Nation-wide Measles/Polio SIAs in Afghanistan, 2012
The action have been prompted by the nation wide measles outbreak in 2012. Three folds increase in the number of cases as compared with 2011High mortality rates in initial phases (before response)
Poor quality of district micro-plans (some provinces) Poor quality of district micro-plans (some provinces)Weak strategy for remote and high-risk areas Shortage of trained health workers Difficulty in reaching all children in problematic provinces (Kandahar, Helmand, Farah, Zabul, Uruzgan, Badghis, Ghor, Kunar and Nooristan, Paktika, Paktya and khost); 54 districts underperformed Over-reporting
Early preparation and proper micro-planning is the keyInaccurate denominator resulted in in-adequate micro-planning including incorrect estimation of vaccine/supplies, human resource need and fund in many instances. Timely inventory of cold chain equipment is vital for adequate handling of vaccine and preventing shortage of vaccines at service delivery levelsIn advance identification of trained health workers and volunteers helps to timely conduct training courses Visiting all households for referring of children to the vaccination sites and adequate daily monitoring /reporting helps taking timely actions during the implementation
Local measles campaigns should be conducted in partially covered districts to reach the un-reached children and supplement declining routine immunization coverage Local measles campaigns should be conducted in partially covered districts to reach the un-reached children and supplement declining routine immunization coverageConduct measles mop-up campaign in the districts that could not achieve 90% coverage for measlesImplement RED strategy in all districts less than 60% coverage for EPI.
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