Reproductive and Child Health (R&CH)
Presented by: Dr. Mariam J. Bakar & Mr. Yusuph Haji
RCH
• The integrated Reproductive and child health
programme comprises of four units
1. Reproductive and child heath
2. Integrated management of child hood illnesses
3. Expanded programme on immunization
4. Prevention of mother to child transmission
Introduction • IMCI stands for: ‘’Integrated Management
of Childhood Illness’’ • The IMCI strategy focuses on
1. Improving case management skills of health care providers
2. Improving overall health systems 3. Improving family and community
health practices
Top ten Cause of death for Under 5 yrs
Top ten cause of death for Zanzibar Hospitals in 2013
TDHS Child Mortality Trend 2004-2010
2004 2008 20100
20
40
60
80
100
120
61
5451
101
79
73
IMRLinear (IMR)U5MRLinear (U5MR)
INTERVENTIONS
• Implementation of IMCI at primary facilities
• Sustained high coverage of immunization among
under 5 years
• Implementation of malaria prevention measures
(ITN, IRS etc)
• Use of effective malaria treatment (ACTs
Achievements 2013 cont..Key planned interventions Achievements
Adaptation, TOT training and training for the new WHO GROWTH standards
NGSTD adopted, printed and piloted in three district
Train dIMCI to HCP for three encounters in all districts Achieved
Finalization of ICATT training tool Training tool finalized
Planned activities, 2013-2014
• Assessment of provision of essential newborn and child health services .
• Essential Newborn Care including HBB training to health care providers.
• Distance learning IMCI training to health care providers.
• Supportive supervision and mentoring
Challenges in 2013
• Shortage of technical staff all levels
• Inadequate of funds for implementation other
planned activities
• Inadequate working tools (e.g. weighing scale)
and IMCI drugs in health facilities
• Implementation of c-IMCI
Recommendation
• Train, allocation and retention of staff
• Government to release more funds
• Procurement of drugs(e.g. dispersable
Amoxycillin, co pack ORS and Zinc)
• Implementation of c-IMCI
IMCI 2014-2015 plansPrioritized interventions for 2014-2015;1. Training of HCP on IMCI and introduction of
Computerized IMCI to CHS2. Training of new WHO growth standards and scale up of
implementation (at least one district in Unguja and 2 district in Pemba)
3. Conduct Supportive supervision and mentoring to trained HCP
4. Dissemination of newborn assessment results and work on the recommendations
5. KMC training and establishment of KMC sites6. Implementation of PDSR
IMCI Finances 2013
2013-2014 finances
Source of funds Planned finances Funds received Expenditure
RGOZ 50,902,966 CONTRIBUTED IN OFFICE CONSTRUCTION
WHO 260,913,000 62,738,400 62,738,400
Source of funds Planned finances Funds received Expenditure
RGOZ 373,577,000
WHO 136,200,000
UNICEF 142,311,000
IMMUNIZATION
Introduction
• The role of immunization is widely recognized as critical to achieving Millennium Development Goals (MDGs).
• Immunization programme Zanzibar aims to maintain high national vaccination coverage at above 95%
• Hepatitis B vaccine introduced in 2002, Hib vaccine was introduced in 2009. (PCV13) and rotavirus introduced in 2013 as well as Measles Second Dose in 2014 .
Planned activities 2013
• Support routine immunization services – Procurement of bundled vaccines– Community mobilization on RI– supportive supervision – African vaccination week – fuel for outreach, distribution of vaccines and
quarterly evaluation meetings on Supplies & gas for vaccine refrigerators
• Introduction of PCV13 and Rotavirus Vaccines
BCG COVERAGE 2012-2014
PENTA 3 COVERAGE 2012- 2013
Measles coverage 2012 -2013
Fully Immunized
UNGUJA PEMBA ZANZIBAR0
20
40
60
80
100
120
140
100
68.3
84.2
102.5
124.9
109.9
FULLY IMMUNIZED 2012
FULLY IMMUNIZED 2013
Challenges in 2013
• Shortage of technical staff all levels
• Lack of funds for cold chain equipment
• Lack of funds for surveillance services
• Inadequate working tools (e.g. weighing scale
& cold chain equipment ) in health facilities
• Knowledge gap among service providers
Suggested Solutions
• MOH to increase No of technical staff at all levels
focusing at service delivery points.
• MOH and partners to support procurement of
working tools and cold chain equipment
• Technical and financial support in knowledge
updating (trainings) of RCH service providers
Planned activities 2013/2014
• Support routine immunization services
– Procurement of bundled vaccines
– Community mobilization on RI and SIAs
– supportive supervision
– African vaccination week
• Introduction of Measles second dose
• Completion of immunization service guideline
Finances 2013 cont..Source of funds Planned finances
(Tsh)Funds received (Tsh)
Expenditure (Tsh)
RGoZ
281,187,000
225,298,914
225,298,914
GAVI/WHO 219,575,000 100,464,100 100,464,100
UNICEF
551,838,060 148,522,450 148,522,450
Thank you