Integrating ITN delivery and mass vaccination - PowerPoint PPT Presentation

1 / 40
About This Presentation
Title:

Integrating ITN delivery and mass vaccination

Description:

CDC Technical Advisor, American Red Cross. Recommendations ... American Red Cross. United Nations Foundation. Centers for Diseae COntrol. UNICEF ... – PowerPoint PPT presentation

Number of Views:79
Avg rating:3.0/5.0
Slides: 41
Provided by: adamw2
Category:

less

Transcript and Presenter's Notes

Title: Integrating ITN delivery and mass vaccination


1
Integrating ITN delivery and mass vaccination
RBM Board Meeting, Geneva, 1 April 2005 Mark
Grabowsky, MD, MPH CDC Technical Advisor,
American Red Cross
2
Recommendations
  • This approach represents a potential breakthrough
    to achieve Abuja targets
  • Need RBM leadership to refine strategy and
    develop country guidance
  • Empower RBM staff for operational coordination
  • Harmonize EPI and RBM assessment methods

3
MM Partners
  • Measles Partnership
  • American Red Cross
  • United Nations Foundation
  • Centers for Diseae COntrol
  • UNICEF
  • World Health Organization
  • Ministries of Health
  • Ghana
  • Zambia
  • Togo
  • Red Cross Societies
  • Ghana
  • Zambia
  • Togo
  • Canadian
  • Danish
  • New Zealand
  • Norwegian
  • Swiss
  • RBM
  • IFRC/IFRC Foundation
  • World Bank
  • ExxonMobil
  • Vestergaard-Frandsjen
  • Rotarians Against Malaria
  • Plan Togo
  • FUCEC
  • CIDA
  • NORAD
  • PSI
  • NetMark
  • DHL
  • Peace Corps
  • Satellife, Inc
  • Freedom from Hunger
  • Liverpool School of Tropical Med.
  • London School of Tropical Med.
  • University of Geneva

4
MM Evaluation Plan
5
Togo Campaign Acknowledgements
  • Togo Ministry of Health
  • Vincent Takpa, EPI Coordinator
  • Kodjo Morgah, Malaria Control Coordinator
  • Red Cross
  • Jean Roy, IFRC-Geneva
  • Nick Farrell, IFRC-Geneva
  • Marcy Erskine, Canadian Red Cross
  • Norbert Paniah, Togo Red Cross
  • Vestergard-Frandsen
  • Mikkel Vestergaard
  • CDC
  • Bill Hawley, Malaria Branch
  • Adam Wolkon
  • Jamie Eliades
  • Jodi Vanden Eng
  • Allen Hightower
  • Mac Otten, NIP/GMB
  • WHO
  • Placide Gbedonou, EPI Focal Person

6
Potential areas for collaboration during SIAs
Delivery of free treated nets, or vouchers, to
children under 5 years
7
"Free mass distribution of malaria bed-nets . . .
for all children in regions of malaria
transmission by the end of 2007. "
8
Reaching 100 million children in two
yearsAnnual number of children attending
measles campaigns, WHO/UNICEF Priority Countries,
1999-2004
9


Polio vaccination
Mebendazole tablets
Insecticide treated nets
Measles vaccination

3
10
Campaign Overview
  • Target Population
  • 870,000 children ages 9-59 months
  • 735,000 households
  • Delivery strategy
  • One-week campaign
  • 1,340 fixed, outreach, mobile posts
  • 20,000 health workers volunteers
  • 840,000 ITNs
  • Financial Resources - 5.9 million
  • Govt contribution CFA 10m (20,500)
  • Cold chain 500,000 (Rotary, GAVI, UNICEF)
  • ITNs 4.4m (CIDA, IFRC, Rotary, Norwegian RC)
  • Measles Initiative 639,000

11
Social Mobilization
More than 7,400 Red Cross volunteers trained,
monitored, and engaged
5,000 TRC volunteers received ITNs 2 weeks before
the campaign, demonstrated use
12
Organization of Posts
  • Registration card
  • Polio vaccination
  • Mebendazole
  • Measles vaccination
  • Bednet distribution

13
Focus of this Presentation
Procurement
Delivery
14
Evaluations
  • Anemia surveys pre- and post-campaign
  • Pre-campaign survey, September 2004
  • Post-campaign survey, September 2005
  • Coverage surveys 1 and 6 months post-campaign
  • 1 month survey completed February 2005
  • 6 month survey planned for June 2005
  • Facility-based mortality study ongoing
  • Cost effectiveness evaluation ongoing

15
Study Methods
  • All 6 regions included
  • 2 Districts/Region
  • 12 Enumeration Areas/District
  • Simple random sample of Enumeration Areas
  • GPS mapping (all houses in EA)
  • PDA selection (16 Households per EA)
  • PDA-based survey

16
Coverage, Post-Campaign
Denominator Children under 5 years of age
Measles vaccination
Polio vaccination
Mebendazole tablets
Coverage 98.4 94.3 92.7

17
ITN Coverage and Equity, Pre- and
Post-Campaign
HHs with lt5 child All HHs
Coverage, pre 10.0 8.0 Coverage,
post 87.0 62.5 Equity
ratio, pre .25 .25 Equity
ratio, post 1.02 1.02
18
(No Transcript)
19
ITN Coverage Children lt 5 (n2599)
Among eligible children, 90.8 received a
campaign net and 44 slept under the net.
20
(No Transcript)
21
Eligible Children and Households Receiving ITNs,
by Region
22
ITN Retention
Retention, among those receiving an ITN, one
month post-campaign
23
Cost Overview, per child, US
Summary Total cost 5.9 million Total children
870,000 6.75 per child for all 4
interventions 0.78 per child vaccinated for
measles
24
Summary
  • Campaign was completed on schedule and on budget
  • ITN coverage was high (90) and equitable
  • ITN logistics costs were low (about 0.50/net
    delivered)
  • ITN use was modest (40), consistent with known
    seasonal patterns
  • Data on efficacy and cost-effectiveness available
    2/2006.

25
Procurement
Delivery
26
Delivery
Procurement
27
Procurement
Delivery
28
Global/Regional Activities

Assessment/Assurance
Research
Policy
Financing
In-country activities
Procurement
Delivery
Monitoring
Proper Use
29
  • there is a huge gap between the current
    understanding at the global (partners') level and
    the likelihood of countries to immediately embark
    on the process.
  • from recent RBM/AFRO MM mission report

30
Not constraining currently
  • Funding
  • Partners
  • Political will

31
Constraints on Integration
  • Ambiguous ownership of integration, Measles or
    RBM?
  • Lack of consensus on strategy (One ITN per child?
    per HH? per Bed?)
  • Mismatch of EPI and RBM staff number, mission,
    support
  • Lack of in-country coordination for both MoH and
    UN agencies
  • Differences in EPI/RBM indicators, assessment
    methods, and use of data

32
Recommendations
  • This approach represents a potential breakthrough
    to achieve Abuja targets
  • Need RBM leadership to refine strategy and
    develop country guidance
  • Empower RBM staff for operational coordination
  • Harmonize EPI and RBM assessment methods

33
(No Transcript)
34
(No Transcript)
35
What is science?
  • A predictive discipline based on falsifiable
    facts.
  • Non-predictive
  • Each social marketing effort has a unique country
    context which precludes extrapolation of results
    to other countries.
  • Non-scientific
  • Social marketing is more sustainable than mass
    distribution. (Non-falsifiable)

36
Post-Campaign Survey Denominators
  • 2254 households
  • 2599 children (all lt5s)
  • 2469 total nets
  • 2194 ITNs
  • 1611 households with at least one ITN

37
ITN Use
  • Houses hanging net

Children lt5 sleeping under net
Pregnant Women
38
Household ITN Coverage (n2254)
Among eligible households, 87 retained a
campaign net.
39
Coordination spreadsheet, AFRO/RBM

40
Campaign Attendance
  • 97 of eligible children attended the campaign
Write a Comment
User Comments (0)
About PowerShow.com