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2.6 1,849,995* BORNO STATE GOVERNMENT An IDP child with the hallmark telltale rash of Rubeola (measles). Northeast Nigeria Response BORNO State Health Sector Bulletin # 10 4 December 2016 3.7 MILLION 2.6 1.8 MILLION 1,849,995* IN NEED OF MILLION INTERNALLY POLIO VACCINATED HEALTH TARGETED BY DISPLACED CHILDREN ASSISTANCE PERSONS THE HEALTH SECTOR HIGHLIGHTS HEALTH SECTOR Borno State Ministry of Health and partners are 18 HEALTH SECTOR PARTNERS continuing with reactive measles vaccination among HEALTH FACILITIES** children aged 6 month to 15 years in IDPs camps in 298 FUNCTIONING** (OF MMC, Jere and Gwoza. Vaccination has been ASSESSED HEALTH completed in 14 camps while ongoing in other four FACILITIES) camps (Dalori, Kofa, NYSC and CBN). Total of 67,497 334 DAMAGED/BURNT/CLOSED children were so far vaccinated, coverage rate of 89.7% IDP CAMPS CUMULATIVE CONSULTATIONS Nigeria is classified by the International Health 864,900 MEDICAL CONSULTATIONS*** Regulations (IHR) as a state infected with wild poliovirus or circulating vaccine-derived poliovirus but EARLY WARNING & ALERT RESPONSE 160 EWARS SENTINEL SITES not currently exporting and hence it is subject to 77 REPORTING SENTINEL SITES temporary recommendations as of November 2016. 23 TOTAL ALERTS RAISED**** WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully VACCINATION vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should 1,849,995* POLIO receive an additional dose of OPV or inactivated polio IPV & OPV***** vaccine (IPV) within 4 weeks to 12 months of travel. SECTOR FUNDING As part of WORLD AIDS DAY 1st December 2016 activities, the campaign against the spread of HIV/AIDS in Nigeria, the Federal Ministry of Health 7 MILLION USD FUNDED (13%) 53.1 MILLION USD REQUESTED launched the National Guidelines for HIV prevention, treatment and care. * Total number of vaccinated children. ** A report of the NE assessment conducted by the Special Duties Unit of the Federal Ministry of Health and the National Health Sector Working Group May 2016 *** Cumulative number of medical consultations at the IDP camps from Epidemiological Weeks 1 - 47 **** The number of alerts change from week to week *****Number of Polio vaccinated children in the Outbreak and Response campaign (IPV Inactivated Polio Vaccine & OPV Oral Polio Vaccine) as November 20161 Situation Update: Since the 2016 Humanitarian Response Plan (HRP) the Heath Sector has almost doubled its partners in the field and this increased capacity means that a more integrated package of health services is available. The sector will support IDPs, people in need in host communities and those returning to areas of origin. The sector includes those returning in their calculation of host communities. Children under five, women of reproductive age, and the elderly, are the most vulnerable population groups in the health sector. As for 2017 HRP, the priority in the health sector remains the provision of life-saving and life-sustaining humanitarian health assistance to affected populations, This objective will be achieved through specific interventions focusing on reproductive health, including maternal and child health, services for gender-based violence, management of malnutrition, management of non-communicable diseases, mental health and psychosocial support, support for people living with HIV/AIDS, as well as the strengthening of referral services. The availability of essential medicines, of medical supplies and equipment combined with the provision of outreach services and continued support to the Expanded Programme on Immunization (EPI) to attain adequate vaccination coverage will be critical to reach targets efficiently. To establish, expand and strengthen the communicable disease surveillance, outbreak prevention, control and response is the second objective of the health sector. Disease surveillance is the corner stone of an early response to cases of epidemic-prone diseases, to reduce morbidity and mortality. Together with the governmental agencies, the health sector partners will enhance surveillance for epidemic-prone diseases including polio by establishing an Early Warning and Response System (EWARS). This system will facilitate the monitoring of disease trends and early detection of potential outbreak diseases. Through EWARS, the States MOH and partners will be able to investigate and respond to key disease alerts, swiftly bringing nascent outbreaks under control. This objective will be supported by ensuring improved readiness for outbreak response through the prepositioning of medicines and supplies. The importance of early detection, notification and response cannot be over emphasized especially under the challenging living conditions in newly liberated areas. Finally, the health sector will seek to strengthen coordination and health system restoration to improve life-saving response for people in need, with an emphasis on enhancing protection and increasing access to health services. This objective will be achieved through the coordination of efforts to increase assistance to hard-to-reach and non-accessible LGAs. By doing so, the health sector partner will synergise and harmonise the response across states to identify gaps and reduce overlap. Protection and gender mainstreaming efforts throughout health programming will continue to be emphasized and advocated for through coordination fora and training/workshops with health partners. Health information systems (HIS) at the sector/working group level will be further strengthened to track essential morbidity and mortality data, creating evidence base information to drive forward health programming. In addition, due to the nature of the conflict and high risk of outbreaks of diseases, coordination structures will focus on joint contingency and preparedness planning for response to disease outbreaks such as cholera across the states. Activities will focus on increasing the size and capacity of the health workforce; strengthening partnerships with national non-governmental organizations (NNGOs); rehabilitating and/or reinforcing damaged health facilities (including physical structures, human resources, and equipment/supplies) for health service delivery, including mobile medical units for emergency response and enhancing community-based health services and initiatives The health sector will continue to work closely with health authorities at the federal, state and local governments’ levels, the WASH, nutrition, food security and livelihoods, protection and DMS/CCCM sectors to promote a multi-sectoral approach, including through joint needs assessments and preparedness plans. The Health Sector 2017 HRP seeks more than US$93 million to address the needs of those in crisis in the three most affected states of Adamawa, Borno and Yobe, (-see table below the health sector PIN breakdown) BREAKDOWN OF PEOPLE IN NEED AND TARGETED BY STATUS, SEX AND AGE (in million) BY STATUS BY SEX AND AGE Host Internally % Female % Children, Adult Total Sector Returnees Communities Displaced % Male and Elderly People in need of humanitarian assistance 12.4 10.6 1.8 54% / 46% 59% / 35% / 6% People to be assisted by the sector 5.9 4.2 1.7 54% / 46% 59% / 35% / 6% Financial Requirements 93.9 2 Public Health Risks and Needs An ongoing measles outbreak has been reported throughout the IDP camps is predominantly among the younger un-immunized population due to immunity gaps as a result of inadequate routine measles coverage among others with a peak of transmission from October to March. Nigeria is one of only three countries in the world with ongoing wild poliovirus transmission, alongside Afghanistan and Pakistan. Environmental surveillance indicated that Sabin type 2 virus quickly disappeared from environmental samples after May 2016 Nigeria is classified by the International Health Regulations (IHR) as a state infected with wild poliovirus or circulating vaccine-derived poliovirus but not currently exporting and hence it is subject to temporary recommendations as of November 2016. -Weekly epidemiological record, 2 December 2016, 91th Year, No. 48, 2016, 91, 561–584 http://www.who.int/wer Malaria cases still the leading cause of morbidity in IDP camps and host communities in the state. In 2015 there were over 35 million people living with HIV and Nigeria accounts for almost 10% of the global burden of people living with HIV (PLWHIV). The north of Nigeria suffers epidemics of diseases such as cholera and meningitis almost every year. Limited access of populations to health facilities in the newly liberated areas due to destruction of health facilities and lack of health personnel remain major challenge. Surveillance and communicable disease control Epidemiological situation in camps: During 15000 Epidemiological (Epi) Week 47 malaria, Acute MALARIA Respiratory Infections (ARI) and watery 10000 diarrhoea continue to be the leading causes of DIARRHOEA morbidity based on 12,175 consultations from 5000 30 IDP camps reporting. The register shows 3,593 case of malaria, 2,493 respiratory CHEST infections and 1,561 of watery diarrhoea. The 0 INFECTION cumulative number of medical consultations for 1 4 7 10131619222528313437404346 Epi Weeks 1 to 47 reached 864,900, with 3,537 referrals over same period. Forty-two new measles cases were recorded during Epi Week 47, for a total cumulative number of 2,565 measles cases. Early Warning Alert and Response System (EWARS): In Epi Week 47, a total of 77 out of 160 reporting sites (including
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