chain assessment was done on same day, Planning meeting was hold at UNICEF CLINIC Rann all the LGA team members and the partners are in attendance in which all issues, challenges’ and gaps from previous implementation have been addressed, and all pre implementation process such as HRA,HROP, Advocacy visit plan, LGA/Ward level training plan, SMC activity plan, Cold chain assessment and DIP update plan also made available.
HIGH RISK ANALYSIS/OPERATIONAL PLAN
High risk analysis was done, and operational plan were develop to see that good coverage was achieved in areas of high risk. In the L.G.A, community Dialogue/Transport plan where the key areas of focus during high risk analysis/operational plan for this round.
BUILD UP TO EXERCISE
Advocacy visits were paid to the District Heads of Rann to appreciate their efforts and participation during the last campaign, soliciting for more support and Involvement in the coming round of Implementation. The Local Government Team had a meeting to develop plans for the pre-implementation Activities, to solicit for their support and commitment toward mobilizing and resolving issues in their respective wards, the meeting was hold and suggestion were made on creating awareness to the community a day to implementation of each and every catchment area, throw conducted one day announcement in all the town, and community dialogue in Rann
ward, and Masjid, church announcement by the religious leaders.
Advocacy visit was also paid to the LGA SEC. for financial support and task force members to participate in supervision of SIPDs activities during implementation as well as political participation during implementation for monitoring and supervision.
SOCIAL MOVILAZATION PLAN MEETING
Local Government Area meeting was held on 15th January, 2021 to Plan for all activities with social mobilization activities and communications inclusive. Advocacy and sensitization visits were paid to the Local Government Area Village Head as well as some Traditional and Religious leaders based on the pending issues from the last round campaign and to solicit for more effort and support for the success of the May round. The SMC to draw a work plan for the campaign discussing other necessary matters which were agreed on to be implemented this round, based on the detailed security Assessment of the Local Government Area. Sensitization meetings were held with some Prominent/Influential Traditional leaders and community leaders.
Public Announcement was also made with Megaphones by town announcers in all the 2 Political wards to increase the rate of awareness
TRAINING AND TEAM SELECTION
The LGA level training of ward focal person and team supervisors was done, the training was facilitated by STF, LGAF,NSTOP and LGA team. And ward level training of house to house vaccinators and community leaders were staggered along must of the wards. So also health workers were trained based on guide from state WHO office. As training agenda were available for all the ward
Almost all participants are recruited within their respective catchments areas. The training objectives were well defined and methodology used include, discussion, practical demonstration and participatory to ascertain and impact good skills for proper implementation.
Pre and posttest were administered to all participants to assess the level of performance of the teams.
The Manpower Recruitments for the JANUARY 2021 SIPDs in Kalabalge Local Government area: 1 Ward Focal Persons, 12 Team Supervisors, 12.House to House Vaccinators, 12 Local Guides, 2 Health Workers, 2 Fixed Post Recorders,2 crown controlar 2 special Team Vaccinators, 2 Recorders, 2 Town Announcers and 6SField Volunteers.
MICRO PLANNING
The Micro Plans were reviewed and updated on desks at all levels throughout the Local Government Area, by developing a new Micro-plan with a total list of Special Population, Nomads, Borders and Hard to Reach Settlements were identified and verified by the Community Leaders together with the Local Government Area Team. Operational Work Plans were made forthe Immunization of such Settlements and Plans were drawn for implementation in Border Settlements and pasted. Finally, Daily Route Maps and Work Plans were developed in all the 7 Political Wards of the Local Government area. A daily route maps shows all catchment areas and settlements to be covered as well as ward maps indicating all the features of each ward e.g. Hard to Reach, Border settlements, Schools, Markets, Masjid, Churches, Water Points and Play Grounds were developed. Cold Chain Inventory indicatingavailability,requirements and short falls of vaccines and other logistic requirements/Transport plans were developed.
VACCINE MOVEMENT
The LGA has functional cold chain equipment for the manufacturing of ice pack. The LGA have 1 Rentail deep freezers for the production of ice packs in the cold store, other include, cold boxes, vaccine carriers, (kick polio/Giostyle).
The following were received from the zonal cold chain office on 14th January, 2021. BOPV –10380 doses with VVM stage 1, and the other antigen ware collected from SDD of each ward measles=0 doses , YF-=0 Penta valent=0,pcv=0 TT=0 doses, AD syringe =0 Pcs, reconstitution syringe=0 Pc, safety boxes =0 pcs and pen markers 120
Distribution plan of vaccine and dry materials, to each ward were drawn, display and followed strictly. Ward level plans and summary at LGA micro-plan for each ward were supervised and verified by STF, LGA facilitator and LGA team before the implementation and also summarized at the LGA level.
SUPERVISORY WORK PLAN
Supervisory work plans were developed for Pre/Post Implementation to ensure supervision and monitoring was conducted thoroughly and intensively on daily basis at different levels with all available supervisors and monitors from different partners and
local government team. This was pasted on the wall at the local government main cold chain office to be duly followed
IMPLEMENTATION
The Outbreak response (SIPDs) was conducted in Kalabalge Local Govt. The Exercise took place from 16h to 20thJan., 2021. During the exercise, BOPV was administered to children based on the target age of 0-59 months in (1) wards across the LGA. With 214 settlements in all the settlement in the ward were able to cover within 4 days including special place by 12 H2H Team and 2 special team, 2 fixed post Teams.
Teams followed House to House and Street by Street to immunize children under five years of age in everywhere there are even as some households refused/rejected the immunization. After intervention by LGA team, most of the non-compliances were resolved as they were no pocket noncompliance, only3 HH with 6 children absent.
MONITORING AND SUPERVISION
Monitoring and supervision by the senior supervisors (LGA team & all partners) are fully participating in identifying the problem areas during implementation and ensure that all eligible children were immunized with potent vaccine as well as dry materials were adequate and in good condition, so as to strengthen team performance at the field. Independent monitors were deployed to carry out in/end process evaluation, using monitoring tools and daily implementation checklist in assessing the quality of work during Implementation.
Daily evening review meeting was carried out at the ward/LGA level where critical issues, challenges and way forward have been discussed. The Local Governmentsec. attended the Evening Review meeting from day1-day4 by representative, in which issues as cold chain materials and have been address, and resolved all noncompliance.
RESULTS/OUTCOME OF IMPLEMEON
Ø The LGA has target population of =9787
Ø Fixed post zero done =18
Ø Other doses =33
Ø Special places = 1300
Ø H2H Imm =8094
Ø RES = 0
Ø Total imm =9580
Ø Vaccine used = 10200
Ø Pending child absent 3 HH with 6 children and
Ø Noncompliant 0 HH with 0 children.
COVERAGE/TP/CHILNDREN IMM.BY WARD
|
S/No |
Ward |
Cov % |
TP |
Children Imm |
|
1 |
Rann |
98% |
9787 |
9580 |
|
0 |
0 |
0 |
||
|
0 |
0 |
0 |
||
|
0 |
0 |
0 |
||
|
0 |
0 |
0 |
||
|
0 |
||||
|
LGA TOTAL |
1 |
98% |
9787 |
9580 |
S
|
|
POST-IMPLEMENTATION
SWOT ANALYSIS
Strength
- Active involvement of Traditional Leaders in the Exercise
- Availability of Pluses aid acceptance
-Commitment of Traditional Leaders in Supervision and resolving some Non-compliance Cases
- Active and Supportive Supervision of Senior Supervisors
OPPORTUNITIES
The Local Government Team and other Agencies supervised and supported tremendously during the Exercise. These lead to resolving some of the Non-compliance and child absent cases across the Local Government Area during the Exercise.
WEAKNESS
-Inadequate senior supervisors for close supervision
-Non Movement of some Ward Focal Persons around the teams for supervision
THREATS
- Lack of enough essential Drugs to take care of other sickness especially paracetamol syrup and others
- Lack of counterpart funding by the State and Local Government Area
RECOMMENDATION
-The Local Government Area should supplement the efforts of the Donor Agencies by procuring essential Drugs for the Treatment of Minor Ailments
- State and Local Government Area should provide counterpart funding to supplement Donor agencies’ efforts.
- Increase more efforts in revisit strategies next round
- Acceptance of faults and effecting necessary corrections made by the Senior Supervisors to the Ward Focal Persons as well as the Teams during evening review meeting.
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