MINISTRY OF COMMUNITY DEVELOPMENT MOTHER AND CH ILD

HEALTHM R S . E L I K A K A M I J I

C H I E F E P I O F F I C E R

IMPLEMENTATION OF GAPPD: ZAMBIAN EXPERIENCE

Global Immunization Meeting: PIASitges, 23-25 June 2015

LAYOUT

• Background• GAPPD – The Zambian Case• Mazabuka GAPPD• Pre and Post GAPPD Launch activities• Challenges• Next steps

BACKGROUND-COUNTRY PROFILE

Population:14,222,307

2.8% Population Annual Growth Rate

Under 1 year population is 653,131 (4.6%)

Under 5 years population is 2,844,461 (20%)

Under 15 years population is 6,471,150 (45.5%)

Geography: has 10 provinces & 81+ districts

GAPPD - THE ZAMBIAN CASE

• Zambia participated in the African Regional Workshop on coordinated approaches to Pneumonia and Diarrhoea Prevention and Control in Nairobi, Kenya, January 2011.

• Identified as a priority country to introduce GAPPD.

• Provided technical support to develop an integrated framework for implementing GAPPD in the context of Zambia’s Roadmap for A Promise Renewed (APR).

MAZABUKA GAPPD

• Mazabuka district in Southern Province was selected as the first district for implementation of GAPPD in partnership with stakeholders.

• Some of the criteria for selection of the district included-

• low levels of coverage of high impact child health interventions,

• high commitment from district health management,

• close proximity to Lusaka facilitating documentation, follow up and monitoring

• Inclusion of activities that address GAPPD initiative in the annual action plan.

MAZABUKA GAPPD CONT’D

• Field visit to Mazabuka district in 2013 undertaken by a team from Ministry, WHO (HQ and Country Office)• led to the development of a Mazabuka GAPPD action plan

which was incorporated into the district annual action plan.

• Minister of MCDMCH launched GAPPD in Zambia on the 14th of October 2014.

• Minister made an early call on relevant government Ministries, civil society, NGOs to expand GAPPD to all districts in the shortest time possible.

MAZABUKA GAPPD CONT’D

• The priority activities identified were: - • baseline KAP survey; • training of health providers in IMCI and (iCCM) supervision; • training of CHWs in iCCM; • Integrated Disease Surveillance and response (IDSR)• training in programme management including focus on protection,

prevention and treatment of pneumonia and diarrhoea.

• PATH expressed interest to consider including Mazabuka in the Better Immunisation Data programme to improve quality and local utilisation of data.

• The protocols and tools for baseline household and facility survey are still being awaited from HQ

• The survey to follow soon after ethical clearance

PRE- AND POST LAUNCH ACTIVITIES CONT’D

• Launch of the introduction of Rota vaccine in the context of GAPPD was conducted in Mazabuka in 2013

• Mazabuka Community Medical Office, with support from WHO, conducted the Integrated Disease Surveillance and Response (IDSR) training in October, 2014

• 34 staff from district office and Health Centers trained in data collection skills, analysis and interpretation and also in efficiently and effectively reporting on notifiable diseases

• By end of 2014, the district had achieved 73% reporting by rural and urban health centres for conditions such as non-bloody diarrhea, dysentery, pneumonia and confirmed malaria, (Target at least 80% reporting by health facilities).

PRE- AND POST LAUNCH ACTIVITIES CONT’D

• 25 health care providers were trained in IMCI in Mazabuka district, October 2014. Last IMCI training was in 2002

• The training of 30 CHWs from 17 Rural Health Centre catchments in iCCM took place in Mazabuka District from December 2014 with the support of WHO.

• During the same period, PATH supported the district in training iCCM supervisors. There were 20 participants from 18 Rural Health Centres & the district office.

PRE- AND POST LAUNCH ACTIVITIES CONT’D

• Advocacy for GAPPD concept as part of technical guidelines for 2015 district plans

• Advocacy to already existing programmes/projects to include GAPPD (EU funded MDGi programme; Health for the Poorest People; Canada H4+; PATH; Programme for Awareness and Elimination of Diarrhoea-PAED)

• Advocacy to upcoming programmes/projects (RMNCH & Nutrition project funded by World Bank; RMNCH Trust Fund

• GAPPD is an agenda item in the IMCI technical working group

CHALLENGES WITH IMPLEMENTING GAPPD IN MAZABUKA

• The district is set to scale up GAPPD. However the development of the survey tools for baseline survey has been delayed.

• Coordination of the different stakeholders from the various sectors and institutions.

HEALTHY CHILD BROCHURE

KEY MESSAGES• GAPPD has became a catalyst to bring

together key stakeholders to plan together and agree on roles and responsibilities

• The Mazabuka GAPPD Action Plan facilitated alignment of activities and pooling resources from different stakeholders

• Multi-sectoral coordination is very critical for a successful implementation especially at district level.

NEXT STEPS• Planning for Mazabuka health facility and household baseline

survey

• Strengthen the application of GAPPD in the National Technical updates and District planning guidelines

• Continued advocacy to all stakeholders for GAPPD

• Strengthening documentation of implementation and progress of GAPPD.

• Need to strategize and mobilize resources to support its rollout.  

• Can link GAPPD with the global financing mechanisms like GAVI, RMNCH Trust Fund, GFF etc.

ACKNOWLEDGEMENTS

• Government of Zambia Line Ministries• World Health Organization• UNICEF• PATH• SAVE THE CHILDREN• CIDRZ• European Union

THANK YOU