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