vaccine and its delivery in nepal

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Glimpse of Vaccine Delivery in “High Altitude & Remote” parts of Nepal

11 Sept, 2014Anuj Bhattachan

http://anujinhimalayas.blogspot.kr /Skype: anuj.bhattachanTweeter: Yeti4mNepal

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Disclaimer: All pictures are sourced and used for educational purpose only

Photo source: www.google.com/picture

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Me and Female Community Health Volunteers (FCHV)

Photo source: Anuj Bhattachan

Foot soldiers for VACCINATION !!

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Agenda1. Introduction of Nepal2. Existing Needs and Problems in

Immunization 3. Solution to the needs or problems4. Future conditions where we can “act”

FocusChallenges during “Vaccine Delivery” in Remote High Altitude Areas

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Nepal

Region

• 5 Regions

District• 75

districts

Mugu

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Health Structure below District level in Nepal

District Health Office

Primary Health Center

FCHVs PHC/ORC clinic

EPI Out reach Clinic

Health PostSub health Post

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District Health Office

Photo source: Anuj Bhattachan

Energy Source (S) in remote districts of Nepal

Firewood

Kerosene

Solar

Hydro

Wind

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Temperature Monitoring

Thermometer Temperature log

Photo source: Anuj Bhattachan

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Delivery – Safe and Effective vaccine

Photo source: Anuj Bhattachan

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But, ??

Photo source: Anuj Bhattachan

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What could be the reason?

Old!! Old and leaky!!Photo source: Anuj Bhattachan

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Drop Out – Complete vs. Incomplete dose(s)

Photo source: Anuj Bhattachan

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Missed children – New Born Babies

Photo source: Anuj Bhattachan

14Photo source: Anuj Bhattachan

Want to vaccinate - not aware “where & when to vaccinate?”

Will walk for hours to vaccinate their children

Children living in wild – “Zero dose”

Want to vaccinate but busy with their “family works”

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Untouchables

Not vaccinated – “Zero Dose” “Not Completely” vaccinatedPhoto source: Anuj Bhattachan

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Questions - How to REACH and VACCINATE these children?

Vaccinator Children at High Risk of diseases

A child diagnosed as “Paralytic poliomyelitis”

Photo source: Anuj Bhattachan

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Geography – 3Ds

Photo source: Anuj Bhattachan

Difficult Days

Dangerous

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Walk & Carry Vaccine(s)

Photo source: Anuj Bhattachan

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Challenges vs. Solution

Photo source: Anuj Bhattachan

Challenge

District Health Officer

Challenges Solution

Macro level

Geographical challenges At local and state level

Resource Management At local and state level

Socio – political landscape At local and state level

Micro level

Sustainable Energy Supply for district cold room

Solar / Wind /Hydro electricity

Vaccine Carrier SMART vaccine carrier

Vaccine Stock management

Information technology + local knowledge and wisdom

Continuous Temperature Monitoring

Vaccine Transportation management

Micro planning of EPI at district / village level (Monitoring, Evaluation and Information management/vaccine supply & quality)

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Future conditions where we can “act”

“The best way to escape from a problem is to solve it”

Photo source: Anuj Bhattachan