bulletin of the who eritrea 1 pdf

7/30/2019 Bulletin of the WHO Eritrea 1 PDF

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Issue No. 4

Aug. 2013

Ambassadors acknowledged on-site evidence ofUN support to Eritrea during UN organized, sup-

ported field visit to the Northern Red Sea Re-

gion..2

WHO Eritrea supported Ministry of Health in

launching GeneXpert, a breakthrough diagnostic

tool for TB and Rifampicin resistance... ..4

WHO Eritrea promoted healthy lifestyle and need

of inter-sectorial collaboration at World Health

Day commemoration event..5

Above half-million children reached during the

WHO/UNICEF supported Eritrea edition of the 3rd

African Vaccination Week....7

WHO Supported Immunization Coverage Survey confirms High EPI Coverage of 96% in Eri-

trea...8

UN Health and Nutrition Thematic Group empha-

sized on coordinated UN support to the govern-

ment..9

WHO supported Maternity Waiting Homes to im-

prove access to emergency obstetric care in Eri-

trea...10

WHO provided IT equipment and variousmedical supplies to support Eritrea MOH on

NCDs control, IHR core capacity and surveil-

lance.12

Contents

For More information please contact:: World Health Organization in Eritrea, Geza Banda, Asmara

Tel. 291-1-200634/ 291-1-114171 Fax: 291-1-125155; E-mail: [email protected]

WHO Representative to Eritrea, Dr Usman Abdul-

mumini briefing on Solar Suitcase.


2/12

Ambassadors acknowledged on-site evidence of UN support to Eritrea during UN

organized, supported field visit to the Northern Red Sea Region

The UN Country Team organized and coordi-

nated visit of the Ambassadors to the Northern

Red Sea Region of Eritrea in April 2013 in col-

laboration with the Government of the State ofEritrea.

The visit was aimed at acquainting the ambassa-

dors on the achievements gained to-date by the

government of Eritrea with support of the UN

Partners, mainly WHO and UNICEF. In addition,

it was a forum to show donors the challenges and

constraints especially related to resources gaps so

as to serve as resource mobilization in various

sectors including health, education, water and social

welfare.

The Ambassador of France, Deputy Chief of Mission

of the United States of America, the Chinese Ambas-

sador, the deputy ambassador of the EU in Eritrea,

the Ambassador of the Southern Sudan, the Charge

dAffaires of Djibouti and representatives from

WHO and UNICEF participated in this high profile

visit. From the government side, Hon. Governor of

the Red Sea Region, the head of Ministry of Foreign

Affairs Protocol Division, Director

A solar Suit Case being demonstrated by

the WHO Representative

General of Social Affairs, Head of the Social Sec-

tors in the Region, Regional Medical Officer and

other government officials in the Region partici-

pated.

The visit was extensive and covered several loca-

tions such as: Sheeb nomadic school, donkey pro-

ject; Foro Health Center; Adulis Historic sites and

Al-Sahab Historic Mosque in Massawa, Northern

Red Sea Museum Center; Port Quarantine (IHR);Amatere HC; Dongolo Tahtay Open Defeacation

(ODF) Free villages; Ghindae Zonal Referral Hos-

pital and Visit to Ghindae Group Home. In addi-

tion, museums and historic sites such as Zula and

Adulis were visited.

Amongst the sites of which were particular interest

to WHO were: Foro Health Center, the Massawa

Port Quarantine unit in relation to the IHR (2005)

and the Amatere Health Center. In Foro Health

Center, WHO has supported the health facility in

the establishment of the Maternity waiting Home

which was instrumental in reducing the suffering

of mothers during the last trimester thus availing

them close to the health facility during their deliv-

ery. This project is expected to reduce the mortal-ity of mothers and neonates significantly in the re-

gion. Similar projects are also implemented in the

neighbouring Region of the Southern Red Sea.

Moreover, WHO has provided a Solar Suite case

which provides light and electric power for various

activities and Doppler to monitor fetal heart rate.


3/12

As part of the continuous support to the government, WHO is supporting the MOH in building the institu-

tional and human capacities in relation to the minimum core capacities required for the IHR (2005). This is

vibrant at the officially designated point of entries namely the sea ports, air ports and ground crossings. Apresentation was given by the head of the Quarantine Unit in the Northern Red Sea Region during the visit,

with further explanations by the WR. Similarly, achievements and challenges were also presented to the Am-

bassadors during the presentation.

The visit to the Amatere Mother Child Health Centre where various activities including nutrition, mother

child health, Integrated Management of Neonatal and Child Illnesses, immunization etc. are carried out by the

government with the technical support from the UN. Preparation is also going on to equip the Health Facility

with materials that enable to conduct emergency obstetric interventions.

The mission has given a very good opportunity for the involved Ambassadors to understand the support given

by various UN organizations to the Government of Eritrea in various aspects of health and development. The

Ambassadors made appreciatory remarks at various occasions during the visit.

The widened understanding of the Ambassadors on UN support has generated a good opportunity for the UN

to mobilize resources for the common cause. Moreover, it enabled the government officials to appreciate on

the support UN Agencies are rendering in the country. Furthermore, joint planning and joint execution of the

plans by UN Agencies for such high level delegates has demonstrated One UN, coordinated and aligned

support.

WHO Representative of Eritrea, Dr Usman Abdul-

mumini briefing on International Health Regulation


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WHO Eritrea supported Ministry of Health in launching GeneXpert, a breakthrough diagnos-

tic tool for TB and Rifampicin resistance

The TB case detection rate has been stagnating for

some time within the National TB Control Pro-

gramme. The programme is relying heavily on spu-

tum smear microscopy; an old and less sensitive tool.

This leads to the challenges in early detection of TB

especially among HIV positive individuals. The de-

tection of drug-resistant TB is a particular challenge

due to the unavailability of culture & DST services

for many years. However, the culture & DST has

been recently resumed but it has an inherent problem

of long reporting time (2-4 months). The WHO led

TB programme review in May 2012 also highlighted

the need for introduction of newer, more reliable di-

agnostic tool within the programme.To address above challenges in diagnosis, the MoH in

consultation with the WHO decided to implement

GeneXpert within the National TB Control Pro-

gramme. The WHO provided technical assistance to

the MoH in developing a national plan for the imple-

mentation of GeneXpert as well on the request from

the MoH, WHO procured 3 GeneXpert machines

through the help of WHO HQ TB Reach mechanism,

at the expense of USD 113,950.

WHO also facilitated recruitment of a consultant for

training of laboratory and programme staff and in-

stallment of machines at three selected sites. The

training was organized in WHO conference room to

provide the participants a facility for the web-based

discussion.

The Xpert MTB/RIF is an automated, cartridge based,

molecular (Nucleic Acid Amplification) test which

uses GeneXpert multi-disease platform to detect TBas well as Rifampicin resistance (proxy to MDR-TB)

from unprocessed sputum samples in less than 2

hours. After a rigorous assessment of efficiency and

its field effectiveness, the WHO endorsed Xpert

MTB/RIF test in Dec 2010, for the widespread use

for the diagnosis of TB and rifampicin resistance in

high burden countries.

Web based training of participants in WHO

Conference room

Installation of Genexpert in Orotta Referral

Hospital Laboratory

The introduction of this assay in the National

TB control will be a breakthrough in diagnos-

ing TB and Rifampicin resistance, quickly andmore reliably. It will improve case detection

within the programme and prevent suffering

and death due to delayed diagnosis of TB and

drug resistance, Dr Abdulmumini Usman,

WHO representative for Eritrea anticipates.


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WHO Eritrea promoted healthy lifestyle and need of inter-sectorial

collaboration at World Health Day commemoration event

Asmara Eritrea, 30 April 2013 To mark World

Health Day and 1000 days to Millennium Develop-

ment Goals (MDGs), WHO Eritrea and Ministry of

Health jointly organized an event on 30 th April 2013,

at the National Confederation of Eritrean Workers

(NCEW). However, the World Health Day is usually

marked on April 7 every year to commemorate the

anniversary of the founding of the World Health Or-

ganization in 1948.

The event was graced by the H.E Minister of Health,

H.E. Minister of Labor, various UN agency represen-

tatives, diplomats from various embassies, govern-

ment officials and representatives of the non-

governmental organizations.

Control your blood pressure was the theme of this

years World Health Day. More than one in three

adults worldwide has high blood pressure, which is

both preventable and treatable. High blood pressure

increases the risk of heart attacks, strokes and kidney

failure.

The United Nations Millennium Development Goals

(MDGs) are eight goals that all 191 member countries

have agreed to try to achieve by the year 2015 and

currently we are about 1000 days away from the dead-

line- said Dr Abdulmumini Usman, WHO represen-

tative to Eritrea. Honorable Minister of Health, Mrs

Amina Nurhussien apprised audience about the major

achievements made toward achieving health related

MDG goals and commended the department of health

for that. We are very much aware that our achieve-ments should not be the causes for satisfaction, as

more work to be done to maintain what has been

gained- remarked the minister.

Speaking on the event, Dr. Abdulmumini Usman,

WHO representative to Eritrea informed that the de-

veloping countries are observing an increasing trend

of non-communicable diseases, like, cardio-vascular

diseases, diabetes, cancers etc. Stating the impor-

tance of eating healthy foods, he advised people to

reduce salt intake; avoid tobacco use and harmful

use of alcohol; control body weight; and regularly

check blood pressure. Health is multi-dimensional

and all sectors have important role in preventing and

promoting healthy behavior- he stressed.

The world is experiencing three major issues

around food: food security, food safety and nutri-

tion- cited by, Dr Moeketsi Mokati, Food and Agri-

culture Organization (FAO) Representative in Eri-

trea. He also showed the global achievements on the

MDG goals related to food and read out the message

from the UN resident coordinator.

Dr Andebrhan Tesfatsion , acting director general,

public health presented on the MDG goals and status

of Eritrea toward achieving those targets. Eritrea is

on track in achieving MDG targets on improving

education and gender equality and reducing child

mortality, maternal mortality, TB, HIV and Ma-

laria- he said.

Dr Usman Abdulmumini, WHO Representative

of Eritrea delivering remarks.


6/12

He emphasized on the need of increasing government commitment, more community participation and mul-

tisectoral partnership to achieve uniform success in all areas of health and development.

Dr Arai Berhane, the Director of Communicable Disease Control Division described the symptoms, causes,

prevention and treatment of high blood pressure. Excess consumption of salt, heredity, overweight, diabe-

tes, alcohol, high fat intake, smoking and lack of exercise are the major risk factors for high bold pressure-

he informed. Furthermore, he said that almost 90% Eritreans have one or two risk factors for high bloodpressure. But, healthy diet, increasing physical activities and avoiding smoking, reducing alcohol and man-

aging stress can minimize the risk of high blood pressure. He too emphasized on strengthening non-

communicable diseases control programme through increasing community involvement and partnership.

In the event, two nurses were assigned to measure the blood pressure of the participants and many took the

advantage. The event was concluded with the cultural show.

Participants of the event.Cultural show of the event.


7/12

Above half-million children reached during the WHO/UNICEF supported Eritrea edi-

tion of the 3rd African Vaccination Week

In response to a resolution adopted by Ministers of Health at the sixtieth session of the WHO Regional Com-

mittee for Africa in Malabo, Equatorial Guinea in 2010, Eritrea has institutionalized implementation of an an-

nual African Vaccination Week since the inception.

The week long campaign usually organized during last week of April is aimed at sustaining advocacy, expand-ing community participation and improving immunization service delivery in areas that are hard to reach or

generally underserved by the health system, as a strategy to reduce child morbidity and mortality in line with

The mothers and children queued for vaccination

WCO Eritrea along with UNICEF provided tech-

nical and financial support to the MoH to imple-

ment the 3rd edition of Africa Vaccination Week

from 26-30 Jun 2013 which was integrated with

Vit "A" supplementation and Mid-Upper-ArmCircumference (MUAC) measurement.

The campaign was aimed at increasing routine

child vaccination coverage; vaccinating children

0-59 months with OPV in polio high risk areas;

sustaining the high coverage of vitamin A;

screening and referral of children 6-59 months

for severe and moderate malnutrition; advocating

with key stakeholders, health workers, and com-

munities.

MOH, WHO, UNICEF, Local Government,

Women Association, Youth association were the

main partners in the campaign.

WHO also supported the MoH in planning and

training of the relevant staff preparation and exe-

cution of the campaign.

As a part of the preparation, various advocacy meet-

ings were organized at different levels. The campaign

team used different strategies to capture children un-

der 5 years. Various modes of media communica-

tions were used widely to enhance the coverage.

As a result of a systematic preparation and extensive

exercise, the campaign ended with significant out-

come. A total of 484,152 (80%) children received Vit

A supplementation and were screened for status of

vaccination. Moreover, a total of 11,933 children re-

ceived BCG, OPV/DPT/HepB|Hib and Measles vac-

cines out of which 1,783 were children of less than 1

year of age and 10,150 were children between 1-2

years. A total of 49,501 children 0-59 months of agehave received OPV vaccine in the targeted Sub-Zoba

of NRS, Gash Barka and Anseba in the bordering of

Sudan.

Furthermore, the campaign could generate substantial

awareness and community partnership. The MoH

foresee a long term effect of this campaign in im-

proving general vaccination coverage.


8/12

WHO Supported Immunization Coverage Survey

confirms High EPI Coverage of 96% in Eritrea

Eritrea has made a substantial progress in addressing

vaccine preventable diseases, which indicates good

awareness among the communities about the impor-

tance of vaccination. However, to determine the cover-

age of immunization and to understand socio-

demographic factors influencing child and maternal

immunization, WHO supported MoH Eritrea to con-

duct EPI coverage survey in April 2013. This survey

was undertaken after a gap of 4 years; the previous one

was in 2009.

The team in Buya conducting the survey.

The team visited five clusters; amongst them, the Buya and Foro were supported by the Health Workers and

community leaders. The team used interviewing by using standard questionnaire and observation of re-

cording as a methodology to collect the information.

The team meeting with one of the Medical Di-

rectorThe survey underway

The survey confirms a Penta 3 coverage of 96% by card and 86% by validity coverage.

Overall, the survey recorded a high EPI coverage and in most places, well-maintained record keeping in

visited areas of Eritrea.

However, in some areas, it also identified minor gaps in record keeping like, recoding wrong date of birth

as well issue of delayed immunization and high proportion of home deliveries.


9/12

UN Health and Nutrition Thematic Group emphasized on coordinated UN sup-

port to the government

Health and Nutrition of being multidimensional in

nature, the interventions encompasses a wide variety

of activities which require more coordination, inte-

grating and convergence within and outside the health

sector.

For reviewing the activities for better coordination,

Health and Nutrition Thematic Group meets regu-

larly. At the meeting on 8th of May 2013 at the WHO

Conference Hall. Mr Semere Gebregiorgis, MPN/Advisor welcomed the participants.

Ms Bemi sola Akinboyo from UNICEF briefed the

participants on the outcome of the UNCT Retreat

2013 and highlighted on the salient features of the

joint plan and challenges in implementation.

Dr Usman Abdulmumini, WR giving a

briefing

Furthermore, the team also found out difficult terrain and weather condition; sizeable nomadic population;

cultural practice of home deliveries and transportation difficulties (staff using camels and donkeys for trans-

porting vaccines) in the area.

At the end of the survey, the teams visited the Regional Medical Directors and debriefed about the findings.

The team recommended MoH to conduct regular training of the staff and to enhance supervision in order tomaintain and improve the coverage.

Nationwide immunization Underway


10/12

Dr Usman Abdulmumini, WHO Representative to Eritrea stressed on initiating implementation of the plan

while the coordination strategy is under finalization. He also advised to create sub-groups under each out-

come to better monitor implementation.

The readers group was assigned to finalize writing work in two week time.

Mr Semere made a presentation by focusing on WHOs contribution to the one UN. The participants actively

discussed on each activity for possible contribution by different UN agencies. UNICEF, UNFPA, UNAIDS,

UNHCR likewise presented their activity plans highlighting areas for joint work.

In conclusion, the participants agreed on the need for coordination to avoid duplication in terms of planning

and reporting for better support to the country. Furthermore, the team decided to produce joint health and nu-

trition activities to reflect the UN support to the government.

The following agencies were present at the meeting under the chairmanship of Dr Abdulmumini Usman,

WHO Representative to Eritrea; WHO, UNFPA, UNHCR, UNICEF, UNAIDS,

WHO supported Maternity Waiting Homes to improve access

to emergency obstetric care in Eritrea

WHO in collaboration with MOH supported communi-

ties of remote areas with the provision of Maternity

Waiting Homes. Community engagement and participa-

tion in the planning, construction and demand creation

ensured that the Maternity Waiting Homes were utilized.

In addition, the availability of all necessary equipment,

supplies and manpower for Basic Emergency Obstetric

and Newborn Care (BEmONC) addressed the 3rd delay

and fostered confidence in the intervention.

Additionally the provision of other health services to the

womans family and children encouraged utilization of

the Maternity Waiting Homes.

The dramatic improvement in maternal and

neonatal health outcomes as a result of timelyaccess to services has augmented trust and utili-

zation of services including women from com-

munities adjacent to the health facilities and

Maternity Waiting Homes. This resulted in the

reduction of the child and maternal mortality.

The availability of Maternity Waiting Homes

has significantly increased skilled attendance inremote areas, resulting in improved maternal

and neonatal health outcomes.


11/12

The concept of Maternity Waiting Homes is effective, efficient and relevant for improving access to skilledcare; it is also sustainable due to community involvement. It has been facilitated through joint efforts by

multiple partners and enjoys political goodwill. The processes modeled in establishment of Maternity Wait-

ing Homes in Eritrea are simple and can be easily adapted by anyone committed to implementing the initia-

tive.

Different models of maternity waiting homes in Eritrea.

As part of the establishment of the Maternity Waiting Homes, it was necessary to ensure that the basic utili-ties to guarantee functionality were in place. These include availability of water, light and human waste dis-

posal mechanisms. MOH partners including WHO therefore supported distribution of water tanks, solar

lighting systems, and construction of latrines for some of the waiting homes. Additionally, the partners sup-plied beds, cooking utensils and occasionally foodstuff to the maternity waiting homes as a way of encourag-ing utilization.

Generally, the criteria for admission to the Maternity Waiting Homes include: any mother who comes fromat least 10km from the health facility or over two hours walk from the facility and who is at 32 weeks gesta-

tion and above; regardless of her gravidity, parity, medical or obstetrical history. Women with risk factors

regardless of gestation or distance are also encouraged to use the maternity waiting homes.

Postpartum women with their babies in the Maternity Waiting Homes

There has been a progressive increase in utilization of the Maternity Waiting Homes as well as in facility

deliveries and skilled birth attendance over time as shown in the figure below: Antenatal care attendancehas been reported at 100% for women in the Maternity Waiting Homes with spillover effect in the commu-

nities bordering the health facilities.


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WHO provided IT equipment and various medical supplies to support Eri-

trea MOH on NCDs control, IHR core capacity and surveillance

Besides providing technical assistance on different health

related issues, the WHO in Eritrea has been supporting the

Ministry of Health for various critical medical, IT and

laboratory supplies on the basis of jointly identified needs.

In line with this, medical supplies and IT equipment worth

over USD 100,000 were donated to the Ministry of

Health.

The computers and other IT equipment were part of the

effort to strengthen the national core capacity for Interna-

tional Health Regulations (IHR) in line with the nationalplan. Strengthening IHR core capacity is necessary for the

country to be able to detect and manage public health

events of international concern.

The World Health Organization Package for Essential

NCDs (WHO PEN) is an innovative and action oriented

response at PHC level to address the major NCDs, namely

diabetes, cardiovascular diseases, chronic obstructive lung

diseases and cancers. Eritrea has already pilot tested the

project in some selected Regions in Maekel Region and iscurrently in the process of expanding nationwide. To sup-

port the expansion effectively, there is a strong need in

building the capacity of health workers at the PHC level

as well as provide the PHC facilities with the required ba-

sic equipment and supplies.

The donation is as part of the organizations continuous

contributions and support to strengthen MOH and the

countrys health system for better health out-

comes. WHO urge for effective utilization of the

items in implementing the health priority pro-

grams.

MOH expressed gratitude to the WHOs con-

tinuous technical and logistical support.

Symbolic handing over to the MOH by WR

Dr Usman Abdulmumini, WHO Representative of Eritrea

urged MOH on effective utilization of the items.

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