EOC COMMUNICATION UPDATE

EOC Communication Update World Immunization Week Special Edition

WWW.ENDPOLIO.COM.PK ISSUE # XX MAY 8, 2015

World Immunization week is being celebrated across the globe every year from 24th to 30th April. The theme for this year World Immunization week was “close the immunization gap”: the gap between the 1 in 5 children who still do not receive basic life-saving vaccines, as well as to the gaps in progress towards the targets set by the Global Vaccine Action Plan (GVAP). The GVAP envisions a world where everyone lives life free from vaccine preventable diseases – whoever they are, wherever they live – by 2020. Communication being integral part of the immunization strategies, supports community response towards vaccination activities. In Federally Administered Tribal Areas, the key strategy being used to reach community is IPC through skilled human Resource i.e ComNet. Representing local tribes. Communication / social mobilization activities were carried out in accordance with social norms and programmatic needs identified by various data sets. COMNet staff conducted Social mobilization interventions to highlight importance of the Routine Immunization. Following activities were conducted across FATA in Agencies and FRs

3 Agency level inauguration sessions and I press Briefing

35 Awareness walks

53 community Hujra session

233 schools sessions

19 sessions in Maddaris

43 sessions with influencers

16 mosques sessions

1 press Briefing

3 sports activities

World Immunization Week observed in FATA

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Mohmand Agency COMNet staff in Mohmand Agency organized various activities including community sessions, Mother Session, school sessions, awareness walk etc In addition some advocacy and coordination meetings were also held with the Political administration, religious leaders, local maliks and heads of different educational institutions. Activities were conducted in all 8 tehsils including 19 school sessions and 9 community Hujra sessions with fathers and elders. In addition, Walks were held in tehsil Ekaghund, Halimzai and pran Ghar while session was conducted with mothers on BCG day at Tehsil Eka Ghund. Bajour Agency World immunization week was also observed in Bajour Agency. Communication and social mobilization activities were held in all 8 tehsils of Bajour Agency. In Tehsil Barang and Khar , two tehsil level inaugurations were also held.The ComNet staff conducted 6 shambolic walks, 17 community sessions with elders and fathers, 37 school sessions with teachers and students, 3 sessions in Maddaris. In addition, 9 Routine out Reach sessions were supported. Central and Lower Kurram Social Mobilization activities held in Central and Lower Kurram. Press briefing was held to orient the local media regarding purpose of the WIW, highlight importance of the Routine immunization and also highlight role of the media in raising awareness of the parents regarding vaccination. Meeting of the EPI technicians held at the Agency Surgeon office to orient them regarding world immunization week and their potential role. After the meeting, the EPI technicians participated in Walk Walk was conducted in Sadda wherein Agency level stakeholders participated including EPI technicians. In addition, 12 school sessions and 2 sessions held in Maddaris. Upper Kurram Agency In upper Kurram Agency, 3 community Hujra Sessions and 34 school sessions held. Walk was organized by schools students and teachers carrying banners and play cards mentioning about world immunization week. Students showed interest in the activity. North Waziristan Agency Despite all the challenges, ComNet staff observed World Immunization Week in NWA in tehsil Shawal, Shawa, spinwam and Garyum. ComNet staff conducted 3 Community Hujra sessions and 6 sessions in schools. South Waziristan Agency Agency level Inauguration held in SWA along with walk. In addition 13 school sessions and 10 sessions in Maddaris also held. In SWA, 106 community mobilizers have been deployed. The community mobilizers represents the sub tribes with in the tribal set up allowing them to have access to households in their catchment areas. Orakzai Agency Social Mobilization activities were held in orakzai Agency including 6 symbolic walks, 16 Mosques sessions with community / fathers and 43 Hujra sessions with community influencers. Khyber Agency, Due to security issues, only school sessions were held in Khyber Agency. Around 44 school sessions were held in different areas of Khyber Agency.

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World Immunization Week observed across FATA – Photos

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By A. Sami Malik

Nankana Sahib, Punjab, Pakistan – “I have been vaccinating children for the last 25 years,” says Farrukh Hussain the 43-year-old vaccinator who works at the Basic Health Unit, Budha village in Nankana district. “I have five children of my own, three girls and two boys, and I have vaccinated all of them myself. Vaccination is the first line of defence against vaccine-preventable diseases and every time I vaccinate a child it feels as if I have saved a life.”

Farrukh’s profession as a vaccinator is also his passion. He has dedicated his life to vaccinating children and works with energy and passion. His sole objective is to protect every single child from vaccine-preventable diseases. With a vaccine carrier placed behind his motorbike, he reaches out to communities living in the remotest areas of the Nankana Sahib district.

Nankana is a city and capital of Nankana Sahib District in Punjab province. Being the birth place of the first Guru

and founder of the Sikh religion, Guru Nanak, it is a popular pilgrimage site for Sikhs from all over the world.

Thousands of pilgrims, mostly from the neighbouring India, visit Nankana Sahib to pay their respect and attend

various festivals held during the year. The district has a population of around 1600,000 of which nearly 58,000 are

live births. The district health authorities work vigorously to vaccinate them against vaccine-preventable diseases.

After completing his intermediate certificate in 1989 from a school in Lahore, the provincial capital of Punjab,

Farrukh returned to his native village in Nankana district. He enrolled in a three-month training course for

vaccinators conducted at the Tehsil (administrative area) Headquarter Hospital Nankana and upon successful

completion, started his practical life as a vaccinator. After working as a vaccinator for quarter of a century, Farrukh

today enjoys the reputation of a highly conscientious and hardworking professional.

Recalling early days as a vaccinator, Farrukh says, “My hands would shake and my heartbeat increased every time

I injected a child. It felt as if I was hurting them. But soon I realised how important it is to vaccinate children during

the early years of their lives. It is like saving children and their parents from a lot of pain and worries later on.”

A Vaccinator’s Resolve to Protect Every Single Child from Vaccine-Preventable Diseases

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The process of immunizing a child against vaccine-preventable diseases begins immediately after birth and will go

on till the child is two years old. During this time, a child is vaccinated against Tuberculosis, Influenza Whooping

Cough, Tetanus, Hepatitis B, Diphtheria, Measles, Polio and Pneumonia. The role of a vaccinator in protecting

children against vaccine preventable diseases is extremely important as vaccines are temperature sensitive and

need to be stored and administered with extreme care.

In 2012, the Government of Pakistan added Pneumococcal vaccine for prevention against Pneumonia to the group

of antigens given to children within the first two years of their lives and became the first country in South Asia to

introduce this particular vaccine. Gavi, the Vaccine Alliance, which brings together public and private sectors with

the shared goal of creating equal access to vaccines for children living in underdeveloped countries, provides the

Pneumococcal vaccine and financial support while UNICEF and WHO provide technical support to health

authorities in Pakistan.

After the decision to add Pneumococcal vaccine to the routine immunization regime, vaccinators working in the

public health system were given a two-day training on management and administering of the vaccine. Farrukh

received this training at the District Headquarter Hospital, Nankana Sahib. “Our entire vaccination team was trained

on handling and injecting Pneumococcal vaccine,” says Farrukh. “The group included Vaccinators, Lady Health

Workers/Visitors (LHW/LHV), Sanitary Inspectors and the Community Disease Control Supervisors. We were given

practical demonstration on how to manage the temperature of the vaccine and how to inject the child’s left leg. We

were given easy to understand literature in local language and were initially made to practice on rubber models.”

The addition of Pneumococcal vaccine to routine immunization has drastically reduced the cases of pneumonia

amongst children. In rural communities of Punjab, the household is usually large and each family has on an average

four to five children with not much age difference between their births. Hygiene level is not ideal and children roam

around in open areas which make them susceptible to community-acquired pneumonia. Earlier, a large number of

children would get pneumonia, especially in winter season. Since the addition of Pneumococcal vaccine to routine

immunization regime, the number of cases has gone down and if a child catches pneumonia despite being

vaccinated, it can be easily controlled with medication and the recovery is quick.

By and large, communities living in Nankana Sahib have a proactive attitude towards getting their children

vaccinated. Farrukh explains, “A complete course of Pneumococcal vaccination comprises three shots/injections

given when the child is six, ten and fourteen weeks old. Mothers have the ‘yellow card’ on which we make an entry

whenever a child is vaccinated. In case our visit to the community is delayed for a day or two, they either bring the

child to the BHU or call us on the phone to ask about the team’s visit to their village.”

The challenge Farrukh faces in vaccinating children is in the far flung remote areas which are not covered by the

Lady Health Worker (LHW). Each LHW is assigned a certain area which generally has around 200 to 250

households. In their catchment areas, the LHWs support the vaccination activities by mobilizing the target children

for vaccination on the day when the vaccinator is supposed to visit the community. In the ‘uncovered’ area which

does not come under the LHW the vaccinator has to go on his own and vaccinate children.

“Pakistan is the world’s sixth largest population with the biggest birth cohort,” says Dr. Saadia Farrukh, UNICEF

Health Specialist EPI. “Each year, more than 350,000 children do not live to celebrate their fifth birthday; one of the

major causes of these deaths is vaccine-preventable diseases, 18 per cent attributed to pneumonia. In 2012, with

the financial support of Gavi, Pakistan introduced PCV-10, realizing that this is an opportunity for strengthening

routine immunization thereby leading to reduction in the disease burden due to Pneumonia in children under five

years of age.”

It is the dedication and resolve of health providers such as vaccinator Farrukh Hussain that makes a difference in

protecting children and women against vaccine-preventable diseases. Vaccination is the most equitable and cost

effective health intervention and healthy children grow up to be healthy adults and become productive members of a

society. Timely vaccination protects children from disease and help them grow to their full potential – one of their

basic rights.

EOC COMMS UPDATE | Issue #XIX 6

Health and Nutrition Festival brings much-needed services to the people living in Tharparker, Sindh

By Abid Hussain

Tharparker, Sindh, Pakistan - The last two years have been tough for those dwelling in the desert landscape of Tharparkar. Drought and famine have resulted in a large number of deaths while infant mortality, maternal mortality and malnutrition in the district present an extremely challenging situation.

The Health Department of the Government of Sindh has responded by holding a 3 day Health and Nutrition Festival in Mitthi which took place from April 8th to 10th. In the words of Chief Minister Sindh, “this festival is a drop in the ocean, yet it is the beginning of a larger relief package to be given to those residing in the arid region.”

The purpose of the festival was to spread awareness and provide services in communities pertaining to maternal and child health, family planning, nutrition and immunization. To keep the participants engaged, puppet shows, play areas for children, food courts, handicraft stalls and musical nights were also arranged.

Approximately 5000 people attended this festival and were beneficiaries of the different services being offered on the spot, these ranged from free blood tests and screenings to routine immunization.

EPI Sindh with support from partners including Emergency Operations Center (EOC) Sindh also set up a stall to immunize the children that were present there. Support provided by EOC Sindh included educational materials as well as videos on routine immunization and polio that were displayed on LCD screens. Awareness sessions were also held among the attendees.

Through this initiative EPI Sindh was able to reach out to more than 1000 children with routine immunization, and 4000 community members with educational entertainment.

A total of 41 children received BCG, 651 children were beneficiaries of OPV, 143 received OPV/Penta/PCV, 103 children received Tetanus Toxoid shots and 124 were immunized against measles.

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Peshawar - World Immunization week (WIW) titled “Close the Immunization Gap” concludes here 30th April with

commitment to bridge the gap between children who do not receive basic life-saving vaccines and the progress towards the targets set by Global Vaccine Action Plan (GVAP) that envisions a world where everyone lives a life free from vaccine preventable diseases.

Mr Akbar Khan, Coordinator Emergency Operation Center, Director General Health Services Dr Pervaiz Kamal, Dr Afzal Khan, President Pakistan Paediatric Association Dr Amin Jan Gandapur, Programme Specialist UNICEF Dr Rafique, officials of the health department Khyber Pakhtunkhwa, paramedical staff, nurses and other relevant officials were present on the occasion.

World Immunization Week is celebrated every year from April 24- 30 to raise awareness among the masses about the importance of routine immunization and the theme for 2015 is “Close the Immunization Gap”.

The health managers while sharing their thoughts on the occasion suggested that immunization should be integrated with other health services and health system should be strengthened to improve vaccine delivery mechanism.

According to a survey nearly a fifth of the world’s infants miss out on basic vaccines and nearly 29 percent of deaths caused in children under five are vaccine preventable.

Speaking on the occasion, Mr Akbar Khan, EOC Coordinator said that the government stand committed to improving healthcare system in the country with focus on routine immunization and rolled out the health plan that would help improve the healthcare indictors in Khyber Pakhtunkhwa and prevent children from deaths caused by lack of vaccination.

He said that “routine immunization was the right of every child and it was the prime responsibility of every parent to ensure vaccination to their children”.

Akbar khan said that Emergency Operation Centres (EOCs) were set up in the country as a first step towards integrated health approach that would help in framing routine immunization policies and interventions under the guidance of technical experts.

Spelling out the new health interventions that were on cards for the province, he said that comprehensive multi-year plan at the cost of 21 billion rupees would be rolled out soon in Khyber Pakhtunkhwa that would address all the issues related to routine immunization and its delivery mechanism.

WIW concludes with commitment from health managers to strengthen routine immunization

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Moreover, he went on to add that Inactivated Polio Vaccine (IPV) has been piloted successfully in Peshawar and Bannu districts and would be introduced in the whole of Khyber Pakhtunkhwa shortly as integral part of routine immunization.

Lady Health Workers (LHWs) has been fully involved in routine immunization and extensive trainings of LHWs were held in this regard, he added.

He appreciated that the coverage of routine immunization stand at 53.80 in Khyber Pakhtunkhwa compared to the 52 percent in the rest of the country. However, he hastened on to add that a lot was still needed to compete with countries like Bangladesh where the RI coverage is 93 percent and Ethiopia and Sudan with 83 and 87 percent respectively.

Senior Paediatrician and President PPA Prof Dr Amin Jan Gandapur, DG Health KP Dr Pervaiz Kamal and Dr Rafique from Unicef also spoke on the occasion calling for strengthening of routine immunization services and health delivery system at the grass root level to help curtail vaccine preventable deaths.

WHO Statement on the Fifth Meeting of the International Health Regulations (2005) Emergency Committee regarding the International Spread of Wild Poliovirus

5 May 2015

The Committee sincerely appreciated the efforts that all countries have made in response to the Temporary Recommendations and reviewed the progress against the criteria previously established by the Committee for countries subject to Temporary Recommendations.

The committee acknowledged Pakistan’s worthy progress in the performance of the eradication program and a reduction of cases occurred during the low season. The Committee also agreed that Pakistan and Afghanistan formed a single epidemiological block with frequent cross-border population movement, which accounts for the ebb and flow of poliovirus in both directions. Much stronger coordination and quality of cross-border vaccination and surveillance activities will be essential to reduce the risk of this international spread. In addition, both countries must achieve interruption of poliovirus transmission simultaneously in order to prevent such international spread from repeatedly setting back progress in both countries. The Committee recommended the extension of the Temporary Recommendations, as revised, for a further three months.

Polio Cases update:

PROVINCE 2009 2010 2011 2012 2013 2014 2015

PUNJAB 17 7 9 2 7 4 0

SINDH 12 27 33 4 10 30 4

KPK 29 24 23 27 11 68 9

FATA 20 74 59 20 65 179 6

BALOCHISTAN 11 12 73 4 0 25 3

GILGIT-BALTISTAN 0 0 1 1 0 0 0

TOTAL 89 144 198 58 93 306 22

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For more details, please visit the official PEI web and social media channels:

Website: www.endpolio.com.pk

Facebook page: https://www.facebook.com/polioeradicationinitiative

Twitter: @PakFightsPolio

This Week on Social Media

EOC COMMS UPDATE | Issue #XIX 10

Pak Fights Polio:

A briefing to #Pakistan Pediatric Association is underway at Prime Minister’s Office in Islamabad.

Pak Fights Polio:

The PPA briefing is being presided by PM's Focal person on #Polio Eradication, Ayesha Raza Farooq at PM's office in

#Islamabad.

Pak Fights Polio:

Ayesha Raza Farooq has called upon Pakistani pediatricians to play a key role in the country's efforts to eradicate #polio

Pak Fights Polio:

We are grateful for the support of PPA & respected health professionals; who are here today to express their all-out

support: Ms. Ayesha Raza

Pak Fights Polio:

"Pediatricians can play an important role in our fight against #polio. They are trusted by communities & command respect

amongst families."

Pak Fights Polio:

In immunization activities we need to have paradigm shift from #children covered to covering continuously missed

children: President PPA Tahir Masood

Real-time tweets from @PakFightsPolio during Government-PPA Collaboration Event