vaccine and its delivery in nepal
TRANSCRIPT
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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