RI Task Force Meeting 20th January 2015

Update of AIA

Accelerated Immunization Activity :Objectives

• To increase the immunization coverage with all vaccines under the National Immunization Schedule.

• To reach the beneficiaries in hard to reach areas, especially those who are left out from routine services.

Fully immunized children aged 12-23 months by province

50

.9%

2.5%

7.0%

7.8

% 13.7

% 19.4

% 25.

9% 31.

6%

39.8

%

41.6

%

45.5

%

45.7

%

49.5

%

50.3

%

51

.0% 55

.7%

57

.1%

59

.1%

61

.5%

62.7

%

64

.1%

64

.9%

65

.3%

66

.3%

67

.0%

70

.0%

70

.4%

71

.6%

72

.8%

76

.8%

77

.3%

80

.6%

82

.7%

86

.3%

86

.8%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Nat

ion

al

Fara

h

No

ori

stan

Hel

man

d

Uro

zgan

Gh

or

Zab

ul

Kan

dah

ar

Bad

ghis

Fary

ab

Dai

kun

dy

Loga

r

Gh

azn

i

Kh

ost

Bad

akh

san

Ku

nar

Sare

-Pu

l

War

dak

Kab

ul

Bag

hla

n

Ku

nd

uz

Nim

roo

z

Par

wan

Nan

garh

ar

Jaw

zjan

Lagh

man

Takh

ar

Pak

tika

Her

at

Bal

kh

Sam

anga

n

Bam

yan

Kap

isa

Pan

jsh

ir

Pa

ktia

Progress GVAP update Efforts to improve coverage PEI to EPI

Accelerated Immunization Activity :Target population

• Category A (Highest priority): Areas which are never or rarely reached e.g.• Not reachable during harsh winter (Seasonal problems), • Sub centers without vaccinator having >10 clients /day, • villages with poor access, • Urban slums, periurban areas,• Villages with poor access,• Vacant sub-centers, • Migrant and mobile populations, • Marginalized population etc.

• Category B (Second priority): Areas where immunization was planned but not held during previous 3-4 months.

• Category C (Third priority): Villages/urban areas where RI is normally done but coverage is considered low.

S N Province District S N Province District S N Province District1 Badakshan 1 Faizabad Gazni 7 Giro 12 Logar 1 Pulialm

Badakshan 2 Darwaz Gazni 8 Nawa Logar 2 M Agha

Badakshan 3 Raghistan Gazni 9 Gillan Logar 3 Khoshi

Badakshan 4 Kohistan Gazni 10 zanakhan 13 Nuristan 1 Kamdish

Badakshan 5 Yawan Gazni 11 Muqor Nuristan 2 Norgram

Badakshan 6 Khahan 7 Ghor 1 Firooz kooh Nuristan 3 Mondol

Badakshan 7 Shahribuzurg Ghor 2 Charsada Nuristan 4 Waigal

Badakshan 8 Yafta-i-Payan Ghor 3 Dulaynah Nuristan 5 Doaba

Badakshan 9 Argoo Ghor 4 Daulatyar 14 Saripul 1 Sangcharak

Badakshan 10 Kiran-o-Munjan Ghor 5 Shahrak Saripul 2 Balkhab

Badakshan 11 Yumgan Ghor 6 Taywra Saripul 3 Saripul

Badakshan 12 Jurum Ghor 7 Pasaband 15 Urozgan 1 Trinikot

2 Badgis 1 Jawand Ghor 8 Lal wa Sar Jangal Urozgan 2 Chora

Badgis 2 Qadis Ghor 9 Toolak Urozgan 3 Dehrawud

Badgis 3 Abkamary Ghor 10 Sghar Urozgan 4 Shahid Asas

3 Diakundy 1 Miramor 8 Helmond Lashkargah Urozgan 5 Khos Urozgan

Diakundy 2 Shahristan Helmond Nahreseraj 16 Wardak 1 Behsood 1

Diakundy 3 Ashterly Helmond Nad Ali Wardak 2 behsood2

Diakundy 4 Bandar Helmond Nawa Wardak 3 Daimerdad

Diakundy 5 Khider 9 Kandahar 1 Panjwai Wardak 4 Chak

Diakundy 6 Kiti Kandahar 2 Khakriz Wardak 5 Nerkh

4 Farah 1 Farah City Kandahar 3 Arghistan Wardak 6 Jaghtoo

Farah 2 bakwa Kandahar 4 Dand 17 Zabul 1 Shajoy

Farah 3 Gulistan Kandahar 5 Shahwalikot Zabul 2 Qalot

Farah 4 Purchaman 10 Khost 1 Tani Zabul 3 Zadk Tarnk

Farah 5 Balaabuluk Khost 2 Nader Shah Kot Zabul 4 Shinkai

Farah 6 Khkisafeed Khost 3 Spera Zabul 5 Mezana

Farah 7 Anardara Khost 4 Ali sheer

Farah 8 Pushtako Khost 5 Dwamanda

Farah 9 Sabi ko Khost 6 Matune Provinces 17

5 Faryab 1 Almar Khost 7 Musa Khel Districts 105

Faryab 2 Qaisar Khost 8 Qalandar

Faryab 3 Pashton Kot Khost 9 Jaji Miedan

6 Gazni 1 Qarabagh Khost 10 Sabari

Gazni 2 Nawor Khost 11 Gurbuz

Gazni 3 Jaghuri Khost 12 Baak

Gazni 4 Malestan 11 Kunar 1 Dangam

Gazni 5 Ajristan Kunar 2 Noorgal

Gazni 6 Waghaz Kunar 3 Peach

Accelarated Immunization Activity 2014

105 Districts 17 Provinces

Provinces-17 out of total 34 Round 1 Round 2 Round 3

Farah, Nuristan, Helmand, Uruapan, Kandahar, Ghor, Kabul, Badghis, Faryab,

Daikundi, Logar, Ghazni, Khost, Badakhshan, Kunzar Sari-Pul, Wardak.

11th to 16th October 2014 22 to 27th November 2014 27th December to 1st January 2015

16/17

15/17

8/17

12/16

6/15

4/8

2296

3

991

2818

3

4362

34

38

2812

2549

8

35

75

2454

1787

1

1731

3

1270

1191

1499

6369

606

507

140

94

5092 64

85

5921

3201

2008

0

5000

10000

15000

20000

25000

30000

35000

40000

Coverage AIA three rounds: I-16 II-8 III- 4

I II III

High coverage of BCG, Penta1,OPV1 PCV1 AND Measles 1 TT1

Implying left out children are being vaccinated through the accelerated activity

18

32

93

1848

722

555

552

233

81

20

13

22

496

18

5

217

54

0 0 0

487

11

31

1476

1113

627

411

713

67

975

1456

611

339

25

100

10

686

137

481

264

12 0 0 0

74

746

1520

2717

672

368

254

62

0

133

597

10

65

1618

461

87

191

162

788

86

212 32

3

0 0 0 0

147

117

1172

2231

547

316

24

7

0

500

1000

1500

2000

2500

3000

3500

Badakshan three rounds

I II III

0 69

4252

937696

341

4441

809577

2187

23534 32 53 0 0 0

27487

6541

1493 1453

935

660

0

1000

2000

3000

4000

5000

6000

7000

Gazni :3 rounds coverage :AIA

I II III

Coverage against the micro-plan target

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

BCG OPV0 OPV/Penta1 OPV/Penta2 OPV/Penta3 OPV4 PCV1 PCV2 PCV3 Measles1 Measles2 Vaccine TT1 TT2 TT3 TT4 TT5

52.6

1.2

47.0

2.5 2.0 1.2

34.2

2.4 2.0

30.5

0.0 0.0 0.01.8

0.1 0.0 0.0 0.0

75.8

0.5

75.4

2.60.3 0.0

78.3

0.0 0.0

58.8

0.0 0.0 0.0

18.2

0.1 0.0 0.0 0.0

% of children covered by antigen against the microplan target

Helmond Urozgon Kunar Logar Sari pul

High coverage of BCG, Penta1,OPV1 PCV1 AND Measles 1

Implying left out children are being vaccinated through the accelerated activity

HELMOND

Kunar

Action points

• Letter to concerned PEMTs to conduct remaining rounds before end of Feb 2015.

• Collection of the reports from the remaining provinces

• Monitoring plan from NEPI and partners

• Regularize Quarterly accelerated catch up rounds:

( based on the coverage and other criteria to make microplans to cover the left outs and dropouts from each district)

Inclusion of age group of 5 to 9 years for the planned measles campaign in 2015

5

14

8 9 12 13

1

0

2

1 19 7

20

119 17

3

8

2

16

17

15

29

27

287

2

1

0

2

15

11

29

4719

44

16

24

17

6

7

11

11

19

13

2

1

1

2

2 9

9

16 13

11

18

15

4

5

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14

Monthly distribution of Measles cases by age category in Afghanistan January 2013-AUG 2014

<1 Year 1-4 Years 5-9 Years 10-14 Years 15-19 Years 20-24 Years 25+ Years

13

26

16

39 40

46 46

49 49

53

0

10

20

30

40

50

60

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

MCV2 National Reported coverage

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Percen

t o

f p

op

ula

tio

n

Age (in years)

Protected by maternal antibodies Protected by routine vaccination with 1st dose

Protected by routine vaccination with 2nd dose Protected by SIAs

Unprotected by vaccination

Current Immunity gap :Measles 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Percen

t o

f p

op

ula

tio

n

Age (in years)

Protected by maternal antibodies Protected by routine vaccination with 1st dose

Protected by routine vaccination with 2nd dose Protected by SIAs

Unprotected by vaccination

Reduction of Immunity gapo with 9 Months to 5

years.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Percen

t o

f p

op

ula

tio

n

Age (in years)

Protected by maternal antibodies Protected by routine vaccination with 1st dose

Protected by routine vaccination with 2nd dose Protected by SIAs

Unprotected by vaccination

Reduction of Immunity gap with 9 Months to 9 years.

Action points

• Explore funding options for inclusion of 5-9 years for the upcoming measles campaign

• Planning for 9months to 9 years

• Preparation steps to including of cold chain management and space for the huge campaign

Thank You