health sector bulletin - humanitarianresponse · malaria: in epi week 31, 6,565 cases of confirmed...
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HEALTH SECTOR
Health Sector Bulletin
Northeast Nigeria
Humanitarian Response
COVID-19 response
July 2020
4.4 Million PEOPLE TARGETED BY
THE HEALTH SECTOR
>2.0 Million*** PEOPLE REACHED IN
2020
1.9 Million* IDPs IN THE THREE
STATES
45 HEALTH SECTOR PARTNERS
(HRP & NON HRP)
HEALTH FACILITIES IN BAY STATES**
1529 (58.1%) FULLY FUNCTIONING
268 (10.2%) NON-FUNCTIONING
300 (11.4%) PARTIALLY FUNCTIONING
326 (12.4%) FULLY DAMAGED
4.9 Million CONSULTATIONS****
1,490 REFERRALS
72,566 CONSULTATIONS THROUGH HARD
TO REACH TEAMS
CUMULATIVE CONSULTATIONS
EARLY WARNING & ALERT RESPONSE
275 EWARS SENTINEL SITES
201 REPORTING SENTINEL SITE
1,477 TOTAL ALERTS RAISED*****
*Total number of IDPs in Adamawa, Borno and Yobe States by IOM DTM XXX
**MoH/Health Sector BAY State HeRAMS September/October 2019/2020
***Number of health interventions provided by reporting partners as of June 2020.
**** Cumulative number of medical consultations from Hard-To-Reach Teams.
***** The number of alerts from Week 1 – 26, 2020
SECTOR FUNDING, HRP 2020
6.2% FUNDED GAP: 80.9M USD
5.6 Million PEOPLE IN NEED OF
HEALTHCARE
• COVID-19 cases are steadily increasing in the three states. In Borno, currently, 12 out of 27 LGAs are affected and >80% of reported cases are among travellers tested at POE locations. Challenges remain around stigma and discrimination among people discharged from quarantine and treatment centres; this results that the majority of confirmed cases (73%) are opting for self-isolation. Partners are working to scale up the COVID-19 surveillance and contact tracing efforts to enable rapid detection, isolation, testing, and management of cases.
• As of 30th July 2020, 88% of 844 confirmed cases in BAY states have been discharged since the beginning of the COVID-19 response. With 40 new cases, Adamawa state maintains a weekly lead in COVID-19 burden among the BAY states; Yola North and South LGAs account for 75% of all cases in the state. Yobe state launched a heroes campaign to celebrate survivors of COVID-19 who were declared as “heroes and heroines”
• As the schools’ plan to resume, SMoH, WHO and other partners are putting measures in place to ensure compliance with the guidelines for the safe reopening of schools in the state through timely IPC measures.
• Malaria SMC Cycle-1 implementation in Borno State Started on 11th July 2020. The campaign was based on three strategies i.e. House to House (H2H), Reach every settlement (RES) and engagement of community informants from inaccessible areas. 25 accessible LGAs were planned for the implementation, with (CIIAs) in these LGAs are fully accessible, partially accessible and inaccessible areas. As such, the fully accessible areas were reached by H2H teams, partially accessible areas were reached using the RES teams, while inaccessible areas were reached through CIIAs. This was to ensure that all eligible children within the 25 LGAs were protected from malaria.
• Since the beginning of the COVID-19 pandemic, attacks on health care have received increasing attention. As health care providers worldwide search for effective solutions to protect health care during the COVID-19 pandemic, it is important to keep in mind that incidents of attacks should not be viewed as isolated events, but as one piece of a larger puzzle. One of the health facility in Chabal Limanti in Magumeri LGA recently renovated by WHO was vandalized by BHT, while drugs and equipment were carried away.
•
Highlights
Health Sector Bulletin | July 2020
2
Situation Updates
Seasonal Malaria Chemoprevention Week
SMC Cycle 1 implementation in Borno State Started on 11th July 2020. Three (3) strategies were used in Cycle 1 due
to complex operating environment: House-to-house (H2H); Reaching every settlement (RES); and Community
informants from inaccessible areas (CIIAs).
25 accessible LGAs were planned for the implementation, within these LGAs are fully accessible, partially accessible
and inaccessible areas. As such, the fully accessible areas were reached by H2H teams, partially accessible areas were
reached using the RES teams, while inaccessible areas were reached through CIIAs. This was to ensure that all eligible
children within the 25 LGAs were protected from malaria.
Several levels of monitoring and supervision took place during implementation and daily review meetings at all levels
held throughout the period of activity.
GIS Tracking was deployed to support the Cycle 1 Campaign of the SMC 2020 Round. GPS Tracking devices were for
teams implementing: H2H strategy in accessible settlements across 23 LGAs, RES strategy in partially accessible
settlements across 13 LGAs, and CIIA support in inaccessible settlements across 9 LGAs. Settlement visitation status
were analyzed and reported daily for H2H strategy, while visitation status for RES and CIIA activities were analyzed
post campaign and settlement coverage (visited and not visited) were reported on a daily basis during LGA and state
evening review meetings.
Implementation of July 2020 (1st
Cycle)
Borno State Map showing implementing LGAs
H2H only RES only Not Accessible RES
& H2H CIIAs
Map showing locations supervised by various agencies across Borno State.
Health Sector Bulletin | July 2020
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Early Warning Alert and Response System (EWARS)
Number of reporting sites in week 31: A total of 196
out of 276 reporting sites (including 32 IDP camps)
submitted their weekly reports. The timeliness and
completeness of reporting this week were 66% and
67% respectively (target 80%).
Total number of consultations in week 31: Total
consultations were 34,750 marking a 3% decrease in
comparison to the previous week (n=35,914).
Leading cause of morbidity and mortality in week 31:
Malaria (suspected n= 9,314; confirmed n= 6,565) was
the leading cause of morbidity reported through
EWARS accounting for 42% of the reported cases,
apart from deaths due to other causes (4), Severe
Acute Malnutrition (2) was the leading cause of
mortality reported through EWARS accounting for
28% of the reported deaths.
Number of alerts in week 31: Seventeen (17)
indicator-based alerts were generated with 100% of
them verified.
Morbidity Patterns
Malaria: In Epi week 31, 6,565 cases of confirmed
malaria were reported through EWARS. Of the
reported cases, 375 were from General Hospital Biu,
273 were from PUI Waterboard Extension IDP Camp
Clinic in Monguno, 211 Algon Clinic in Monguno, 204
were from Uba General Hospital in Askira-Uba, 200
were from ICRC FSP Clinic in Monguno, 187 were from
Peta Model Health Centre in Kwaya Kusar, 151 cases
each from AAH Waterboard Extension IDP Camp Clinic
in Monguno and MCH Clinic Konduga and 146 were
from AAH Veterinary IDP Camp Clinic in Monguno. No
associated death was reported.
Figure 2: Trend of malaria cases by week, Borno State, week 34 2016 – 31 2020
Acute watery diarrhea: In Epi week 31, 499 cases of
acute watery diarrhea were reported through EWARS.
Of the reported cases, 102 were from Ngaranam PHC
in MMC, 48 were from PUI Gana Ali IDP Camp Clinic in
Monguno, 32 were from Gwoza Wakane IDP Clinic in
Gwoza, 31 were from Gamadadi PHC in Bayo, 30 were
from PUI Waterboard IDP Camp Clinic in Monguno
and 20 were from Gamboru PHC in MMC. No
associated death was reported.
Figure 3: Trend of acute watery diarrhea cases by
week, Borno State, week 34 2016- 31 2020
Acute respiratory infection: In Epi week 31, 6,317
cases of acute respiratory infection were reported
through EWARS. Of the reported cases, 322 were from
Algon Clinic in Monguno, 294 were from PUI
Waterboard Extension IDP Camp Clinic in Monguno,
251 were from AAH GGSS IDP Camp Clinic in
Monguno, 238 were from AAH Fulatari IDP Camp
Clinic in Monguno, 222 were from Waterboard
UNICEF IDP Camp Clinic in Monguno and 216 were
from AAH Veterinary IDP Camp Clinic in Monguno. No
associated death was reported.
Health Sector Bulletin | July 2020
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Figure 3: Trend of acute respiratory infection cases by
week, Borno State, week 34 2016- 31 2020
Suspected Measles: One (1) suspected measles case
was reported through EWARS from Dalaram PHC in
Jere. Seven (7) additional cases were reported
through IDSR* from MMC (5) and Monguno (2) LGAs
making a total of 8 suspected measles cases. No
associated death was reported.
Figure 4: Trend of suspected measles cases by week,
Borno State, week 34 2016- 31 2020
Suspected Yellow Fever: Three (3) suspected yellow
fever cases were reported through EWARS from
Chibok General Hospital (1) and Njimtilo Health Clinic
(2) in Konduga. Four (4) additional suspected cases of
Yellow Fever were reported through IDSR from Hawul
(2), Jere (1) and Monguno (1) LGAs making a total of 7
suspected yellow fever cases. No associated death
was reported.
Suspected Meningitis: No suspected meningitis case
was reported in week 31.
Suspected VHF: No suspected VHF case was reported
in week 31.
Suspected COVID-19: Two (2) confirmed COVID-19
cases were reported through EWARS from University
of Maiduguri Teaching Hospital in Jere. No associated
death was reported.
Suspected cholera: No suspected cholera case was
reported in week 31.
Malnutrition: 1,454 cases of severe acute
malnutrition were reported through EWARS in week
31. Of the reported cases, 124 were from Kurbagayi
MCH in Kwaya Kusar, 103 were from AAH Waterboard
IDP Camp Clinic in Monguno, 50 cases each from
Damboa MCH and Fori PHC in Jere, 44 were from
Muna Garage Camp Clinic B in Jere and General
Hospital Ngala (FHI360). Two (2) associated deaths
were reported from Chibok General Hospital
Neonatal death: One (1) neonatal death was reported
through EWARS from University of Maiduguri
Teaching Hospital in Jere.
Maternal death: No maternal death was reported
through EWARS in week 31.
*IDSR- Integrated Disease Surveillance and Respons
Health Sector Actions
AAH continue to enhance Sexual and Reproductive Health in humanitarian response in Borno and Yobe State through dissemination of appropriate maternal counselling, and providing access to quality basic health care services that
support women have a fit pregnancy, deliver safely and have a healthy baby. Thus, 8,469 women (ANC-6,912 and PNC-1,557) received Sexual Reproductive Health Services and 359 live births were attended by skilled health personnel. 75,302 (Male – 32,144 Female – 43,158) received health care services at our health facilities. Among those 27,808 are under 5 children and 47,494 are 5 years old and above. The major consultations were malaria (17,662) being the major cause of consultation, followed by AWD (10,086), RTI (8,768), and other medical conditions (38,786). A total of 21,107 (Male – 2,547 Female – 18,560) were reached with six key hygiene messages through mother-to-mother support groups and Community Health Mobilizers. The key messages disseminated include childhood illness danger signs and early referral to health facilities, MIYCN including balance diet with the use of locally available nutritious foods. In addition, importance of ANC cervices,
Sensitization on COVID-19 at Daddawel PHC
Health Sector Bulletin | July 2020
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institutional delivery, immunization, malaria prevention through environmental sanitation and appropriate use of insecticide treated mosquito nets, cholera preventive and control measures, availability of STIs care at health clinics and COVID-19 preventive measures. Support to routine immunization continued with the provision of immunization services to 13,925 (Male – 6,482, Female-7,443). Children and pregnant women were vaccinated against vaccine preventable diseases by providing BCG, OPV, PENTA, PCV, IPV as well as TT vaccines. Capacity enhancement sessions were also conducted for health professional and community workers of different cadres where 136 (39 males, 97 females) Community Health Mobilizers received refresher training on Infant and Young Child Feeding in Emergency (IYCF-E) while 30 (12 males, 18 females), compromising of 1 Medical Doctor, 8 Nurses/Midwives, 4 Pharmacy Technicians and 17 Community Health Extension Workers (CHEWs)/Health Educators had a refresher training on Emergency Preparedness and Response. Other 30 Health workers (1 male, 29 females), comprising of 1 Medical Doctor, 29 Nurses/Midwives had a refresher training on Basic Emergency Obstetric and Newborn Care (BEmONC). Two (2) sessions of continuous Medical Education (CME) on-the-job training on Paediatrics Medical Emergency training was conducted for 22 (12 males, 10 females) stabilization centre staff, comprising of 2 Medical Doctors, 8 Nurses, 8 Nurses’ aides, 1 Laboratory Technician, 1 Pharmacy Technician, 1 Psychosocial, and 1 Community Health Extension Worker, and in Yobe State, 25 Health workers (17 males, 8 females), comprising of 1 Medical doctors, 3 nurse/midwives, 1 pharmacy technicians, 20 community health extension workers, have received BEmONC refresher training. In addition, ACF project staff and government staff provided supportive supervision and mentoring at 7 health facilities to improve the quality of Health Care Services. In the case of COVID-19 response, 47,213 (male – 19,398, female – 27,815) clients were sensitized on COVID -19 Infection Prevention and Control measures across facility sites.
AHI conducted training and orientation for 10 National Union of Road Transport Workers (NURTW) drivers with their stakeholders and 4 Health Care providers in Dikwa on
referral/transport scheme in Dikwa to bridge the gap of referral in the LGA. 13 Health facilities were supported with Reproductive Health drugs and consumables. The facilities are: General Hospital Dikwa, MCH Dikwa, 1000 IDP clinic Dikwa, Rabiri clinic Dikwa, Shehu Masta clinic, PHC Dikwa, MCH Monguno, UNICEF clinic Waterboard Monguno, PUI Clinic ALGON Monguno, PUI Clinic Waterboard Monguno, FP Kuya Monguno and ICRC clinic GGSS Monguno. Sexual and Reproductive Health sessions with adolescent girls, young women and medical house to house outreaches is still ongoing. Sensitization of Adolescent girls on health messages, general hygiene and sexual violence was conducted. Pregnant women were enlightened on the need of Anti-natal care, post-natal care and were referred to clinics which we support with delivery kits and relief materials. 24 dignity kits were given to returnees from Baga in Monguno LGA and 10 dignity kits to returnees from Gomboru.
ALIMA provided a total of 2,555 outpatient consultations for children under 5 in Muna Clinic with 15 referrals and 3,024 consultations for all ages in TVC Clinic with 102 referrals. 743 OPD consultations for all ages were provided at Waterboard Reception Clinic in Monguno LGA of Borno State. In Hawul and Askira in Southern Borno, 4,158 OPD consultations were conducted for children under 5. Six (6) measles cases were treated at ALIMA’s health facilities in Monguno LGA of Borno State. Most
of the cases were from Fulatari and GGSS IDP camps. 1 case of gunshots wounds was received at ALIMA facility and 1 case of deep laceration cut was referred to Maiduguri in collaboration with ICRC. For Sexual and Reproductive activities, 1,277 were provided with ANC and 180 PNC consultations in MMC and Jere, out of which 551 ANC are first visits and 180 PNC within 72 hours of delivery at Muna Clinic with no referrals. At the Teachers’ Village Clinic, 1,098 pregnant women in total came for ANC while the total PNC consultations were around 159 (123 PNC within 72 hours). BEmOC activities were conducted at CBDA clinic where 129 deliveries were recorded, which is higher compared to previous month delivery. A total of 1 referral was made to secondary/tertiary care and 134 deliveries were conducted at TVC Clinic, the total number of deliveries is higher compared to preceding month deliveries. Traditional Birth Attendants (10) in Muna and TVC (8) were engaged to refer patients from the community for delivery at CBDA and TVC Clinic. 203 deliveries were recorded and 1,119 ANC consultations were conducted in Askira and Hawul LGAs in southern Borno. MHPSS activities were conducted which include 10 trauma psychotherapeutic sessions with 53 participants in total, 9 Individual therapeutic consultations and Community awareness for 8 group sessions. These were all conducted in Monguno LGA.
Health Sector Bulletin | July 2020
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TOPIC OBJECTIVES OF TRAINING PARTICIPANTS LOCATION
MHPSS Overview • Discuss MHPSS in emergency context.
• Establish referral paths and services.
Community Health workers (27)
Monguno
PFA Place of PFA in Humanitarian response. How, when and Where and principles for using PFA. Communication skills in PFA
Community Health workers and Nurses. (31)
Monguno
SGBV Establish a common understanding of SGBV, Awareness, medical and psychological management. Identify contributing/risk factors, scope and consequences and appropriate referral path for SV.
Midwives, Nurses, and CHW’s (62)
Monguno.
eHealth Africa is currently partnering and providing technical support to the Borno State
government and WHO in tracking the settlement coverage of Community Drug Distributors
(CDDs) for the 2020 SMC Round as they carry out drug distribution and administration to children aged between 3
to 59 months in households across settlements in the state. The 2020 SMC round is targeting about 2 million children
in Borno state. eHealth Africa also piloted the GIS tracking support and provided support for data-driven decision
making for microplanning, provision of GPS enabled devices for tracking CDDs, intra-campaign tracking of
settlements coverage, tracking and resolution of missed settlements during the campaign.
FHI 360 provided 13,951 outpatient curative consultations in her clinic facilities in Dikwa, Banki,
Ngala and Damasak. Acute Respiratory Infection (ARI) was the leading cause of communicable
disease morbidity with 3,710 cases. It accounts for the highest morbidities in four (4) sites (Dikwa,
Ngala, and Banki). Also, malaria (2,106 cumulative cases) was the second major cause of morbidity across the four
(4) sites. Peptic Ulcer disease remains the leading single etiology of non-communicable disease (NCD) morbidity, and
a total of 819 persons with peptic ulcer were treated across all FHI 360’s clinics. Cases of hypertension was also seen
in significant numbers, at 466 cases. A total of 535 children were vaccinated against various vaccine-preventable
diseases in Banki and Damasak. Also, 842 women of reproductive age received tetanus toxoid vaccination in Banki
and Damasak as well. One (1) case of sexual violence was managed at the health facility accordingly while maintaining
confidentiality. The patient was referred appropriately to Protection for Psychosocial support.
FSACI with support from the Civil Society on Malaria Control, Immunization and Nutrition (ACOMIN)
carried out discussions and enlightenment in Sabon Gari Community and Primary Health Care Centre
at Dwam Ward of Demsa LGA of Adamawa State. The purpose was to involve community members
on Risk Communication and Community Engagement on Malaria and COVID-19. Clients Exit
Interviews, Key informant interviews at the PHC and Focus Group Discussion with Community leaders and members
were also conducted to evaluate the accessibility of health facility and services to pregnant women and children from
0-5 years. Health education and Community Mobilization on COVID-19 was conducted. Posters on hand washing
techniques were distributed and the community members were advised to seek medical care early and maintain
social distancing.
INTERSOS carried out a total of 29,253 outpatient consultations (male – 13,700 and female –
15,553) of which under 5 was 11,467(39%). The total number of consultations for the reporting
month recorded an increase compared to the previous month of June. Under 5 consultations were the predominant
age range for consultations; an increase compared to the previous month. A total number of 5,943 of Acute
Respiratory Infection was reported and it continues to be the highest cause of morbidity, closely followed by Malaria
with a total of 3,318 cases. INTERSOS health facilities registered a slight increase in the cases of Acute Watery
Diarrhea, and Blood Diarrhea across all sites, compared to the previous month, with 24 cases for Acute Watery
Diarrhea, and 230 for Bloody diarrhea respectively. Sexual and Reproductive Health Services were provided to a total
of 2,611 women who attended ANC services at our health facilities, and out of which 1,198 were first time attendees
and 1,413 were follow-up attendees. Ngala Clinic recorded the highest number of ANC attendees with a total of 885
attendees. A total of 304 PNC attendance was recorded and 79 new deliveries across 5 health facilities. Magumeri
Hospital recorded the highest number of PNC attendance and new deliveries with a total of 143 attendees and 42
new deliveries respectively.
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146 hospitalizations were recorded, out of which 58 cases were SAM cases with complications, 39 were Non SAM
cases under 5 years, with life threatening conditions, 27 non SAM above 5 years, with life threatening conditions, 15
Gynecology/Obstetric cases (complicated cases admitted for more than 24hrs) and 7 patients were hospitalized for
other reasons. A total of 19 referrals were made. 13 were discharged, 1 is still on admission and 5 deaths were
registered.
PUI in collaboration with Ministry of Health and NCDC was able to provide training to all staff
on Infection Prevention and Control. This is to enable staff to effectively promote and prevent
themselves of infection especially COVID-19. A total number of 15,095 OPD consultations was
recorded, more than the previous month which was 12,141. For Sexual and Reproductive Health Services, 3,643
women were provided with SRH services. 280 post-natal hygiene kits were distributed to mothers who gave birth in
our facilities. Malaria cases confirmed by RDT indicates that the disease is on the increase as 905 cases were
recorded, which much higher compared to the preceding month where 711 cases were recorded. 2,497 cases of
Acute Watery Diarrhea were recorded while 2756 ARI cases were recorded.
Immunization services were also provided to beneficiaries, and a total of 1,435 doses of different vaccines were
provided to women and children at Herwa Peace PHC, 1,237 doses at Ngarannam PHC and 1,729 doses of different
vaccines were provided to pregnant women and children by Mobile Health Teams at Bayan Texaco, Jajeri Kantudu
and Bulabulin Alhajiri. MHPSS were provided to 37 beneficiaries at Herwa Peace PHC, 15 at Ngarannam PHC as well
as 17 beneficiaries by Mobile Health Teams at Bayan Texaco, Jajeri Kantudu and Bulabulin Alhajiri.
RHHF supported by UNFPA is implementing the integrated one stop approaches to GBV prevention,
mitigation and responses project in Adamawa, Borno and Yobe States through the establishment and
management of One Stop Centers (OSCs). The project also strengthens the provision of Sexual and
Reproductive Health (SRH) information and services at the supported health facilities across the
intervention sites. These are parts of effort to ensure continuous access and utilization of comprehensive SRH and
GBV (health care, GBV Case management, access to police and legal support, shelter, as well as culturally and age
appropriate counseling and psychosocial support) services by women and girls experiencing GBV or at risk of GBV
across the intervention sites at this critical time. A 3-day virtual training on GBV case Management was conducted
for twenty (20) community primary health caregivers and social workers from Borno, Yobe and Adamawa States in
partnership with UNFPA. The training contents were adapted from the Inter Agency Standing Committee (IASC)
guidelines on GBV Case Management) guidelines. The training aimed to strengthened the capacity of GBV service
providers across the intervention states in the provision of quality services to GBV survivors, respond to disclosure
and facilitating referral of GBV survivors to higher level of care when the need arises.
Also, a 3-day virtual training on Mental Health and Psychosocial support (MHPSS) was conducted for thirty- five (35)
service providers from the OSCs and the SRH service delivery points of the supported health facilities in Borno,
Adamawa and Yobe (BAY) states as well from the States Ministry of Women Affairs, Justice, Health and the Nigeria
Police Force. The training was conducted using Adult Learning Methodology and adheres to key principles of the
Inter-Agency Standing Committee (IASC) guidelines on MHPSS
training in Emergency; which are building local capacities,
supporting self-help and strengthening the resources already
present in affected communities.
RHHF/UNFPA donated COVID-19 PPE and commodities to the
OSC and SRH units of General Hospital Potiskum and General
Hospital Mubi, in Yobe and Adamawa States respectively. The
items donated include mechanized hand washing spots,
Hazmat suits, N95 face masks, sterile gloves, sterile face
masks, re-washable face masks, alcohol-based hand sanitizers,
family planning commodities, RH Kits and malaria test kits.
Local production of COVID-19 Personal Protective materials and reusable sanitary pads as well as assembling of
Dignity Kits is ongoing at the Dignity Kit production Centre in Maiduguri. This is being supported by UNFPA.
Production of reusable sanitary pads in Maiduguri
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TdH continue to provide humanitarian assistance in Mafa Central LGA by organizing Health
Mobile Hub in GGSS IDP Camp, Mafa Rural LGA with support to Zanari PHC Clinic and Health
post in Host Community and IDPs population and in Rann, Kala Balge LGA, with specialized
MNCH and CU5 Health Mobile Hub. A total of 3,169 medical consultations (women and children) were provided in
the 3 locations. 3,834 PLW received Reproductive health services (ANC, delivery and PNC). TdH continue to create
awareness on COVID-19 to all beneficiaries accessing the TdH supported health facilities. IPC measures are in place
for the prevention of COVID-19 transmission at the point of service delivery. A total of 44,788 persons were sensitized
on COVID-19 within TdH areas of intervention.
UNFPA in collaboration with Borno State Ministry of Health and Primary Health Care Development
Agency has sustained continued access to Sexual Reproductive Health Services through
coordination and provision of lifesaving commodities and COVID-19 Infection prevention control
measures. It has procured and prepositioned infections prevention and control materials in 16 integrated facilities
in addition to the earlier COVID-19 prevention ongoing compliance mechanism. 16 motorized hand washing aqua
kits were placed in integrated facilities including Fistula Centre of Excellence. 90 alcohol-based sanitizers and liquid
hand washing soap were distributed, 3 infrared thermometers for taking beneficiaries temperature at integrated
facilities, 500 disposable pieces of facemask were distributed to beneficiaries and 15 Hazmat suit, hand gloves and
other protective disposable wears were provided to services providers across integrated facilities.
UNFPA also supported the One Stop Centre for GBV & SRH at General Hospital Potiskum with Toll Free Help Lines to
facilitate Health Response to GBV, and provided care to 14 individuals, and also 76 cartons of Emergency
Reproductive Health Kits expected to cater for up 150, 000 people in need.
UNFPA continue to support provision of Sexual and Reproductive Health (SRH) Services, emergency obstetric care
including family planning. The service provision sites include integrated facilities and mobile medical outreaches to
most affected communities within 3 supported LGAs, including strengthening referral mechanism for SRH Services
and survivors of GBV.
S/N INDICATOR TOTAL
1 # of affected population reached with all type Family Planning services 91
2 # of people diagnosed and treated for an STI/HIV (new) 119
3 # of pregnant women who attended Ante-Natal Care 1st visit 419
4 # of deliveries attended by a skilled health personnel (not traditional attendant) 30
5 # of Women that attend at least one Post Natal Clinic Visit 34
6 # of adolescents and young persons reached with SRH services including Family Planning and HIV education
840
7 Nutrition counselling (IYCF) 51
8 # number VVF survivors mobilized screened in Fistula unit 56
9 Fistula repaired 36
10 # individuals reached key lifesaving SRH information 2,571 1,676
11 Other services 9
Total 4,256
A mini Obstetric Fistula Campaign to reduce burden of Fistula cases in Borno was conducted. Community mobilization
and engagement of stakeholders including traditional and religious leaders across IDP camps and host communities
focusing on prevention of child/force marriage, improve attendance to antenatal care, delivery at health facilities
and uptake of family as part of VVF prevention measures was carried out. 2,571 individuals were reached during
community sensitization, 56 fistula survivors – women and girls were mobilized and screened at State Specialist
Fistula unit. 36 fistula survivors were repaired, treated and recuperated at the Fistula Centre of Excellence. 100
survivors were followed up, counselled and ready to be enrolled in comprehensive skills acquisition and
reintegration, rehabilitation packages.
UNICEF reached a total of 168,030 children, women and men with integrated PHC in all the UNICEF
supported health facilities in the IDP camps and host communities in Adamawa, Borno and Yobe
States, out of which 88,968 (53.04%) were children below five years. 72,131 Out-Patient Department
(OPD) consultations were recorded with Malaria – 20,585 being the major cause of consultation, followed by ARI –
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11,760; AWD – 8,517 measles – 182, and other medical conditions – 31,087. A total of 88,751 prevention services
were recorded including 4,710 children vaccinated against measles through RI services; 40,541 children and pregnant
women reached with various other antigens; Vitamin A capsules – 14,132, Albendazole tablets for deworming –
8,779, and ANC visits – 17,795, and 2,794 LLINs distributed through RI and ANC clinics in Adamawa, Borno and Yobe
States. A total of 2,567 deliveries (skilled delivery – 2,304, unskilled – 263) and 4,581 postnatal/home visits were
recorded.
WHO continue to provide support to States Ministries of Health in Borno, Adamawa and Yobe in the
fight against COVID-19 pandemic. There is a total of 844 cases (Borno- 613 %, Adamawa 164, Yobe-67
confirmed cases) including 53 deaths (case fatality ratio 6.3%). Overall, Eight-three (83) health workers
are among the confirmed cases since the start of the outbreak in the BAY states, making up 9.8% of all
cases. To date, 37 (60%) out of 65 local government areas (LGAs) have reported at least one confirmed case of COVID-
19. There are 231 active contacts across the BAY states, of which an average of 156 (68%) are seen in the past 24
hours. Active case search is ongoing, and alerts are being report both at health facility and at the community level of
which > 95% of COVID-19 related alerts are verified/investigated within 48hours of reporting.
Up until week 30, there has being decrease in the number of confirmed cases of COVID-19 and deaths reported in
Borno and Yobe state, whereas Adamawa have seen a recent surge in COVID-19 cases compared with the 2 other
states. Though the positivity rate is relatively low, the level of established community transmission is of concern.
Apparent failure to follow public health guidelines by the population, inadequate contact tracing (about 68% of
contacts are seen daily) and occasional stock out of reagents (leading to delayed test results) remains a challenge in
the response. Public health actions still ongoing include regular coordination meetings in the BAY states, screening
of travelers at point of entry locations, which has seen over 35,340 travelers screened, Health Facility and Community
surveillance in the 3 states except inaccessible LGAs, risk communication activities including motorized campaign at
IDP camps, entry point locations in Jere, Konduga and MMC LGAs. Messages are focused on community voluntary
testing, de-stigmatization, timely reporting of cases, high-risk age group, use of facemask, handwashing and social
distancing. Training and deployment of additional contact tracers to strengthen contact tracing efforts is also ongoing
in the 3 states. WHO implemented the 1st cycle of SMC in Borno State beginning from the 11th July 2020. Three (3)
strategies were used in Cycle 1 due to complex operating environment: House-to-house (H2H); Reaching every
settlement (RES); and Community informants from inaccessible areas (CIIAs). 25 accessible LGAs were planned for
the implementation, within these LGAs are fully accessible, partially accessible and inaccessible areas. As such, the
fully accessible areas were reached by H2H teams, partially accessible areas were reached using the RES teams, while
inaccessible areas were reached through CIIAs. This was to ensure that all eligible children within the 25 LGAs were
protected from malaria. Several levels of monitoring and supervision took place during implementation and daily
review meetings at all levels held throughout the period of activity.
CAPACITY BUILDING ON COVID-19 110 Government frontline healthcare worsskers from Girei and Ganye LGAs were trained by WHO on COVID-19 IPC, case reporting and risk communication. IEC materials were provided to these cohort of trainees to enhance risk communication to clients and patients in the health facilities and to the support outreach services in the communities. They are also expected to cascade to other staff in their facilities. 124 team members of HTR Mobile teams across the 21 LGAs of the State were also trained. These HTR Mobile teams are supported by UNICEF (60), SOML (30) and WHO (36). They were trained on COVID-19 IPC, case reporting and risk communication. Trained personnel will enhance activities of PoE and strengthened compliance and reporting of cases.
101% 102% 99% 102% 105% 107%99%
113%
84%92% 99% 104% 103% 98% 100%
146%
100% 100% 100% 99%
126%
100%92%
Ask
ira/
Ub
a
Bam
a
Bay
o
Biu
Ch
ibo
k
Dam
bo
a
Dik
wa
Gu
bio
Gu
zam
ala
Gw
oza
Haw
ul
Jere
Kag
a
Kal
a/B
alge
Ko
nd
uga
Ku
kaw
a
Kw
aya
Ku
sar
Maf
a
Mag
um
eri
Mai
du
guri
Mo
bb
ar
Mo
ngu
no
Nga
laPERCENTAGE COVERAGE BY LGAS
Health Sector Bulletin | July 2020
10
ICCM 1,367 children were treated for malaria, diarrhea and Pneumonia by 48/63 CoRPs in 8 LGAs of the state. 1080 of the children were screened for malnutrition using MUAC. 53 (5%) of the children screened had MAM and were counseled on proper nutrition, while 0 (0%) of them had SAM demonstrated by Red on MUAC and were referred to CMAM sites for proper management. HTR 15,640 clients were seen by WHO supported 8 H2R teams providing services in 8 LGAs of Adamawa state. The teams treated 14,341 persons with minor ailments and dewormed a total of 2,003 children during the month. Pregnant women were provided FANC services with 806 of them receiving Iron folate to boost their hemoglobin concentration while 615 received Sulphadoxine Pyrimethamine (SP) as IPTp for prevention of malaria in Pregnancy.
WHO – Mental Health outreach sessions have continued, and 94 MH sessions were conducted in 11 LGAs (Bama,
Damboa, Dikwa, Gubio, Jere, Kaga, Kalabalge, Konduga, Mafa, MMC, and Nganzai) across 37 health facilities. A total
of 2,583 patients were treated, with 16 referrals to Federal Neuro Psychiatric Hospital (FNPH) Maiduguri for further
management. 3 patients were provided with transport to FNPH, and 14 admitted for inpatient treatment.
WHO supported State Ministries of Health in Borno, Adamawa and Yobe to train 44, 50, and 50 social workers
respectively in the month of July 2020, on COVID-19 Psycho Social Support (PSS) response in order to meet the unmet
gap of COVID-19 PSS counselling. These trained social workers will scale up COVID-19 PSS counselling at the
community levels, HFs, and provide synergy with other pillars providing COVID-19 response.
238 MH patients with their care givers were supported with COVID-19 PSS counselling during routing MH outreaches
in Jere, Mafa, MMC and Gwoza LGA on basic information on COVID-19, and standard precautionary measures.
JHF continue to support to the affected population in Adamawa state by verbally screened a total of 12,410
persons, 1,044 presumptive TB cases were detected out of which 827 had their sputum samples
transported. 534 samples were analysed using GeneXpert equipment while 270 were analysed by AFB
microscopy. A total of 73 All Forms of TB cases were detected and enrolled on TB treatment. Of the 1044 presumptive
TB cases detected, 782 had HCT out of which 7 were found to be HIV+ and were linked to ART sites for Treatment,
care and support.
Nutrition Updates ALIMA continue to provide lifesaving Nutrition services across all implementing sites. A total of 259 new
SAM cases were admitted at Muna Clinic and 378 cases were discharged from the program. 36 SAM cases
with complications were transferred out to ALIMA ITFC at UMTH. In total, 172 new SAM cases with
complications were admitted at ALIMA ITFC at UMTH and 168 were discharged. 46 new SAM cases were admitted
in the ATFC at Waterboard Reception Clinic in Monguno LGA. 15 were discharged from the programme. In Askira and
Hawul LGAs, 189 children suffering from SAM were admitted in ATFC and 12 complicated SAM cases at the ITFC in
Askira General Hospital. 10,438 caretakers completed ALIMA facilitated MUAC-Mother training sessions; and 89%
have shown mastery in the use of the MUAC tapes during the training post-test evaluations. The number has
drastically reduced because of the reduction of participants in order to maintain social distance during the training
session.
262, 10%230, 9%
974, 38%
1117, 43%
Proportion of MH Pts. treated
BOYS
GIRLS
MEN
WOMEN
90227
7157
131626
12696
188925
46
0 200 400 600 800 1000
Bama
Dikwa
Gwoza
Kaga
Mafa
Nganzai
MH Pts treated by LGA
Health Sector Bulletin | July 2020
11
PUI provided Nutrition services at Herwa Peace PHC where 59 new admissions for SAM cases in OTP
were recorded, 173 new admissions in Ngarannam PHC for SAM cases in OTP and 223 new admissions
for SAM cases in OTP by Mobile Health Teams at Bayan Texaco, Jajeri Kantudu and Bulabulin Alhajiri.
WHO screened 8,742 children were screened for Malnutrition using MUAC by WHO supported 8 H2R teams. Of this number, 67 (0.77%) children had MAM and their caregivers were counseled on proper nutrition, while 25 (0.3%) of them had SAM as demonstrated by Red on MUAC. The SAM cases were
referred to the Outpatient Therapeutic Program (OTP) centers, while the SAM cases with medical complications were referred to the stabilization centers across the state for proper management.
Public Health Risks and Gaps • High risk of COVID-19 spread due to various factors including population living in congested IDP camps, weak
surveillance due to insecurity issues, porous international borders, poor compliance in the use of facemask, social distancing, and good hygiene practices by the general public.
• High risk of epidemic outbreaks especially cholera, meningitis, measles, yellow fever. The northeast region is highly endemic for malaria and cholera.
• Unpredictable security situation hampers movements of health workers, drugs and other medical supplies.
• Although health situation is improving under the NE Nigeria Health Sector 2019 Strategy, the health service delivery continues to be hampered by the breakdown of health facilities infrastructure.
• There is a serious shortage of skilled health care workers, particularly doctors, nurses and midwives, with many remaining reluctant to work inaccessible areas because of ongoing armed conflict.
• Continuous population displacements and influx of returnees and/or refugees disrupt and further challenges the health programs implementation.
• Access to secondary health care and referral services in remote areas is significantly limited.
• Unavailability of network coverage in the newly liberated areas negatively affects timely submission of health data for prompt decision-making.
ssssHealth Sector Partners and Presence Federal Ministry of Health and Adamawa, Borno and Yobe State Ministries of Health, UN Agencies: IOM, OCHA,
UNFPA, UNICEF, UNDP, WHO, National and International NGOs: ALIMA, Action Against Hunger, Action Health
Incorporated, AGUL, CARE International, COOPI, GOAL PRIME, Janna Foundation, MSF (France, Belgium, Spain and
Switzerland), ICRC, INTERSOS, Malteser International, Medicines du Monde, Premiere Urgence Internationale,
International Rescue Committee, eHealth Africa, FHI-360, International Medical Corps, Catholic Caritas Foundation
of Nigeria, Nigerian Red Cross Society, Victims of Violence, Terre des hommes, SIPD, Swift Relief Foundation, Nigeria
Centre for Disease Control, RUWASA, BOSEPA, PCNI, BOSACAM; other sectors (WASH, Nutrition, Protection, CCCM,
Food Security, Shelter and RRM), Nigerian Armed Forces and Nigerian Air Force.
-Health sector bulletins, updates and reports are now available at http://health-sector.org
For more information, please contact:
Dr. Salisu Aliyu Kwaya-bura
Commissionner for Borno State Ministry of Health
Email: [email protected]
Mobile: (+234)08035774564
Dr. Kida Ibrahim
Incident Manager PHEOC
Email: [email protected]
Mobile : (+234)08035570030
Mr. Muhammad Shafiq
Health Sector Coordinator-NE Nigeria
Email: [email protected]
Mobile: (+234)07031781777
Mr. Oluwafemi Ooju
Health Sector IMO-NE Nigeria
Email: [email protected]
Mobile: (+234)08034412280
Mr. Safianu Ado Ibrahim
Health Sector IMO-NE Nigeria
Email: [email protected]
Mobile: (+234)07039236199