Workplan for PB 2006-2007

TITLE: / Strengthening routine immunization services and measles control in poor areas
Implementation Sites and target groups: / Site(s):5 counties and 2 prefectures in Guizhou province / Target groups: Families with
Children under 12 years of age
Implementing Unit: / Ghuizhou Health Bureau
Co- implementing unit(s) or agencies / Guizhou Health Bureau / China Center for Disease Control / Ministry of Health
Ministry of Education
Workplan Coordinator: (name and designation) / Dr
CDC / Tel.: / Fax:
Email:
Workplan Focal Point (s) at Implementing Unit: (Name and designation) / Miss
Guizhou HB / Tel.:
Email / Fax:
Dr
Guizhou HB / Tel:
Email: / Fax:
Estimated TOTAL COST: / 115,000 / From WHO: / 95,000 / National Contribution: / 20,000 / Other funds: / X
Background and Rationale:
Over the past two decades, China has made remarkable progress in achieving high levels of measles control. Since the early 1990s, the reported incidence has been less than 10 cases per 100 000, a historic low. Measles morbidity and mortality have been reduced >95% compared to pre-vaccination levels and measles is no longer an important cause of childhood mortality in most parts of China. Measles incidence and mortality, however, are 10-20 times higher in the west compared to the east - a reflection of regional differences in development, including and quality and coverage of routine immunization services
While Guizhou has made significant progress in EPI over the past two decades, routine immunization coverage and quality of immunization services are still relatively weak compared to other provinces due to less rapid economic development, insufficient funding to support delivery of immunization services, mountainous terrain, and weaker program management.
Guizhou has been selected because this province typifies many of the major challenges to achieving measles elimination in China -- much of the population lives in small difficult to access villages and are very poor. The health authorities want to develop and test a model to ensure that all children are fully immunized. Developing strategies to strengthen routine immunization services and improve supplementary immunizations in the poorest areas of China, such as Guizhou, will be essential to achieving national and regional elimination goals.
During the 1990s, incidence rates in Guizhou ranged from 16 to 50 cases per 100 000 population with epidemics every four years. In contrast, the national average incidence was 6 cases per 100 000. In 2003, 65% of all measles related deaths in China occurred in Guizhou. The reasons for the high mortality from measles in Guizhou are unclear. Vitamin A deficiency is a known risk factor for measles-related death and a recent survey of serum retinol levels found moderate levels of deficiency in some rural areas of Guizhou.
On third of all measles cases in Guizhou occurred in primary school-age (7-12 years) children. Because school entry rates are so high, checking the immunization status of children entering pre-school and primary school, and offering those children who have no immunization certificate or who have an immunization certificate and are under-immunized another opportunity to be immunized, would have marked impact on improving coverage.
Objectives:
To develop and test a successful model for strengthening routine immunization services and accelerating control measles in a province
with high levels of measles morbidity and mortality.
Expected Results
Support provided to increase capacity of health staff for measles surveillance and control /
Indicators
Proportion of children fully immunised
Training courses on control and surveillance of vaccine-preventable diseases
Reported measles related deaths /
Means of Verification
Reports on coverage
Monitoring visits by WHO/DIC staff
Project final report
Statistical reports
Assumptions: what are the factors that can affect the success or failure of the activities in the workplan?
Availability of relevant staff for training activities
Prompt availability of support from CDC/DIC and WHO (TA/funds/ supplies) to implementing agency
Effective collaboration with Ministry of Education

WORK PLAN

SUMMARY OF PRODUCTS AND ACTIVITIES

Activity Code /

Description

/ Type of component / Planned budget / TDI /
(Expected Result) 01 / Support provided to increase capacity of health staff for measles surveillance and control
(Product)
01.01  / Strengthening EPI management
(Component)
01.01.01. / Planning meeting and training workshop for provincial health and education staff on the objectives and key activities involved in the intervention / LC / US5000 / Q1
2006
01.01.01 / Visits to other provinces / FE
01.01.02. / Mid-term Evaluation / AW01 / Q4
2006
01.01.02. / Evaluation and documentation / AW02 / Q3-Q4
2007
01.01.02 / Dissemination seminar for representatives from relevant provinces / AW03 / 40000 / Q4
2007
01.02 / Strengthening surveillance system
01.02.01 / Review and adaptation of guidelines for improved surveillance / AW / 2000 / Q1-Q2
2006
01.02.01 / Developing materials for training staff at provincial level and below (including support from CDC/NIP) / AW / 40000 / Q2
2006
01.02.02 / Training Course / LC / 40000 / Q2-Q3 2006
01.02.03 / Monitoring and supervision visits by CDC / AW / 40000 / Q1-Q4
2006
01.03 / Advocacy and social mobilisation
Development and adaptation of education materials / AW
Printing educational materials and monitoring form / SE
01.03.01. / Orientation activities on school entry checks / LC
Total:


LIST OF ESSENTIAL MEDICAL EQUIPMENT

(Order by priority)

/ Equipment / Specifications / Unit / Cost / End User / LP/OP
1 / 2 / 3 / 4 / 5 / 6 / 7
Total

CONSULTANT

  1. Product: None
  2. Key Counterpart:
  3. Terms of Reference and expected outputs:
  4. Dates:
  5. Preferences (e.g. names, specialty, country or institution etc)

1