Bulletin of the WHO Eritrea 1 PDF
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Transcript of Bulletin of the WHO Eritrea 1 PDF
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7/30/2019 Bulletin of the WHO Eritrea 1 PDF
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Issue No. 4
Aug. 2013
Ambassadors acknowledged on-site evidence ofUN support to Eritrea during UN organized, sup-
ported field visit to the Northern Red Sea Re-
gion..2
WHO Eritrea supported Ministry of Health in
launching GeneXpert, a breakthrough diagnostic
tool for TB and Rifampicin resistance... ..4
WHO Eritrea promoted healthy lifestyle and need
of inter-sectorial collaboration at World Health
Day commemoration event..5
Above half-million children reached during the
WHO/UNICEF supported Eritrea edition of the 3rd
African Vaccination Week....7
WHO Supported Immunization Coverage Survey confirms High EPI Coverage of 96% in Eri-
trea...8
UN Health and Nutrition Thematic Group empha-
sized on coordinated UN support to the govern-
ment..9
WHO supported Maternity Waiting Homes to im-
prove access to emergency obstetric care in Eri-
trea...10
WHO provided IT equipment and variousmedical supplies to support Eritrea MOH on
NCDs control, IHR core capacity and surveil-
lance.12
Contents
For More information please contact:: World Health Organization in Eritrea, Geza Banda, Asmara
Tel. 291-1-200634/ 291-1-114171 Fax: 291-1-125155; E-mail: [email protected]
WHO Representative to Eritrea, Dr Usman Abdul-
mumini briefing on Solar Suitcase.
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Ambassadors acknowledged on-site evidence of UN support to Eritrea during UN
organized, supported field visit to the Northern Red Sea Region
The UN Country Team organized and coordi-
nated visit of the Ambassadors to the Northern
Red Sea Region of Eritrea in April 2013 in col-
laboration with the Government of the State ofEritrea.
The visit was aimed at acquainting the ambassa-
dors on the achievements gained to-date by the
government of Eritrea with support of the UN
Partners, mainly WHO and UNICEF. In addition,
it was a forum to show donors the challenges and
constraints especially related to resources gaps so
as to serve as resource mobilization in various
sectors including health, education, water and social
welfare.
The Ambassador of France, Deputy Chief of Mission
of the United States of America, the Chinese Ambas-
sador, the deputy ambassador of the EU in Eritrea,
the Ambassador of the Southern Sudan, the Charge
dAffaires of Djibouti and representatives from
WHO and UNICEF participated in this high profile
visit. From the government side, Hon. Governor of
the Red Sea Region, the head of Ministry of Foreign
Affairs Protocol Division, Director
A solar Suit Case being demonstrated by
the WHO Representative
General of Social Affairs, Head of the Social Sec-
tors in the Region, Regional Medical Officer and
other government officials in the Region partici-
pated.
The visit was extensive and covered several loca-
tions such as: Sheeb nomadic school, donkey pro-
ject; Foro Health Center; Adulis Historic sites and
Al-Sahab Historic Mosque in Massawa, Northern
Red Sea Museum Center; Port Quarantine (IHR);Amatere HC; Dongolo Tahtay Open Defeacation
(ODF) Free villages; Ghindae Zonal Referral Hos-
pital and Visit to Ghindae Group Home. In addi-
tion, museums and historic sites such as Zula and
Adulis were visited.
Amongst the sites of which were particular interest
to WHO were: Foro Health Center, the Massawa
Port Quarantine unit in relation to the IHR (2005)
and the Amatere Health Center. In Foro Health
Center, WHO has supported the health facility in
the establishment of the Maternity waiting Home
which was instrumental in reducing the suffering
of mothers during the last trimester thus availing
them close to the health facility during their deliv-
ery. This project is expected to reduce the mortal-ity of mothers and neonates significantly in the re-
gion. Similar projects are also implemented in the
neighbouring Region of the Southern Red Sea.
Moreover, WHO has provided a Solar Suite case
which provides light and electric power for various
activities and Doppler to monitor fetal heart rate.
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As part of the continuous support to the government, WHO is supporting the MOH in building the institu-
tional and human capacities in relation to the minimum core capacities required for the IHR (2005). This is
vibrant at the officially designated point of entries namely the sea ports, air ports and ground crossings. Apresentation was given by the head of the Quarantine Unit in the Northern Red Sea Region during the visit,
with further explanations by the WR. Similarly, achievements and challenges were also presented to the Am-
bassadors during the presentation.
The visit to the Amatere Mother Child Health Centre where various activities including nutrition, mother
child health, Integrated Management of Neonatal and Child Illnesses, immunization etc. are carried out by the
government with the technical support from the UN. Preparation is also going on to equip the Health Facility
with materials that enable to conduct emergency obstetric interventions.
The mission has given a very good opportunity for the involved Ambassadors to understand the support given
by various UN organizations to the Government of Eritrea in various aspects of health and development. The
Ambassadors made appreciatory remarks at various occasions during the visit.
The widened understanding of the Ambassadors on UN support has generated a good opportunity for the UN
to mobilize resources for the common cause. Moreover, it enabled the government officials to appreciate on
the support UN Agencies are rendering in the country. Furthermore, joint planning and joint execution of the
plans by UN Agencies for such high level delegates has demonstrated One UN, coordinated and aligned
support.
WHO Representative of Eritrea, Dr Usman Abdul-
mumini briefing on International Health Regulation
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WHO Eritrea supported Ministry of Health in launching GeneXpert, a breakthrough diagnos-
tic tool for TB and Rifampicin resistance
The TB case detection rate has been stagnating for
some time within the National TB Control Pro-
gramme. The programme is relying heavily on spu-
tum smear microscopy; an old and less sensitive tool.
This leads to the challenges in early detection of TB
especially among HIV positive individuals. The de-
tection of drug-resistant TB is a particular challenge
due to the unavailability of culture & DST services
for many years. However, the culture & DST has
been recently resumed but it has an inherent problem
of long reporting time (2-4 months). The WHO led
TB programme review in May 2012 also highlighted
the need for introduction of newer, more reliable di-
agnostic tool within the programme.To address above challenges in diagnosis, the MoH in
consultation with the WHO decided to implement
GeneXpert within the National TB Control Pro-
gramme. The WHO provided technical assistance to
the MoH in developing a national plan for the imple-
mentation of GeneXpert as well on the request from
the MoH, WHO procured 3 GeneXpert machines
through the help of WHO HQ TB Reach mechanism,
at the expense of USD 113,950.
WHO also facilitated recruitment of a consultant for
training of laboratory and programme staff and in-
stallment of machines at three selected sites. The
training was organized in WHO conference room to
provide the participants a facility for the web-based
discussion.
The Xpert MTB/RIF is an automated, cartridge based,
molecular (Nucleic Acid Amplification) test which
uses GeneXpert multi-disease platform to detect TBas well as Rifampicin resistance (proxy to MDR-TB)
from unprocessed sputum samples in less than 2
hours. After a rigorous assessment of efficiency and
its field effectiveness, the WHO endorsed Xpert
MTB/RIF test in Dec 2010, for the widespread use
for the diagnosis of TB and rifampicin resistance in
high burden countries.
Web based training of participants in WHO
Conference room
Installation of Genexpert in Orotta Referral
Hospital Laboratory
The introduction of this assay in the National
TB control will be a breakthrough in diagnos-
ing TB and Rifampicin resistance, quickly andmore reliably. It will improve case detection
within the programme and prevent suffering
and death due to delayed diagnosis of TB and
drug resistance, Dr Abdulmumini Usman,
WHO representative for Eritrea anticipates.
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WHO Eritrea promoted healthy lifestyle and need of inter-sectorial
collaboration at World Health Day commemoration event
Asmara Eritrea, 30 April 2013 To mark World
Health Day and 1000 days to Millennium Develop-
ment Goals (MDGs), WHO Eritrea and Ministry of
Health jointly organized an event on 30 th April 2013,
at the National Confederation of Eritrean Workers
(NCEW). However, the World Health Day is usually
marked on April 7 every year to commemorate the
anniversary of the founding of the World Health Or-
ganization in 1948.
The event was graced by the H.E Minister of Health,
H.E. Minister of Labor, various UN agency represen-
tatives, diplomats from various embassies, govern-
ment officials and representatives of the non-
governmental organizations.
Control your blood pressure was the theme of this
years World Health Day. More than one in three
adults worldwide has high blood pressure, which is
both preventable and treatable. High blood pressure
increases the risk of heart attacks, strokes and kidney
failure.
The United Nations Millennium Development Goals
(MDGs) are eight goals that all 191 member countries
have agreed to try to achieve by the year 2015 and
currently we are about 1000 days away from the dead-
line- said Dr Abdulmumini Usman, WHO represen-
tative to Eritrea. Honorable Minister of Health, Mrs
Amina Nurhussien apprised audience about the major
achievements made toward achieving health related
MDG goals and commended the department of health
for that. We are very much aware that our achieve-ments should not be the causes for satisfaction, as
more work to be done to maintain what has been
gained- remarked the minister.
Speaking on the event, Dr. Abdulmumini Usman,
WHO representative to Eritrea informed that the de-
veloping countries are observing an increasing trend
of non-communicable diseases, like, cardio-vascular
diseases, diabetes, cancers etc. Stating the impor-
tance of eating healthy foods, he advised people to
reduce salt intake; avoid tobacco use and harmful
use of alcohol; control body weight; and regularly
check blood pressure. Health is multi-dimensional
and all sectors have important role in preventing and
promoting healthy behavior- he stressed.
The world is experiencing three major issues
around food: food security, food safety and nutri-
tion- cited by, Dr Moeketsi Mokati, Food and Agri-
culture Organization (FAO) Representative in Eri-
trea. He also showed the global achievements on the
MDG goals related to food and read out the message
from the UN resident coordinator.
Dr Andebrhan Tesfatsion , acting director general,
public health presented on the MDG goals and status
of Eritrea toward achieving those targets. Eritrea is
on track in achieving MDG targets on improving
education and gender equality and reducing child
mortality, maternal mortality, TB, HIV and Ma-
laria- he said.
Dr Usman Abdulmumini, WHO Representative
of Eritrea delivering remarks.
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He emphasized on the need of increasing government commitment, more community participation and mul-
tisectoral partnership to achieve uniform success in all areas of health and development.
Dr Arai Berhane, the Director of Communicable Disease Control Division described the symptoms, causes,
prevention and treatment of high blood pressure. Excess consumption of salt, heredity, overweight, diabe-
tes, alcohol, high fat intake, smoking and lack of exercise are the major risk factors for high bold pressure-
he informed. Furthermore, he said that almost 90% Eritreans have one or two risk factors for high bloodpressure. But, healthy diet, increasing physical activities and avoiding smoking, reducing alcohol and man-
aging stress can minimize the risk of high blood pressure. He too emphasized on strengthening non-
communicable diseases control programme through increasing community involvement and partnership.
In the event, two nurses were assigned to measure the blood pressure of the participants and many took the
advantage. The event was concluded with the cultural show.
Participants of the event.Cultural show of the event.
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Above half-million children reached during the WHO/UNICEF supported Eritrea edi-
tion of the 3rd African Vaccination Week
In response to a resolution adopted by Ministers of Health at the sixtieth session of the WHO Regional Com-
mittee for Africa in Malabo, Equatorial Guinea in 2010, Eritrea has institutionalized implementation of an an-
nual African Vaccination Week since the inception.
The week long campaign usually organized during last week of April is aimed at sustaining advocacy, expand-ing community participation and improving immunization service delivery in areas that are hard to reach or
generally underserved by the health system, as a strategy to reduce child morbidity and mortality in line with
The mothers and children queued for vaccination
WCO Eritrea along with UNICEF provided tech-
nical and financial support to the MoH to imple-
ment the 3rd edition of Africa Vaccination Week
from 26-30 Jun 2013 which was integrated with
Vit "A" supplementation and Mid-Upper-ArmCircumference (MUAC) measurement.
The campaign was aimed at increasing routine
child vaccination coverage; vaccinating children
0-59 months with OPV in polio high risk areas;
sustaining the high coverage of vitamin A;
screening and referral of children 6-59 months
for severe and moderate malnutrition; advocating
with key stakeholders, health workers, and com-
munities.
MOH, WHO, UNICEF, Local Government,
Women Association, Youth association were the
main partners in the campaign.
WHO also supported the MoH in planning and
training of the relevant staff preparation and exe-
cution of the campaign.
As a part of the preparation, various advocacy meet-
ings were organized at different levels. The campaign
team used different strategies to capture children un-
der 5 years. Various modes of media communica-
tions were used widely to enhance the coverage.
As a result of a systematic preparation and extensive
exercise, the campaign ended with significant out-
come. A total of 484,152 (80%) children received Vit
A supplementation and were screened for status of
vaccination. Moreover, a total of 11,933 children re-
ceived BCG, OPV/DPT/HepB|Hib and Measles vac-
cines out of which 1,783 were children of less than 1
year of age and 10,150 were children between 1-2
years. A total of 49,501 children 0-59 months of agehave received OPV vaccine in the targeted Sub-Zoba
of NRS, Gash Barka and Anseba in the bordering of
Sudan.
Furthermore, the campaign could generate substantial
awareness and community partnership. The MoH
foresee a long term effect of this campaign in im-
proving general vaccination coverage.
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WHO Supported Immunization Coverage Survey
confirms High EPI Coverage of 96% in Eritrea
Eritrea has made a substantial progress in addressing
vaccine preventable diseases, which indicates good
awareness among the communities about the impor-
tance of vaccination. However, to determine the cover-
age of immunization and to understand socio-
demographic factors influencing child and maternal
immunization, WHO supported MoH Eritrea to con-
duct EPI coverage survey in April 2013. This survey
was undertaken after a gap of 4 years; the previous one
was in 2009.
The team in Buya conducting the survey.
The team visited five clusters; amongst them, the Buya and Foro were supported by the Health Workers and
community leaders. The team used interviewing by using standard questionnaire and observation of re-
cording as a methodology to collect the information.
The team meeting with one of the Medical Di-
rectorThe survey underway
The survey confirms a Penta 3 coverage of 96% by card and 86% by validity coverage.
Overall, the survey recorded a high EPI coverage and in most places, well-maintained record keeping in
visited areas of Eritrea.
However, in some areas, it also identified minor gaps in record keeping like, recoding wrong date of birth
as well issue of delayed immunization and high proportion of home deliveries.
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UN Health and Nutrition Thematic Group emphasized on coordinated UN sup-
port to the government
Health and Nutrition of being multidimensional in
nature, the interventions encompasses a wide variety
of activities which require more coordination, inte-
grating and convergence within and outside the health
sector.
For reviewing the activities for better coordination,
Health and Nutrition Thematic Group meets regu-
larly. At the meeting on 8th of May 2013 at the WHO
Conference Hall. Mr Semere Gebregiorgis, MPN/Advisor welcomed the participants.
Ms Bemi sola Akinboyo from UNICEF briefed the
participants on the outcome of the UNCT Retreat
2013 and highlighted on the salient features of the
joint plan and challenges in implementation.
Dr Usman Abdulmumini, WR giving a
briefing
Furthermore, the team also found out difficult terrain and weather condition; sizeable nomadic population;
cultural practice of home deliveries and transportation difficulties (staff using camels and donkeys for trans-
porting vaccines) in the area.
At the end of the survey, the teams visited the Regional Medical Directors and debriefed about the findings.
The team recommended MoH to conduct regular training of the staff and to enhance supervision in order tomaintain and improve the coverage.
Nationwide immunization Underway
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Dr Usman Abdulmumini, WHO Representative to Eritrea stressed on initiating implementation of the plan
while the coordination strategy is under finalization. He also advised to create sub-groups under each out-
come to better monitor implementation.
The readers group was assigned to finalize writing work in two week time.
Mr Semere made a presentation by focusing on WHOs contribution to the one UN. The participants actively
discussed on each activity for possible contribution by different UN agencies. UNICEF, UNFPA, UNAIDS,
UNHCR likewise presented their activity plans highlighting areas for joint work.
In conclusion, the participants agreed on the need for coordination to avoid duplication in terms of planning
and reporting for better support to the country. Furthermore, the team decided to produce joint health and nu-
trition activities to reflect the UN support to the government.
The following agencies were present at the meeting under the chairmanship of Dr Abdulmumini Usman,
WHO Representative to Eritrea; WHO, UNFPA, UNHCR, UNICEF, UNAIDS,
WHO supported Maternity Waiting Homes to improve access
to emergency obstetric care in Eritrea
WHO in collaboration with MOH supported communi-
ties of remote areas with the provision of Maternity
Waiting Homes. Community engagement and participa-
tion in the planning, construction and demand creation
ensured that the Maternity Waiting Homes were utilized.
In addition, the availability of all necessary equipment,
supplies and manpower for Basic Emergency Obstetric
and Newborn Care (BEmONC) addressed the 3rd delay
and fostered confidence in the intervention.
Additionally the provision of other health services to the
womans family and children encouraged utilization of
the Maternity Waiting Homes.
The dramatic improvement in maternal and
neonatal health outcomes as a result of timelyaccess to services has augmented trust and utili-
zation of services including women from com-
munities adjacent to the health facilities and
Maternity Waiting Homes. This resulted in the
reduction of the child and maternal mortality.
The availability of Maternity Waiting Homes
has significantly increased skilled attendance inremote areas, resulting in improved maternal
and neonatal health outcomes.
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The concept of Maternity Waiting Homes is effective, efficient and relevant for improving access to skilledcare; it is also sustainable due to community involvement. It has been facilitated through joint efforts by
multiple partners and enjoys political goodwill. The processes modeled in establishment of Maternity Wait-
ing Homes in Eritrea are simple and can be easily adapted by anyone committed to implementing the initia-
tive.
Different models of maternity waiting homes in Eritrea.
As part of the establishment of the Maternity Waiting Homes, it was necessary to ensure that the basic utili-ties to guarantee functionality were in place. These include availability of water, light and human waste dis-
posal mechanisms. MOH partners including WHO therefore supported distribution of water tanks, solar
lighting systems, and construction of latrines for some of the waiting homes. Additionally, the partners sup-plied beds, cooking utensils and occasionally foodstuff to the maternity waiting homes as a way of encourag-ing utilization.
Generally, the criteria for admission to the Maternity Waiting Homes include: any mother who comes fromat least 10km from the health facility or over two hours walk from the facility and who is at 32 weeks gesta-
tion and above; regardless of her gravidity, parity, medical or obstetrical history. Women with risk factors
regardless of gestation or distance are also encouraged to use the maternity waiting homes.
Postpartum women with their babies in the Maternity Waiting Homes
There has been a progressive increase in utilization of the Maternity Waiting Homes as well as in facility
deliveries and skilled birth attendance over time as shown in the figure below: Antenatal care attendancehas been reported at 100% for women in the Maternity Waiting Homes with spillover effect in the commu-
nities bordering the health facilities.
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WHO provided IT equipment and various medical supplies to support Eri-
trea MOH on NCDs control, IHR core capacity and surveillance
Besides providing technical assistance on different health
related issues, the WHO in Eritrea has been supporting the
Ministry of Health for various critical medical, IT and
laboratory supplies on the basis of jointly identified needs.
In line with this, medical supplies and IT equipment worth
over USD 100,000 were donated to the Ministry of
Health.
The computers and other IT equipment were part of the
effort to strengthen the national core capacity for Interna-
tional Health Regulations (IHR) in line with the nationalplan. Strengthening IHR core capacity is necessary for the
country to be able to detect and manage public health
events of international concern.
The World Health Organization Package for Essential
NCDs (WHO PEN) is an innovative and action oriented
response at PHC level to address the major NCDs, namely
diabetes, cardiovascular diseases, chronic obstructive lung
diseases and cancers. Eritrea has already pilot tested the
project in some selected Regions in Maekel Region and iscurrently in the process of expanding nationwide. To sup-
port the expansion effectively, there is a strong need in
building the capacity of health workers at the PHC level
as well as provide the PHC facilities with the required ba-
sic equipment and supplies.
The donation is as part of the organizations continuous
contributions and support to strengthen MOH and the
countrys health system for better health out-
comes. WHO urge for effective utilization of the
items in implementing the health priority pro-
grams.
MOH expressed gratitude to the WHOs con-
tinuous technical and logistical support.
Symbolic handing over to the MOH by WR
Dr Usman Abdulmumini, WHO Representative of Eritrea
urged MOH on effective utilization of the items.