Health action in crisis

WHO Emergency Health Programme for the Food Crisis in Situation Report # 19 13 December to 19 December 2005

I. Highlights • The fifth round of the national immunization campaign 19-24 December 2005 was offi- cially launched in the district of Say, region of Tillaberi by the Minister of Public Health and Endemic Disease on the 19 December 2005. Delegates included the President of the Repub- lic of Niger, His Excellency Mamadou Tandja, the Prime Minister, the president of the Na- tional Assembly, the Regional Governor, local authorities, the WHO Niger Representative, the UNICEF Niger Representative, the Global Fund Niger Representative and other partner or- ganizations. The national vaccination campaigns target over 3.5 million children under 5 years. A total of 16000 people - 8000 teams of two will be mobilized throughout the six days of the campaign. Each passage costs approximately two million United States dollars. Along with the administration of the polio vaccination, over 2 million Long Lasting Insecticidal Mosquito Nets will be distributed to women who vaccinate their children. Over 3800 volun- teers and community health workers have been mobilized for this distribution. The Interna- tional Federation of Red Cross and Red Crescent Societies estimate that the distribution of the mosquito nets will save the lives of 40,000 children in Niger in the first year alone.

• Preliminary results of the nutritional study carried out by the Government of Niger, UNICEF and CDC Atlanta between 17 September and 14 October 2005. The study re- vealed that 15.3% of children between 6 and 59 months suffer from acute malnutrition. The rate of acute malnutrition varies between 9% in the region of and 18% in the region of .

I. The WHO emergency programme Axis 1: Enhance capacities to treat severe malnutrition at health centre levels by ensuring that staff receives focused training and that therapeutic food supplies are available. • A summary of activities undertaken by Medecins Sans Frontières France (MSF-France) from 1 January until 4 December 2005 was communicated to the Ministry of Public Health and En- demic Disease. o A total of 42 156 children suffering from sever malnutrition children were admitted and treated for severe malnutrition in the MSF-France programmes 1 January to 4 December 2005 o Average rate of recovery: 85% o Average Rate of mortality: 5% o Average rate of abandonment and transfers to others centres: 10 % o An estimated 53 000 children received targeted free food distribution and family ra- tion during 3 months. o On 4 December 2005, a total of 2 935 children suffering from severe malnutrition were being treated in the MSF programs (335 in Intensive Nutritional Rehabilitation

WHO Emergency Health Programme for the Food Crisis in Niger page 1 of 4 Situation Report # 19 Period: 13 December to 19 December 2005 E-mail: [email protected] http://www.who.int/hac/crises/ner/sitreps/en/index.html Health action in crisis

Centres (CRENI) and 2 600 in Outpatient Rehabilitation Centres for Severe Malnutri- tion (CRENAS))

MSF-France currently has the following centres in operation in the region of Maradi: o 1 CRENI in the district of and 4 CRENAS in the districts of Sae, Saboua, Guin- dan Roumdji, Tiberi o 1 CRENI in the district of Maradi and 4 CRENAS in the districts of (Dan Issa, , , Maradi.

• Prevalence of acute malnutrition in children aged between 6 and 59 months, retrospec- tive mortality in the population and retrospective mortality of children under five years par region. Nutritional study carried out by the Government of Niger, UNICEF and CDC Atlanta between 17 September and 14 October 2005

SD: standard deviation CI: confidence interval

Axis 2: Strengthen health sector coordination and information management to en- sure better targeting and to address needs in under-serviced areas

• The Maradi Region Health Partners Coordination meeting was held at the Regional Depart- ment of Public Health (DSRP) on 6 December 2005. The meeting was held at the Regional Director of the DRSP and included representatives of the Regional Department of Public Health, WHO, World Food Programme, OCHA, UNICEF, the International Federation of Red Cross and Red Crescent Societies, Hilfsaction and MSF-France

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o For the epidemiological week 48, there were 846 cases of sever malnutrition includ- ing 7 deaths and 921 cases of moderate malnutrition including 11 deaths reported. It is important to note that these figures are not finale.

Axis 3: Early identification and control of suspected outbreaks: supporting health partners in surveillance systems and strengthening preparedness for epidemic prone diseases through provision of technical expertise and pre-positioning of medical kits • A death from a suspected case of diphtheria was reported at the Maradi Regional Hospital. The child was from the commune of Zaria, region of Maradi. Further investigations are being undertaken.

• The Core Group in charge of distribution logistics for the fifth round of national vaccination campaign days19 to 24 December held micro-planning meeting in Niamey on 14 December 2005. Logistic requirements for all partners for the distribution of resources (medical, techni- cal and personnel) were discussed. Over 3.4 million children were vaccinated during the fourth round of the national campaign, 12-17 November 2005.

Axis 4: Support the development of an emergency policy and strategy to improve reliability of access to and affordability of essential health care The mission to provide technical support for the development of concepts on the access of vul- nerable groups to healthcare services at the regional and peripheral level 25 November to 5 De- cember 2005 concluded that the health sector reforms currently in place and a strong political commitment for development are important assets for health sector improvement. The mission also noted the possible commitment of the international community to contribute to the re-financing of the health sector provided that: o Long-term strategies are developed; o Implementation should be progressive; o All mentioned factors are taken into account; o The management is transparent; o Progressive institutional capacity building to managed pooled funds. WHO is continuing to provide technical support for the development of the next stages for the preparation of the operational proposal to be submitted to the government. Within the framework of the National Health Development Programme (PDS) 2005-2010, the Ministry of public Health and Endemic Diseases has planned to establish a PTF-government “think tank”.

III. Operations Travel • Nutritional data collection. The WHO Crisis Operations Team is providing technical and financial support for the organization of three joint missions with the Ministry of Public Health and Endemic Diseases (MPH/ED) department of Nutrition, the SNIS and WHO for the collec- tion of all available nutritional data. The teams are due to return to Niamey on the 21 Decem- ber 2005. The main objective of the missions is to collect thorough and uniform epidemiologi- cal data from all partners working on the treatment of malnutrition in all the 8 regions of Niger, for the period of July to December 2005. The first team will cover the regions of Tahoua and , the second team will cover the regions of , Maradi and . The third team will cover the regions of Dosso, Niamey and Tillaberi.

WHO Emergency Health Programme for the Food Crisis in Niger page 3 of 4 Situation Report # 19 Period: 13 December to 19 December 2005 E-mail: [email protected] http://www.who.int/hac/crises/ner/sitreps/en/index.html

Nutritional Centres in Operation, region of Dosso.

WHO Emergency Health Programme for the Food Crisis in Niger page 4 of 4 Situation Report # 19 Period: 13 December to 19 December 2005 E-mail: [email protected] http://www.who.int/hac/crises/ner/sitreps/en/index.html