Health services delivery



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1

HEALTH SERVICES DELIVERY

1.4

DISEASE CONTROL PROGRAMME

1.4.2.d.6

Communicable Diseases Control: Immunisable Diseases Control

Poliomyelitis Eradication Initiative




A

Focal Point

Epidemiology Unit

B

Implementing Agencies

Epidemiological Unit

Provincial Director of Health Services



Deputy Provincial Director of Health Services

C

Target Areas & Beneficiaries

Institutional Staff, Public Health Staff and the Community









Project Summary:
Sri Lanka is on the verge of eradicating poliomyelitis after achieving and maintaining a high immunization coverage and established AFP (Acute Flaccid Paralysis) surveillance. Most of the standard WHO indicators of Polio Surveillance have been met and to improve existing AFP surveillance practices and to sustain the achieved targets it is necessary to conduct following activities.

  • Routine Immunization with OPV

  • National and Sub National Immunization Days

  • Mopping up immunization

  • Enhanced AFP Surveillance.

  • Review meetings at National, Provincial and Regional level

  • Consultative Meetings of Virologists, Epidemiologists, Physicians, Paediatricians and Neurologists





1. Justification:
Sri Lanka is on the verge of eradicating poliomyelitis after achieving and maintaining a high immunization coverage and established AFP surveillance. Most of the standard WHO indicators of Polio Surveillance have been met and it is important to improve the existing AFP surveillance activities throughout the country. As the neighbouring country India is continuing to isolate wild polio virus from the community there is a risk of importation of wild polio virus to Sri Lanka and outbreak of polio. It is necessary to strengthen the AFP surveillance activities in Sri Lanka
2. Important Assumptions/Risks/Conditions:


  • Government of Sri Lanka will continue to procure vaccine

  • EPI programme will continue to maintain its high standard

  • Vaccine acceptance by the community will be 100%


3. Project Objective:


Objective

Indicators

Means of Verification

Eradication of Poliomyelitis

  • No cases of polio occurring in the country and in the South East Asia for 3 consecutive years

  • AFP surveillance

  • IMMR

  • MRI data on AFP





4. Project Output/Product


Outputs

Indicators

Means of Verification

All children immunized with OPV

  • Review data at Epidemiological Unit quarterly and annually, EPI reviews

National and Sub-National Immunization Days continued


  • Review data at Epidemiological Unit quarterly and annually, EPI reviews

Surveillance enhanced

  • Non polio AFP rate in children < 15 yrs. of age. (Target >/= 1/100,000)

  • Completeness and timeliness of reporting

  • Reported AFP cases investigated within 48 hrs. of report (Target >/= 80%)

  • Reported AFP case with stools specimens collected within 14 days of onset and follow-up examination at least 60 days after onset of paralysis

  • Quarterly review by NCCPE and NPEC

  • Monthly quarterly and annually review

Laboratory surveillance strengthened


  • Specimens of stools arriving at National Laboratory (MRI) within 03 days of being collected (Target> 80%)

  • Specimens of stools with a turn around time <28 days (Target>80%)

  • Stool specimens from which non-polio enterovirus was isolated (Target> 10%)

  • Monthly quarterly and annually review


5. Related Projects:


Project No.

Project Title




Immunization with OPV (EPI




National Immunization Days

Sub National Immunization Days

Immunization of children following an AFP case

Mopping-up immunization






Quarterly Meetings of National Polio Expert Committee

Quarterly Meetings of National Committee for Certification of Polio Eradication Quarterly review of AFP surveillance activities at Regional Epidemiologists conferences

Consultative Meetings of Virologists, Epidemiologists, Physicians, Paediatricians and Neurologists

Supervisory Visits




6. Relevant Agencies to be Coordinated:
WHO, UNICEF, Ministry of Health
7. Monitoring & Evaluation:
1. Who? Epidemiologist /National Committee for Certification of Polio

Eradication/Regional Certification Committee

2. When? Monthly /Quarterly /Annually

3. What actions to be taken based on results of monitoring & evaluation?



Continuous review with regional / national level
8. Activities:





Activities

Expected Results

Process Indicators

1

Continue Immunization programme with OPV (EPI)

100% coverage

Immunization coverage

2

Organize National Immunization Days

100% coverage

Immunization coverage

3

Organize Sub National Immunization Days

100% coverage

Immunization coverage

4

Conduct Mopping-up immunization

100% coverage

Immunization coverage

5

Organize Quarterly Meetings of National Polio Expert Committee

To improve AFP surveillance

4 meetings/year


6

Carryout Quarterly review of AFP surveillance activities at Regional Epidemiologists conferences

To improve AFP surveillance

4 meetings/year


7

Organize Quarterly Meetings of National Committee for Certification of Polio Eradication

To get experts help on diagnosing doubtful AFP cases

4 meetings/year


8

Conduct Consultative Meetings of Virologists, Epidemiologists, Physicians, Paediatricians and Neurologists

To review AFP surveillance activities


4 meetings/year


9

Supervisory Visits

To improve AFP surveillance





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