Status of EPI In GuineaDR. Mariama BAHChild Survival AdvisorUSAID/GuineaJune 13, 2002

Country Background

Surface: 245,857 kmPopulation: 8,225,750Children < 1: 329, 030WOCA: 2,056,000IMR: 98/1000UNDER 5 MR: 177/1000No. of Regions: 8No. of Health Facilities: 817

Health StructureCentral levelNational HospitalRegional HospitalRegional LevelPrefectoral HospitalPrefectoral LevelHealth CenterSub-Prefectoral LevelDistrict LevelHealth Post

Organigram of the MOH

Trends In Immunization Coverage

Data

Reported DPT3 coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Guinea217204152527373485356575757

(rev 19/11/2001)BCG coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Ethiopia56781113282744702926364665545247505156

Uganda18375174771001001009810098100968469777781

Ghana67513135353770715661686167657277889591

Guinea531505751517878596969727171

Mali1915216485827269776780767675848268

Senegal329193916965697190908080898989

OPV3 coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Ethiopia334467161626492112283657424137404250

Uganda9141421394060777771747979795947525360

Ghana7222319151836504039474850526169727280

Guinea217204152527373485356575757

Mali361826423633463949525252523251

Senegal545971665146525780806565494949

Measles coverage by country: African Region, 1978 - 2001

Country818283848586878889909192939495969798990001

Guinea917253956566969495658615959

TT2+ coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Ethiopia223345710241669121625274024313229

Uganda2057131420313983847677774538404245

Ghana1197422825191011231120148918527387

Guinea620212951516666434548484343

Mali1382231373319191720191919626118

Senegal832373326303239393434824545

DPT3

1118111

828282828282

838383838383

848484848484

858585858585

86868628686

878787878787

888888888888

898989178989

909090209090

919191419191

929292529292

939393529393

949494739494

959595739595

969696489696

979797539797

989898569898

999999579999

000000570000

010101570101

#REF!

#REF!

#REF!

Guinea

#REF!

#REF!

Years

Coverage (%)

DPT3 Coverage: 1986-2001

Measles

1118111

828282828282

838383838383

848484848484

858585858585

86868698686

878787878787

888888888888

898989178989

909090259090

919191399191

929292569292

939393569393

949494699494

959595699595

969696499696

979797569797

989898589898

999999619999

000000590000

010101590101

#REF!

#REF!

#REF!

Guinea

#REF!

#REF!

Years

Coverage (%)

Measles Coverage, Selected Countries: 1981-2001

Data

Reported DPT3 coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Guinea217204152527373485356575757

(rev 19/11/2001)BCG coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Ethiopia56781113282744702926364665545247505156

Uganda18375174771001001009810098100968469777781

Ghana67513135353770715661686167657277889591

Guinea531505751517878596969727171

Mali1915216485827269776780767675848268

Senegal329193916965697190908080898989

OPV3 coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Ethiopia334467161626492112283657424137404250

Uganda9141421394060777771747979795947525360

Ghana7222319151836504039474850526169727280

Guinea217204152527373485356575757

Mali361826423633463949525252523251

Senegal545971665146525780806565494949

Measles coverage by country: African Region, 1978 - 2001

Country818283848586878889909192939495969798990001

Guinea917253956566969495658615959

TT2+ coverage by country, African Region: 1981-2001

Country818283848586878889909192939495969798990001

Ethiopia223345710241669121625274024313229

Uganda2057131420313983847677774538404245

Ghana1197422825191011231120148918527387

Guinea620212951516666434548484343

Mali1382231373319191720191919626118

Senegal832373326303239393434824545

DPT3

1118111

828282828282

838383838383

848484848484

858585858585

86868628686

878787878787

888888888888

898989178989

909090209090

919191419191

929292529292

939393529393

949494739494

959595739595

969696489696

979797539797

989898569898

999999579999

000000570000

010101570101

#REF!

#REF!

#REF!

Guinea

#REF!

#REF!

Years

Coverage (%)

DPT3 Coverage, Selected Countries: 1981-2001

Measles

1118111

828282828282

838383838383

848484848484

858585858585

86868698686

878787878787

888888888888

898989178989

909090259090

919191399191

929292569292

939393569393

949494699494

959595699595

969696499696

979797569797

989898589898

999999619999

000000590000

010101590101

#REF!

#REF!

#REF!

Guinea

#REF!

#REF!

Years

Coverage (%)

Measles Coverage: 1986-2001

Polio Eradication Progress

Indicators of surveillance for AFP

Non polio AFP>= 1 and stools within14 days>= 80%

Did not reach the 2 indicators

Factors Affecting Immunization Performance:Basic elements of an immunization system

Strengthened Human CapacityRecruitment of 800 new health agents of which 80% were assigned to a health center or health postFour national consultants supported by USAID, UNICEF and WHOAdd No. of Polio technical advisorsInvolvement of NGOsStaff training in polio, measles, and essential drug management

Improved Management5 year /annual plansmicro-planning for NIDSmonitoring/supervisionICCInjection safety policy

Improved FinancingGovernment purchase of vaccineGAVI support Debt ReliefBamako Initiative

Improved OperationsCold ChainLogisticsService DeliverySocial Mobilization

ConstraintsGeographical AccessVaccine stock-outs polioAntiquated equipmentInsufficient communications/social mobilizationStaff competency

Lessons LearnedCommitment of partners, community , health and admin authorities: Functional ICC KeyUse of debt relief funds to implement the EPIUse of mass media and theater groupsStrengthening of EPI through NIDSStrengthening of MOH capacity ( TA)Commitment of the GOG to manage funds allocated by GAVI

Conclusions: Role of USAIDUSAID/GUINEA in partnership with other partners have significantly contributed to the accomplishment of the MOH EPI . This was achieved through:Participation in ICCAddressing Immunization system strengthening in discussions with UNICEF, WHO, the Japanese

Conclusions ContinuedParticipating in discussions and development of GAVIThrough the BOOST immunization Initiative participating in the design and implementation of NIDS activities to raise Immunization Coverage Rates

State what your objectives are :

3-4 points you want to make:

1. Status of EPI in a country in some conflict2. Context affecting positive and negative the EPIPolio, Gavi, BI, ETC.3. Role of USAIDI think you should say something about the political context I.e Displanced Persons; IDPs; Conflict

WOCA= women of childbearing age: ( THS FOR TT)You have great maps and they should be used to show the difficult circumstances of guinea

use DHS as your data source.While presenting this state: No. of health centers incrase; Countries receiving support through USAID BOOST AND Grants to AFRO/UNICEF for Routine showing changes>Countries receiving support through USAID BOOST AND Grants to AFRO/UNICEF for Routine showing changes>

Key Levers to strengthening EPI AReStrengthen the 3 basic elements:ManagementCapacity buildingFinancingin order to implement effective & efficient operations:Vaccine supply and qualityLogisticsService deliverySurveillanceAdvocacy and communicationImprove financing for:Op. costs & perdiem for supervision & outreachCold chain & transport rehabilitationImprove management at central & district levels for:Monitoring & reporting + feedbackFight drop-out & missed opportunitiesIntensify capacity building for:Improving management capabilitiesImproving operational capabilitiesSelf-monitoring & use of data at all levelsState how much was due to polio if you can. Always highlight benefits and negatives of polio, and other things like gavi, bamako Initiative, outbreaks etc. New central Cold Store315 refrigerators123 motorcycles10 vehicles for districts ( Polio FUNDS???Spare Parts400 bikes ( Polio)Increased Access5 health centers and 48 new health posts ( 2001)Theater groups etc