liberia experience: national level coordination and partnership in cholera control. 14-16 may 2008...
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![Page 1: Liberia Experience: National Level Coordination and Partnership in Cholera Control. 14-16 May 2008 Dakar, Senegal](https://reader035.vdocuments.site/reader035/viewer/2022081518/5514c03855034640138b583d/html5/thumbnails/1.jpg)
Liberia Experience:National Level Coordination and Partnership in Cholera
Control.
14-16 May 2008Dakar, Senegal
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Background Situation• 15 counties and 88 districts• Estimated 3 million people- Sparse Pop - density, 84 per sq mile except
Monrovia (1 million people) - Infrastructures destroyed by war- Access to safe water - 24% (UNDP 2006),
sanitation nationwide - 26% - (UNICEF, 2006)- Low households incomes. ¾ pop on less than
US$1 a day (iPRS, 2007)- Infant mortality rate, 102/1000 & crude
morality estimate 1.1/10,000/day (CFSN, 2006).- Diarrhea 2nd cause in morbidity/mortality- Seasons– Wet –April – Oct, Dry Nov-March.
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Cholera hot spot areas
• Occurrence (slides line graph)
Sierra
Leone Guinea
Cote D’Ivoire
Atlantic Ocean
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Trends :2005 -2007
0
200
400
600
800
1000
1200
1400
jan feb mar april may jun jul aug sept oct nov dec
2005
2006
2007
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Liberia cholera trend in 2008
231
80
107
2 0 00
50
100
150
200
250
J anuary February March
Months
Cas
es a
nd D
eath
s
Cases
Deaths
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LIBERIA MAP SHOWING CHOLERA HOT SPOTS COUNTIES
Lofa
Nimba
Bong
Sinoe
Gbarpolu
Grand Gedeh
Grand Bassa
River Gee
River Cess
Grand Kru
Bomi
Margibi
Grand Cape Mount
Maryland
Montserrado
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National Strategy
• Coordination• Partnership• Surveillance / EWARNS• Institutional capacity
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Coordination
• Multisectoral approach • Decentralized epidemic task force • Standardized case management,
surveillance & monitoring• Partners mapping & up dates.• Leadership – MOH/CHT• Annual integrated plans.• Pooled contingency plans / stocks
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Partnerships• Relevant GOL Ministries / Depts • CBOs Hygiene behaviors promotion• UN agencies: UNICEF, WHO, UNMIL- Tech. asst; Finance; Resources;
logistics.• Health/WATSAN NGOs and WATSAN
CONSORTIUM• Communities
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Surveillance• Standardized data collection tools
& analysis at county levels.• Pre-positioned investigation & case
detection teams.
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Institutional capacity
• INGO – (9), LNGO) (26) & CBOs in 4 counties
• UN agencies –(WHO, UNICEF, UNHCR)• Community – ORT corners / Treatment
centers, trained • Trained staffs & community own
resource persons (volunteers).
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Successes• Consistent reduction in attack rates• Sustained multisectoral & integrated
approach to cholera control• Availability of trained local resources at
community level.• Sustained partners support.• Decentralized chlorine stocks• Response within 24hrs-48hrs• Coherence approaches &Team work.• Functional surveillance systems
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OUR UNIQUE WAYS OF WORKING.
• Merged GOL coordination & WASH cluster.
• Innovations - Pooled funding (DFID/ECHO) -WASH consortium – 5 INGOs – services delivery & capacity building through GOL.
- Pool funding from partners
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Limitations/Challenges• Deplorable infrastructure states• High Poverty level• Meager resources skewed towards curative services.• Low WASH coverage.• Insufficient resources – human & materials• Weak national systems / policies enforcement.• Inadequate mid-level skilled health personnel to manage
cholera control• Transition from humanitarian to development.• Low access to health services • Unreliable data for planning
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LESSONS LEARNT• Pre positioning of stocks - chlorine• Routine Well chlorination. • HH water chlorination practice• Pre-mapping and identification of
resources at county levels. • Community based hygiene education • ORT corners / Treatment centers• Sustained partnership & coordination
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Our Needs• Long-term funding from donors,
targeting AWD/Cholera / WASH.• Support for Skill training on cholera
management. • Expansion of decentralized cholera
confirmation laboratories - Counties • Research on cholera to establish
evidences for intervention.• Support for sustainable WASH activities.