Aimag, the capital city and districts’ IPPA

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MINISTRY OF HEALTH

MINISTRY OF FOOD, AGRICULTURE AND LIGHT INDUSTRY

NATIONAL EMERGENCY MANAGEMENT AGENCY

SPECIALIZED GENERAL INSPECTION AGENCY

VETERINARY INSTITUTE

NATIONAL CENTRE FOR COMMUNICABLE DISEASE

STATE CENTRAL VETERINARY LABORATORY

NATIONAL CENTRE FOR INFECTIOUS DISEASES WITH NATURAL FOCI

“AVIAN INFLUENZA CONTROL AND HUMAN PANDEMIC INFLUENZA PREPAREDNESS AND RESPONSE’’ PROJECT

INFLUENZA PANDEMIC PREPAREDNESS ASSESSMENT FINAL REPORT

Ulaanbaatar 2009

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INFLUENZA PANDEMIC PREPAREDNESS ASSESSMENT FINAL REPORT

REPORT COMPILED BY: D.Naranzul, NCCD D.Nyamkhuu, NCCD N.Dondog, NCCD Ch.Мunkhtsetseg, NCCD L.Dashtseren, NCCD Ch.Batchuluun, NEMA R.Sodnomdarjaa, SCVL U.Munkhchuluun, “Avian Influenza Control and Human Pandemic Influenza Preparedness and Response” project

CONSULTANT: Prof. P.Nymadawa, MD, PhD, DSc (Med)

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TABLE OF CONTENTS:

1. Table of contents ...... 4

2. Glossary of Abbreviations ...... 5

3. Preface ...... 8

4. Influenza Pandemic Preparedness Assessment Final Report ...... 9

5. Influenza Pandemic Preparedness Assessment Team ...... 10

6. Influenza Pandemic Preparedness Assessment Tools ...... 11

7. Assessment Involved Organizations ...... 12

8. Assessment Participants ...... 12

9. The Final Summary on Influenza Pandemic Preparedness Assessment ...... 13

10. Summary ...... 19

11. Recommendations ...... 20

12. Annex 1. IPPA participants’ list ...... 21

13. Annex2. The final summary on IPPA ...... 43

14. Annex 3. IPPA tools outline ...... 47

15. Annex 4. IPPA timetable ...... 64

16. Annex 5. IPPA photos ...... 66

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GLOSSARY OF ABBREVIATIONS

1. AR – Arkhangai province

2. IF - Incomplete Fellowship

3. IPPA- Influenza pandemic preparedness assessment

4. BGD – Bayangol District

5. CIDNF – Centre for Infectious Diseases with Natural Foci

6. NCIDNF – National Centre for Infectious Diseases with Natural Foci

7. BZD – Bayanzurkh District

8. BND – Baganuur District

9. ED – Environmental Department

10. DET – Department of Environment and Tourism

11. RDTC-Regional Diagnostis and Treatment Centre

12. BU –Bayan-Ulgii province

13. BUL – Bulgan province

14. DE – Department of Education

15. BHD –Bagakhangai District

16. BH –Bayanhongor province

17. GA – Gobi-Altai province

18. GS – Gobisumber province

19. DA –Darkhan-Uul province

20. DG – Dornogobi province

21. DO –Dornod province

22. DU- Dundgobi province

23. ZA –Zavkhan province

24. GAO –Governor’s Administration Office

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25. SGIA – Specialized General Inspection Agency

26. DVS –Department of Veterinary Service

27. VI - Veterinary Institute

28. ND – Nalaikh District

29. CFDF – Capital Funded Department of Factory

30. NEMA –National Emergency Management Agency

31. OR –Orkhon province

32. HOO- Housing and Operational Office

33. UV –Uvurkhangai province

34. UM – Umnugovi province

35. ChD-Chingeltei District

36. SBD- Sukhbaatar District

37. SHD – Songino Khairkhan District

38. SU- Sukhbaatar province

39. SE –Selenge province

40. TU –Tuv province

41. SOC –State Owned Company

42. ILI- Influenza Like Illnesses

43. UBP DJSC – ’’Ulaanbaatar’’ Power Distribution Joint Stock Company

44. UV – Uvs province

45. SCVH –State Central Veterinary Laboratory

46. DMH – Department of Meteorology and Hydrology

47. CMH –Centre of Meteorology and Hydrology

48. KhO – Khovd province

49. KhU – Khuvsgul province

50. NCCD –National Centre for Communicable Diseases

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51. DFASMI-Department of Food, Agriculture, Small and Medium Interprizes

52. KhUD – Khan-Uul District

53. LLC – Limited Liability Company

54. KhE- Khentii province

55. MoFALI – Ministry of Food, Agriculture and Light Industry

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PREFACE

Inluenza and inluenza-like illnesses (ILI) are the most common human infectious disease group in the current World. Among ILI influenza is singled out while this infection is causing periodically pan- demics causing enormous health and economic burden to the human society. It has been documented in the last century three influenza pandemics in 1918-1920, 1958-1960 and 1968-1970.

The mankind is still struggling to find out reasons leading to the changes of influenza virus to evolve pandemics. However, it is now well documented scientifically the pandemic viruses are arising from in- teractions of animal, avian and human influenza viruses. Therefore the sudden change of avian influenza virus A(H5N1) in 1997 starting to be transmitted to humans causing mostly severe disease has alerted the world public health society and WHO has alerted its member countries to prepare for possible influenza pandemics. On this call the Government of Mongolia has responded in 2005 issueing a comprehensive program to prevent avian influenza and human influenza pandemics.

However, the evolution and spread of new avian influenza virus A(H5N1) among wild bird populations and poultry has exceeded the expected projections are challenging the Governments of countries world- wide and requesting to review their respective influenza pandemic preparadness plans (IPPP). CDC, USA has developed an inventory tool to be used to review IPPP in the countries and has tested it in more than 40 countries of the World, including Mongolia in 2008. The results were encouraging for all involved parties. So, we have developed an inventory tool for assessment of IPPP at the subnational level in Mon- golia on the basis of the CDC tool and has conducted an assessment countrywide in March 2009 with the support of WB Project on “Avian influenza control and human pandemic influenza preparedness and response”. The assessment has been conducted by 5 teams consisting of main stakeholders of IPPP and has mobilized countrywide more than 500 officials in all provinces and 9 districts of Ulaanbaatar City. We are submitting the results of the survey to you by this compilation and hope it is the most evidence- based assessment of the current situation of IPPP throughout Mongolia.

However, the influenza pandemics situation is changing very rapidly. The spread of a new influenza virus A(H1N1)swl from the North America starting from April 2009 is complicating the situation.

So, we need to review and revise the country IPPP based on this assessment and the new situation as soon as possible and than to develop and implement local plans for every administrative unit of the country and the concerned ministries and agencies of the Government.

Prof. P.Nymadawa, MD, PhD, DSc (Med), May 14, 2009, Ulaanbaatar, Mongolia

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INFLUENZA PANDEMIC PREPAREDNESS ASSESSMENT FINAL REPORT

The Influenza Pandemic Preparedness Assessment had been conducted on March 5-19, 2009, in 21 aimags and 9 districts of Mongolia within the ’’Avian Influenza Control and Human Pandemic Influenza Preparedness and Response’’ project activities being implemented and funded by the World Bank grant. The assessment had been based on the inventory tool by the CDC, U.S.A and the appointed team consisted of the project staff such as health, veterinary, emergency, technical sectors and consultants and have adapted the “Influenza Pandemic Preparedness Assessment’’ methodology for aimags and local conditions. The IPPA had been ensured by Mr. Amgalanbayar.Ts, Chief, High Commissioner and the Project Director, Head of the National Emergency Management Agency.

GOAL:

To assess preparedness of Pandemic influenza early warning and response.

OBJECTIVES:

1. Conduct aimag, and the capital city and district-wide IPPA 2. Compile the ’’Pandemic Influenza Preparedness’’ assessment findings. 3. Develop the recommendations on further activities to strengthen the pandemic and avian influenza preparedness and distribute to the relevant (decision-making and executing) organizations.

SCOPE OF WORK: 21 aimags, 9 districts of Ulaanbaatar

TIMETABLE :

March 5 -19, 2009

FUNDING:

“Avian Influenza Control and Human Pandemic Influenza Preparedness and Response’’ project which is being implemented and funded by the World Bank grant aid.

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IPPA TEAM

IPPA team IPPA team members Assessed Route number provinces number

IPPA report Team leader: To aggregate aggregating D.Naranzul, Deputy director, NCCD and develop team Members: IPPA report D.Nyamkhuu, Director-General, NCCD N.Dondog, Consultant, NCCD Ch.Munkhtsetseg, Head, NIR, NCCD L.Dashtseren, Epidemiologist, NCCD Ch.Batchuluun, Head, Policy implementation and coordination division, NEMA R.Sodnomdarjaa, Director, SCVL U.Munkhchuluun, Human health officer, “Avian Influenza Control and Human Pandemic Influenza Preparedness and Response “ project Local Technical Assistance: Prof P.Nymadawa MD, PhD, DSc (Med)

1st team Team leader: Gobi-Аltai, Route 1 Ch.Munkhtsetseg, NCCD Bayan-Ulgii, Members: Khovd,Uvs, Z.Adyasuren, Consultant, NCIDNF Zavkhan, D.Turbat, NEMA Arkhangai B.Sarantuya, VI

2nd team Team leader: Khentii, Route 2 L.Dashtseren, NCCD Dornod, Members: Sukhbaatar, A.Enkhtuya, SGIA Dornogobi, B.Davaadorj, NEMA Gobi-Sumber J.Bekhochir, VI

3rd team Team leader: Darkhan-Uul, Route 3 Ts.Selenge, NCCD Selenge, Members: Orkhon, М.Tsolmon, NCCD Bulgan, D.Ariundalai, NEMA Khuvsgul S.Boldbaatar, SCVL

4th team Team leader: Tuv, Dundgobi, Route 4 N.Tsend, Consultant, NCCD Umnugobi, Members: Bayankhongor, D.Nyamkhuu, Director, NCCD Uvurkhangai B.Darmaa, NCCD N.Suvsmaa, NCCD B.Delgermaa, NEMA A.Saruuljargal, SCVL

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5th team Team leader: Capital districts Route 5 D.Naranzul, NCCD Members: N.Dondog, Consultant, NCCD R.Oyungerel, NCCD A.Dolgorkhand, NCIDNF А.Enkhbat, NEMA D.Erdenechimeg, VI

IPPA Tool addressed 15 areas of pandemic influenza preparedness and response: 1. Country Planning 2. Cross-Sector Cooperation 3. Communication 4. Epidemiologic Capability 5. Laboratory Capability 6. Routine Influenza Surveillance 7. National Respiratory Disease Surveillance and Reporting 8. Outbreak Response 9. Resources for Containment 10. Community-based Interventions to prevent spread of influenza 11. Infection Control 12. Health Sector Pandemic Response 13. Veterinary Sector Pandemic Response 14. Emergency Sector Pandemic Response 15. Family Clinic Prepapredness

The aimags’, and the capital city and district-wide obliged representatives of the “Influenza Pandemic Preparedness Plan’’ had participated in the arranged assessment. The representatives evaluated each capacity involved in the assessment by them based on the arguments.

Each capacity of the “Influenza Pandemic Preparedness Assessment’’ was assessed as 4 levels and was marked as 0-3.

• 0 - Insufficient (red). • 1-2 Average (yellow) • 2-3 Above average (dull green) • 3- Satisfactory (bright green)

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ORGANIZATIONS INVOLVED IN THE ASSESSMENT ARE:

• The aimag, and the capital city and district’s Governor’s Administration Offices • Emergency Agency, Department and Offices in aimags, the capital city and districts. • Health Departments in aimags, the capital city and districts (Family Hospitals, NTCIDNF) • The State Clinical and Specialized Hospital • Regional Diagnostic and Prophylaxis Centre, Central Hospitals • The Health Association of the Districts • Departments of Food, Agriculture, Small and Medium Factories in the aimags, the capital city and districts. • Telecommunication, Power, Water and Heat supplying organizations • Special Inspection Departments of aimags, the capital city and districts • Police Departments of aimags, the capital city and districts • Departments of Environment and Tourism of aimags, the capital city and districts

THE ASSESSMENT PARTICIPANTS:

Approximately 500 people such as governors and deputy governors of aimags, the capital city and districts, heads of the Administration Offices, heads of the Development Policy Departments, specialists, heads, deputies and specialists of the National Emergency Agency, Departments and Offices, heads, deputies and quality managers, epidemiologists, epidemiologic researchers, bacteriologists of the Health Departments, Associations and Central Hospitals and the Regional Centre for Diagnosis and Prophylaxis, family specialists, heads of family hospitals, clinics at the particular territory such as Military Centre, Central Hospital#3 named after Mr. Shastin, Clinical Hospital#2, CIDNF, Departments of Food, Agriculture, Small and Medium Factories, infrastructure specialists of the Industry and Service Departments of districts, specialists of the Education and Land Departments and Financial and State Funds. Also, specialists in charge of heating, accomplishment and services and senior specialists from Mongolian Telecommunication, infrastructure organizers, specialists from Traffic Police Units and Red Cross Society have participated(ANNEX 1).

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THE FINAL SUMMARY ON INFLUENZA PANDEMIC PREPAREDNESS ASSESSMENT

№ Capability 2008 2009 National State Province Capital average average average average 1. Country Planning 1,6 0,77 1,2 0,35 2. Cross-Sector Cooperation 2,25 1,56 1,2 1,92 3. Communication - 1,8 1,5 2,1 4. Epidemiologic Capability 1,25 1,25 0,9 1,6

5. Laboratory Capability 1,75 1 0,7 1,3

6. Routine Influenza Surveillance 2,5 2,27 1,8 2,75 7. National Respiratory Disease 1,25 1,94 1,7 2,18 Surveillance and Reporting 8. Outbreak Response 1 1,45 1,3 1,6 9. Resources for Containment 0,25 0,78 0,7 0,86 10. Community based Interventions 1,5 1,05 1,1 1 to prevent spread of Influenza 11. Infection Control 1,75 1,53 1,15 1,92 12. Health Sector Pandemic 0,5 0,85 0,7 1 Response 13. Veterinary Sector Pandemic - 1,77 1,35 2,2 Response 14. Emergency Sector Pandemic - 1,28 1,35 1,22 Response 15. Family Clinic Preparedness - 1,41 1,3 1,53 Average 1,45 1,38 1,19 1,56

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CAPABILITY 1. COUNTRY PANDEMIC INFLUENZA PREPAREDNESS PLANNING: Average 0,77

The “Country Pandemic Influenza Preparedness Planning’’ capability state average is 0.77, province average is 1.2, and the capital city average is 0.35, which are unsatisfactory. The 12 of (40%) provinces and districts are average, 18(60%) are above average. According to the 2008 nationwide assessment the “Country Pandemic Influenza Preparedness Planning’’ capability was 1.6. But, according to the 2009 assessment the state average has declined to 0.77, which is related to the absence of consolidated “Country Pandemic Influenza Preparedness Planning’’. Although provinces, the capital city and districts have reflected the human prophylaxis, veterinary and emergency department activities to the avian and human influenza plan, the activities of the infrastructure organizations haven’t been completely reflected. Chingeltei, Bagakhangai, Khan-Uul districts have avian and human pandemic influenza plan in place. Provinces such as Tuv, Govisumber, Dornod, Khentii, Uvs, Gobi-Altai, Khovd, and Dornogobi had approved their pandemic influenza preparedness plan by the Governor’s resolution. Other aimags and districts have activity plans in case of disasters, human and animal highly infectious diseases. Some of the capital city districts such as Chingeltei, Khan-Uul haven’t disseminated their plans to other infrastructure organizations. They planned to hand over only organizations involved in the plan and conduct the testing only for them. However, the plan implementing coordination structure has been established in the above mentioned 3 districts, they’ve planned to withdraw resources from the budgeted resource for the human and animal highly infectious diseases. Although the human and veterinary hospitals and emergency agencies, departments and offices have plans, they have insufficiency of not considering the implementation. Aimag, the capital city and districts haven’t budgeted resources for the plan implementation and they utilize governor’s resources in case of necessity.

CAPABILITY 2. CROSS-SECTOR COOPERATION: Average 1.56

The cross sector cooperation state average is 1.56, province average 1.2; the capital city average is 1.92. 6 (20%) of the aimags and districts are insufficient, 19(63.3%) are average, 5 (16.7%) are above average. According to the 2008 nationwide assessment the “Cross-Sector Cooperation’’ capability was 2.25. But, according to the 2009 assessment it has declined to 1.56 due to the absence of the consolidated “Cross Sector Colloboration Plan’’ in the aimags, the capital city and districts. However, the governors of aimags, the capital city and districts, the emergency agency, departments and offices, police and veterinary organizations colloborate in case of human and animal highly infectious diseases, they don’t have a consolidated collaboration plan, which covers infrastructure organizations such as water, power and heat supplying and road and transportation, food and telecommunication and accomplishment organizations. The food resources in case of the emergency haven’t been created. Also, necessary facilities such 14 Aimag, the capital city and districts’ IPPA

as storages and warehouses in case of food resource creation don’t exist. However, the warehouses of the private traders and enterprises are available, no agreements were signed. All the aimags don’t have final report on the food creation. The plan on the water supply and power system and road transportation organizations in case of human pandemic influenza don’t exist. An issue of providing their activities with the necessary regulation is still unclear, and the present understanding and participation of these sectors are still insufficient.

CAPABILITY 3. COMMUNICATION: Average 1.8

The state average of the communication is 1.8, aimag average is 1.5,the capital city average is 2.1. 19 of aimags (63.3%) are average, 11(36, 7%) are above average. The issue of communication had been reflected to the Influenza Pandemic Preparedness Plan. Aimags and districts have non-permanent access to low speed internal network system and have the USW (ultra-short-wave) and SW (short-wave) radio communication system and exchange disaster information and data countrywide. Aimags and districts of the capital city are working on the creation of disaster database and transferring it into the electronic version. The emergency agency, departments and offices are executing the duty of communication in case of the disaster in aimags and the capital city and districts. Aimags and districts of the capital city (except BZD) have sirens, conducted the testing and have been ensured.

CAPABILITY 4. EPIDEMIOLOGIC CAPABILITY: Average 1.25

The ’’Epidemiologic Capability’’ state average is 1.25, aimag average is 0.9, and the capital city average is 1.6. 7 (23.3%) of the aimags and districts are insufficient, 18 (60%) are average, 5(16.6%) are above average. According to 2008 nationwide assessment of the ’’Epidemiologic Capability’’ it is equal to 2009 assessment level. The professional skills of the epidemiologists in Bayan-Ulgii, Arkhangai, Dundgobi, Songinokhairkhan, Bagakhangai, and Nalaikh are above average, and Tuv aimag, Chingeltei, Sukhbaatar, Baganuur districts are average and other aimags and districts are at insufficient level. The epidemiologic skills of veterinary hospitals are insufficient in all aimags.

CAPABILITY 5. LABORATORY CAPABILITY: Average 1.0

The state average of laboratory capacity is 1.0, aimag average is 0.7, and the capital city average is 1.3. 16 of aimags (53.3%) are insufficient, 11(36, 6%) are average, 3(10%) are above average. According to the 2008 nationwide assessment the laboratory capability is equal to 2009 assessment level.

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In case of necessity the veterinary laboratories of all aimags utilize limited amount of rapid tests allocated from the state budget and seepage precipitation reaction for detecting the avian influenza A sphere virus antibody. They have been provided with necessary packages for taking specimens for diagnostic, ensuring and dispatching purposes for the central laboratories. The observation and surveillance muster points based on the pandemic laboratories of Dornogobi, Dornod, Uvurkhangai, Khovd, Selenge, Darkhan-Uul, Orkhon aimags and 8 districts of the capital city gather specimens and analyze at the NCCD respiratory virology laboratory. Orkhon aimag is planning to establish pandemic virology laboratory in the next 5 years.

CAPABILITY 6. ROUTINE INFLUENZA SURVEILLANCE: Average 2.27

The state average of “Routine Influenza Surveillance’’ is 2.27, aimag average is 1.8, the capital city average is 2.75. Khuvsgul aimag is insufficient, 19(30%) of aimags and districts are average, 20(66.6%) are above average. According to the 2008 nationwide assessment “Routine Influenza Surveillance’’ capabiliity is equal to 2009 assessment level. Dornod, Dornogobi, Selenge, Khovd, Darkhan-Uul, Orkhon, Uvurkhangai aimags are implementing “Sentinel Surveillance Network Based on Influenza Laboratory’’. All aimags are implementing a week of passive pandemic surveillance. Aimags and the capital city districts are weekly reporting on influenza like illnesses. The report covers all the units of health organizations and being distributed to the administrative units on quarterly basis. Above 95% of them report in timely manner. It has been assessed that feedback information from the National Influenza Center of Mongolia is being distributed to health organizations at the aimag centers.

CAPABILITY 7. RESPIRATORY DISEASE SURVEILLANCE AND REPORTING: Average 1.94

The state average of “Respiratory Disease Surveillance and Reporting’’ is 1.94, aimag average is 1.7, and the capital city average is 2.18. 14(46.6%) of aimags are average, 16(53.4%) are above average. According to the 2008 nationwide assessment the “Respiratory Disease Surveillance and Reporting’’ had increased comparing to the 2009 assessment level. All aimags and the capital city districts have passive surveillance structure on human respiratory infectious diseases. Khentii, Sukhbaatar, Uvurkhangai, Bayankhongor, Zavkhan, Khovd, Uvs, Bayan-Ulgii, Khuvsgul aimags and the capital city districts are implementing infectious diseases’ surveillance structure of early prevention on outbreak and response. The process of informal information surveillance implementation is only no more than start.

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CAPABILITY 8. OUTBREAK RESPONSE: Average 1.45

The state average of the ’’Outbreak Response’’ is 1.45, aimag average is 1.3, and capital city average is 1.6. 28(93.6%) of aimags are average, 2(6.4%) are above average. According to the 2008 nationwide assessment the outbreak response capability is equal to 2009 assessment level. However, specialized emergency personnel in charge of the urgent response exist in the aimags and the capital city districts, there isn’t enough necessary equipment. Except human and veterinary hospitals and emergency departments, there haven’t been created a complete team consisted of the related infrastructure organizations for emergency response. In case of the informed public health emergency, information can reach within 24 hours.

CAPABILITY 9. RESOURCES FOR CONTAINMENT: Average 0.78

The state average for “Resources for Containment’’ is 0.78; aimag average is 0.7, and the capital city average is 0.86. 20(67%) of the aimags are insufficient, 10(33%) are average. According to the 2008 nationwide assessment “Resources for Containment’’ capability level has a little increased (which is 0.5) comparing to the 2009 assessment level. None of the aimags and districts has antivirals. There is possibility of using a certain part of the state and enterprises’ facilities and and store some antivirals. It has been considered that it’s possible to hand over containment materials within 24 hours to 25-49% of the local aimags, soums and districts. Any exercises and practices had been conducted in the aimags and districts.

CAPABILITY 10. COMMUNITY-BASED INTERVENTIONS TO PREVENT THE SPREAD OF INFLUENZA: Average 1.05

The state average for “Community-Based Interventions to Prevent the Spread of Influenza’’ is 1.05, aimag average is 1.1, and the capital city average is 1. 7(23.3%) of aimags are insufficient, 19(63%) are average, 4(13.3%) are above average. According to the 2008 assessment on the “Community Based Interventions to Prevent the Spread of Influenza’’ capability has declined comparing to the 2009 assessment level.

All the aimags and districts have regulations, guidelines and procedures on the appointment of the necessary personnel and quarantine and containment of the community based prevention measures from pandemic spreading. But, there are no plans for voluntary isolation and quarantine.

CAPABILITY 11. INFECTION CONTROL :Average 1.53

The average for the “Infection Control’’ capability is 1.53; aimag average is 1.15, the capital city average is 1.92. 3(10%) of aimags and districts are insufficient, 22(73.3%) are average, 4(13%) are above average. According to the 2008 nationwide assessment “Infection Control’’ capability level had a little declined 17 Aimag, the capital city and districts’ IPPA

comparing to the 2009 assessment level. The staff trained by infection control is working at Infection Control Committee of aimags’ Health Departments. 26-50% of human and veterinary hospitals are provided with infection control logistics and equipment.

CAPABILITY 12. HEALTH SECTOR PANDEMIC RESPONSE: Average 0.85

The state average for “Health Sector Pandemic Response’’ capability is 0.85, aimag average is 0.7, and the capital city average is 1. 21(70%) of aimags and districts are insufficient, 9(30%) are average. According to the 2008 assessment the “Health Sector Pandemic Response’’ level had a little increased comparing to the 2009 assessment level. 13 (43%) of aimags and districts are insufficient and 16 (53%) are average, 1 (3%) is above average in terms of emergency tools, and human resource planning in case of respiratory deficiency. In terms of spare beds - 4 (13%) are insufficient or uncertain, 20(66%) are average, 6(20%) are above average. 7(23%) are insufficient, 16(53%) are average, 7(23%) are above average in terms of the staff involvement in the pandemic clinical management training. There is an insufficient planning of buring the deceased during the pandemic influenza.

CAPABILITY 13. VETERINARY SECTOR PANDEMIC RESPONSE : Average 0.77

The state average of ’’Veterinary Sector Pandemic Response’’ is 1.77, aimag average is 1.35, and the capital city average is 2.2. 2(6.7%) of the aimags are insufficient, 18(60%) are average, and 10(33.3%) are above average. In terms of vet’s availability 5(16.6%) are insufficient, 11(36.6%) are average and the remaining are above average. In terms of active surveillance of avian influenza 3(10%) are insufficient, 10(3, 3%) are average, the remaining are above average. In terms of passive surveillance of avian influenza 1(3, 3%) is insufficient and 14(46, 6%) are average, and the rest are above average. In terms of compensation and restocking work 8(26, 6%) are insufficient, 14(46, 6%) are average, and the rest are above average. 1(3,3%) is insufficient, 12(40%) are sufficient and the rest are above average in terms of the disinfection chemicals reserve. By determining avian influenza antibody the pandemic diagnosis and surveillance laboratory analysis capability at the Central Veterinary and Hygiene Laboratory has increased 40% comparing to previous years. Central Veterinary and Hygiene Laboratory had started using the BSL-3 laboratory for avian influenza diagnosis and research purposes, which gives a possibility of isolation for the researcher and surroundings from the infection. The issue of providing laboratories with the diagnosticum by the Ministry of Food, Agriculture and

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Light Industry for avian influenza diagnostic and surveillance purposes is still at the previous years’ level.

CAPABILITY 14. EMERGENCY SECTOR PANDEMIC RESPONSE: Average :1.77

The state average for “Emergency Agency Capacity’’ is 1.28, aimag average is 1.35, and the capital city average is 1.22. 2(6.6%) of aimags and districts are insufficient, 23(76.6%) are average, 5(16.6%) are above average. However, there is an ensured list of officials to work in case of pandemic mobilization; there is insufficiency of necessary transport, equipment and personal protection equipment.

CAPABILITY 15. FAMILY CLINIC PREPAREDNESS: Average 1.41

The state average of the “Family Clinical Preparedness” is 1.41, aimag average is 1.3, and the capital city average is 1.53. 1(3.3%) of aimags are insufficient, 27(90%) are average, and 2(6.7%) are above average. 27(90%) are average, 3(10%) in terms of the family hospitals’ capacity research in aimags and capital city districts. 2(6.6%) are average and the remaining are above average in terms of the research of the involved territory community. 4(13,3%) are insufficient, 24(80%) are average, 2(6.6%) are above average in terms of research and estimation of involved territory community in case of the pandemic. 5(16,6%) are insufficient, 21(70%) are average, 4(3.3%) are above average in terms of research of extra resources needed in case of pandemic.

SUMMARY

Influenza pandemic preparedness at aimags, and the capital city and districts’ level is at a moderate level.

FINDINGS:

1. The Influenza Pandemic Preparedness Plan which involves the participation level of all sectors such as aimags, the capital city districts, soums, khoroos and citizens hasn’t been precesily developed. Therefore, any researches were conducted regarding resources and its fundings for measures to be taken in case of pandemic influenza. Nevertheless, the human power, logistics and financial resources were budgeted as during the measures in case of highly infectious human and animal diseases, which doesn’t provide with necessary conditions for creating pandemic influenza preparedness. 2. In case of disaster and highly infectious diseases the necessary resources are being withdrawn from the budget. 3. The mutual cooperation of sectors who attended the “National Influenza Workshop IV’’ has

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been increased by one time than during the previous assessment. 4. The collaboration of the sectors is insufficient due to the absence of consolidated outline for activities, designed for power, food and water supply systems and public accomplishment and service organizations at aimags, districts, soums, and khoroo level. 5. Any experiences; practices, trainings and advertisement were constantly arranged upon pandemic influenza preparedness provison for aimags, districts, soums, khoroos and citizens. Also, the determinations weren’t amended to the plan. 6. Among the assessed capabilities the “Country Pandemic Influenza Preparedness Planning’’ and “Health Sector Pandemic Response Capability and Resources for Containment’’ were at insufficient level.

RECOMMENDATIONS:

1. To refine upon the cross sector consolidated plan towards the pandemic influenza preparedness, and the response main directions and activities according to the recommendations updated by the WHO and ensure by the government and amend determinations to the plan. 2. To develop the pro-forma format for “Pandemic Influenza Preparedness Plan, Budget and Estimation for Resource Supply’’ for aimags, districts, soums and khoroo level and acquire approval from the National Emergency Management Agency, Ministry of Health, Ministry of Food, Agriculture and Light Industry and distribute to the local organizations. 3. To arrange exercises, practices and trainings involving the participation of all sectors such as aimags, the capital city, districts, soums, khoroos, the community and citizens and conduct a research and estimate the necessary human power, antivirals, preparations, vaccinations, diagnosticums, personal protection equipment and disposal, sterilization and disinfection chemicals, emergency aid tools, equipment, hospital accommodations, beds, water, food, power and heat supply resources and provide with preparedness (To direct a certain part of the local governor affiliated disaster budget for the supply of pandemic preparedness according to the law on State Resources). 4. The criteria of the above mentioned further activities on pandemic preparedness strengthening are planned for implementation and achievement of all sector satisfactory level in the pandemic preparedness by 2011.

The attached are the results of ’’Influenza Pandemic Preparedness Assessment’’ of 21 aimags, and 9 districts of Ulaanbaatar city (ANNEX 2).

20 Aimag, the capital city and districts’ IPPA

ANNEX 1

IPPA PARTICIPANTS LIST OF 21 PROVINCES

1. Arkhangai province

# Participants’s name Organization 1. B.Erdenechimeg CIDNF 2. A.Noru Family clinic 3. D.Tserendulam Family clinic 4. T.Ishjamts Family clinic 5. U.Amgalan Family clinic 6. N.Baasan Provincial Health Department 7. S.Erdenechimeg Provincial Veterinary Service 8. N.Munkhgerel Provincial Veterinary Laboratory 9. B.Tsevegdorj Provincial Veterinary Laboratory 10. G.Batbaatar Provincial Veterinary Service 11. J.Erdenebat Provincial Emergency Management Division 12. Kh.Ganzorig Provincial Emergency Management Division 13. N.Yumchinsuren CIDNF 14. D.Khongor Provincial Emergency Management Division 15. B.Mungunmogoi Provincial Emergency Management Division 16. B.Tuvshinbat Provincial Emergency Management Division 17. B.Azjargal Provincial Health Department 18. D.Dagvasumberel Provincial Health Department 19. J.Ariunaa Family clinic 20. E.Tserendolgor Provincial Police Division 21. D.Naranbaatar “Information, communication and network” LLC 22. Sh.Erdene-Ochir Provincial Specialized Inspection Agency 23. O.Javzansuren Emergency headquarter, Erdenebulgan soum 24. G.Enkhtaivan “Undarga” LLC 25. B.Delgetkhangai Provincial Hospital 26. Ts.Tserendolgor Provincial Hospital 27. A.Sodnompil Provincial Hospital

21 Aimag, the capital city and districts’ IPPA

28. G.Narantsetseg Provincial Hospital

2. Bayankhongor province

# Participants’s name Organization 1. Т.Mukhbaatar Provincial Emergency Management Division 2. L.Purevdorj Provincial Emergency Management Division 3. О.Erdenechimeg Provincial Emergency Management Division 4. D.Tserendash Provincial Emergency Management Division 5. B.Мyagmarsuren Provincial Emergency Management Division 6. О.Оlzvoi Provincial Emergency Management Division 7. Ch.Тumurbaatar Provincial Emergency Management Division 8. S.Аrildii Provincial Emergency Management Division 9. Ts.Gantumur Provincial Veterinary Service 10. Ch.Bat-Ulzii Provincial Veterinary Laboratory 11. D.Оtgon Veterinary 12. L.Baasanbilegt Provincial Veterinary Laboratory 13. D.Tsedevsuren Provincial Veterinary Service 14. Т.Sarantsetseg Provincial Specialized Inspection Agency 15. D.Тuya GAO 16. L.Sangijav Veterinary 17. М.Dolgorsuren “Duvuntiin numur” Veterinary 18. М.Erkhembayar “Теchnologiin huvisgal” Veterinary 19. S.Тegshbayar Zootechnician 20. B.Оyunchimeg “Tsagaan sarlag” Veterinary 21. Ch.Davaakhuu DFASMI 22. Kh.Serjkhorol DFASMI 23. Т.Khishigbaatar DFASMI 24. Ts.Doljinsuren Provincial Health Department 25. B.Tserenkhand Provincial Health Department 26. E.Tsend CIDNF 27. V.Narantuya GAO 28. L.Byambasuren Provincial Health Department

22 Aimag, the capital city and districts’ IPPA

29. S.Оchirhuyag Family clinic 30. Ch.Javzan Family clinic

3. Bayan-Ulgii province

# Participants’s name Organization 1. J.Bulbul Provincial Health Department 2. К.Еrnergul Family clinic 3. N.Маiragul Family clinic 4. N.Bahithan Family clinic 5. R.Bolat Provincial Health Department 6. N.Аmingul Provincial Hospital 7. N.Тuguldur CIDNF 8. Ch.Urjikh CIDNF 9. А.Маrat CIDNF 10. А.Nurbolat CIDNF 11. B.Nurhulan DFASMI 12. М.Khuat DFASMI 13. Kh.Аnan Provincial Specialized Inspection Agency 14. К.Асан Provincial Specialized Inspection Agency 15. J.Umigrbek Provincial Emergency Management Division 16. Т.Еrlan Provincial Emergency Management Division 17. М.Аldanish Provincial Emergency Management Division 18. А.Аmirbek Provincial Emergency Management Division 19. К.Аmalkhan GAO 20. B.Shekerbai “Information, communication and network” LLC 21. М.Sakan Provincial Police Division 22. Kh.Jagsalag DMH 23. М.Кuniur DMH 24. Ch.Bonbolat Provincial Emergency Management Division 25. М.Аmantai Provincial Emergency Management Division

23 Aimag, the capital city and districts’ IPPA

4. Bulgan province

# Participants’s name Organization 1. D.Batpurev Provincial Specialized Inspection Agency 2. D.Bujmaa Provincial Specialized Inspection Agency 3. Kh.Narantuya GAO 4. D.Uuganbayar Local Emergency Management Agency 5. M.Myagmar Provincial Hospital 6. D.Narantuya Provincial Health Department 7. Ya.Altankhundaga Local Emergency Management Agency 8. N.Gurtod Local Emergency Management Agency 9. D.Uuganbayar Local Emergency Management Agency 10. B.Enkhbold DFASMI 11. R.Enkhbat “Electricity supply network” SOC 12. B.Naranjav “Information, communication and network” LLC 13. B.Tsolmon Provincial Hospital 14. E.Nergui Family clinic 15. L.Jargalsaikhan Provincial Police Division 16. G.Budjargal GAO 17. L.Tsengelmaa Provincial Veterinary Service

5. Gobi-Altai province

# Participants’s name Organization 1. N.Darjaabuu DFASMI 2. M.Sandag DFASMI 3. Ch.Tsengelmaa DFASMI 4. R.Burenbaysakh DFASMI 5. B.Alimaa DFASMI 6. Ch.Erkhambayar DFASMI 7. O.Enkhamgalan DFASMI 8. Ts.Yanjmaa DFASMI 9. D.Oyunchimeg Family clinic 10. B.Batsuren Family clinic 24 Aimag, the capital city and districts’ IPPA

11. D.Gombosuren Provincial Health Department 12. N.Sumyabazar CIDNF 13. G.Burenchudur Provincial Hospital 14. J.Batsukh Provincial Emergency Management Division 15. D.Sumya Provincial Emergency Management Division 16. Kh.Tumurochir Provincial Emergency Management Division 17. Ts.Luvsanjamts Provincial Emergency Management Division 18. J.Purevdorj Provincial Emergency Management Division 19. B.Оyunbadrakh Provincial Emergency Management Division 20. D.Nanjaddorj Provincial Emergency Management Division 21. S.Munkhjargal DMH 22. G.Delgermaa DMH 23. S.Gantulga Electricity power station department 24. E.Zoltsetseg Electricity power station department 25. Sh.Tsoodol Provincial radio 26. J.Tuvshinjargal Provincial Specialized Inspection Agency 27. G.Altangerel GAO 28. Ts.Zorigt Provincial Specialized Inspection Agency 29. N.Gund CIDNF

6. Gobisumber province

# Participants’s name Organization 1. D.Urtnasan GAO 2. S.Amarbat DFASMI 3. Sh.Amarsaikhan Provincial Veterinary Service 4. Sh.Chinbold “Us – Du” LLC 5. Sh.Altantsetseg Provincial Hospital 6. B.Narantsetseg Provincial Health Department 7. B.Bayanmunkh Provincial Emergency Management Division 8. D.Puntsagkhorloo Family clinic 9. B.Bat-Ulzii Family clinic 10. G.Shurenchuluun “Electricity supply network” SOC

25 Aimag, the capital city and districts’ IPPA

11. P.Otgonbayar DET 12. J.Oyunchimeg Provincial Specialized Inspection Department 13. D.Amarsaikhan Provincial Specialized Inspection Department 14. D.Sunjidmaa Railway hospital 15. L.Udval GAO

7. Darkhan-Uul province

# Participants’s name Organization 1. Kh.Khavsamet DFASMI 2. Sh.Erdenebaatar Local Emergency Management Agency 3. T.Azjargal Provincial Health Department 4. Sh.Oyun GAO 5. B.Battsengel Provincial Health Department 6. D.Ganbold Family clinic 7. G.Batbayar Local Emergency Management Agency 8. L.Ulziijargal Provincial Hospital 9. N.Enkhtuya Family clinic 10. S.Tuya Family clinic 11. Ts.Tumurtogoo Provincial Hospital 12. D.Batmandakh Provincial Hospital 13. B.Erdenebold Provincial Hospital 14. B.Ulzii Family clinic 15. D.Lonjidsuren Provincial Police Division 16. Sh.Lkhavgasuren Local Emergency Management Agency

8. Dornogobi province

# Participants’s name Organization 1. A.Sharkhuukhen DFASMI 2. Ts.Dorj Provincial Veterinary Service 3. U.Dolgor Provincial Specialized Inspection Department 4. B.Erdenechimeg Provincial Veterinary Laboratory 5. G.Enkhtsetseg Provincial Health Department

26 Aimag, the capital city and districts’ IPPA

6. N.Ulziijargal Provincial Health Department 7. J.Myagmarsuren Family clinic 8. Ts.Dulamjav Family clinic 9. O.Uranchimeg Family clinic 10. Kh.Mendsaikhan Railway hospital 11. N.Naranbileg Railway hospital 12. Sh.Munkhzaya Provincial Hospital 13. B.Nyamgerel Provincial Hospital 14. Ch.Tsetsegmaa GAO 15. G.Gantuya GAO 16. R.Altantsetseg Provincial Specialized Inspection Department 17. S.Jargalsaikhan Provincial Emergency Management Division

9. Dornod province

# Participants’s name Organization 1. O.Battumur Telecommunication agency 2. B.Jadambaa Provincial Veterinary Service 3. M.Davaasambuu Provincial Specialized Inspection Department 4. A.Enkhtuvshin DFASMI 5. Yo.Oyuntsetseg RDTC 6. D.Gereltuya Provincial Health Department 7. D.Oyunbileg RDTC 8. L.Surennyam Provincial Police Division 9. D.Battulga Provincial Emergency Management Division 10. D.Erdenebaatar Provincial Emergency Management Division 11. D.Khadbaatar Provincial Emergency Management Division 12. A.Badamdorj Provincial Emergency Management Division 13. N.Khishigjargal DMH 14. Kh.Enkhsaikhan Provincial Emergency Management Division 15. Ch.Azzaya Family clinic 16. B.Enebish Family clinic 17. A.Enkhtuya Family clinic

27 Aimag, the capital city and districts’ IPPA

18. D.Oyunkhuu Family clinic 19. Ts.Bayarjargal GAO

10. Dundgobi province

# Participants’s name Organization 1. Ch.Khureltogoo Provincial Emergency Management Division 2. Ts.Enkhsaikhan Provincial Health Department 3. D.Tsetsegee CIDNF 4. N.Мunguntsetseg Epidemiologist 5. М.Мunkhjargal Provincial Veterinary Service 6. М.Kuubayan DFASMI 7. B.Мunkhjargal Provincial Emergency Management Division 8. B.Byambadorj Provincial Emergency Management Division 9. D.Badamsuren Family clinic 10. Ts.Tsegmed Family clinic 11. L.Yukhaiz Family clinic 12. D.Dolzodmaa Provincial Hospital 13. S.Khulan GAO 14. S.Narangerel Provincial Hospital 15. Kh.Khishigbat Family clinic 16. B.Unentsetseg Provincial Health Department

11. Zavkhan province

# Participants’s name Organization 1. B.Enebish CIDNF 2. D.Ganchimeg Provincial Health Department 3. B.Оyuntsatsral Provincial Health Department 4. S.Sarantuya GAO 5. Т.Badamgarav Provincial Hospital 6. B.Purevdorj Provincial Veterinary Laboratory 7. Ch.Doljinsuren DFASMI 8. Т.Аriunbold Provincial Emergency Management Division

28 Aimag, the capital city and districts’ IPPA

9. B.Puntsagdulam Provincial Hospital 10. D.Аril CIDNF 11. D.Bayanmunkh GAO 12. D.Batbayar Provincial Emergency Management Division 13. B.Yadamjav Provincial Emergency Management Division 14. B.Unurbuyan DFASMI 15. U.Bold Provincial Emergency Management Division 16. D.Аlzakhgui DMH 17. J.Ganchimeg Provincial Emergency Management Division 18. G.Nominchimeg Provincial Emergency Management Division 19. G.Baymbasuren Provincial Emergency Management Division 20. E.Tserendulam Family clinic 21. D.Gansukh

12. Uvurkhangai province

# Participants’s name Organization 1. Т.Enkhbaatar Provincial Emergency Management Division 2. N.Enkhbold CIDNF 3. B.Dolgorsuren Provincial Veterinary Service 4. J.Gendenjav Family clinic 5. М.Uurtsaikh Family clinic 6. B.Chuluuntsetseg Family clinic 7. Yo.Оyuntsetseg Family clinic 8. S.Sosorburam CIDNF 9. Ch.Erdenetuya RDTC 10. Z.Tserenbat RDTC 11. G.Nadmidsuren RDTC 12. G.Dolgornyam RDTC 13. А.Аdiya GAO 14. D.Shivaanurdev GAO 15. D.Narantsetseg Provincial Health Department

29 Aimag, the capital city and districts’ IPPA

13. Orkhon province

# Participants’s name Organization 1. L.Uranchimeg Provincial Specialized Inspection Department 2. D.Davaa Provincial Veterinary Service 3. O.Tugsjargal DFASMI 4. D.Oyunchimeg “Erdene khutagt” veterinary 5. Ts.Chogjmaa Telecommunication agency 6. L.Bayardavaa DFASMI 7. B.Chinzorig “Zest-Us” cooperative 8. A.Batkhuu Provincial Veterinary Service 9. Ts.Khuyag GAO 10. G.Erdenechuluun Local Emergency Management Agency 11. B.Khashchuluun Local Emergency Management Agency 12. B.Ulambayar “Erdenet us” LLC 13. G.Bayasgalan Provincial Health Department 14. O.Battsengel Provincial Health Department 15. P.Otgonbileg Provincial Health Department 16. S.Davaasuren Veterinary 17. O.Siilegmaa Veterinary 18. L.Myagmarsuren Veterinary 19. M.Tserendorj GAO 20. U.Nurbek GAO

14. Umnugobi

# Participants’s name Organization 1. О.Sainkhuu Provincial Emergency Management Division 2. B.Тugsuu Provincial Emergency Management Division 3. Ch.Bayarjargal Provincial Health Department 4. D.Enkhmandakh Provincial Hospital 5. D.Аltanchimeg CIDNF 6. N.Jamyankhorol GAO 7. М.Tsendsuren GAO

30 Aimag, the capital city and districts’ IPPA

8. B.Byambajav Epidemiologist 9. L.Lkhagvasuren Family clinic 10. L.Khuukhenduu Family clinic 11. А.Tsetsegmaa Family clinic 12. G.Shijirtuya Provincial Hospital 13. G.Shurtsetseg CIDNF 14. М.Мunkhchuluun Provincial Veterinary Laboratory 15. М.Тumentsetseg Provincial Hospital

15. Sukhbaatar province

# Participants’s name Organization 1. Ts.Gundegmaa Provincial Health Department 2. A.Naranbayar Provincial Emergency Management Division 3. Ts.Sukhbaatar Provincial Health Department 4. T.Dashsuren Provincial Veterinary Service 5. L.Altantsetseg Provincial Specialized Inspection Department 6. Ts.Munkhtsetseg Provincial Specialized Inspection Department 7. T.Gan-Ochir DFASMI 8. Ch.Ganzorig Provincial Emergency Management Division 9. B.Gantulga Provincial Specialized Inspection Department 10. S.Ezennairamdakh Provincial Police Division 11. J.Bazar Provincial Emergency Management Division 12. S.Batsukh Provincial Emergency Management Division 13. G.Batgerel Provincial Emergency Management Division 14. B.Naragerel Family clinic 15. S.Unurtsetseg Family clinic 16. N.Enkhmaa Family clinic 17. Kh.Enkhbayar DMH

16. Selenge province

# Participants’s name Organization 1. N.Erdenedolgion Provincial Health Department

31 Aimag, the capital city and districts’ IPPA

2. D.Gantuya Provincial Specialized Inspection Department 3. S.Munkhdavaa Provincial Specialized Inspection Department 4. B.Nyamdorj Provincial Specialized Inspection Department 5. G.Tugsjargal Provincial Health Department 6. S.Otgonjargal GAO 7. B.Batnasan Provincial Police Division 8. R.Bumdari GAO 9. E.Myagmarsuren DFASMI 10. M.Regzedmaa CMH 11. D.Batdelger Land department 12. O.Tsogzolmaa Provincial Border Specialized Inspection Department 13. B.Amarsanaa Provincial Emergency Management Division 14. Sh.Dolgormaa Provincial Hospital 15. D.Chimgee Family clinic 16. D.Khaltar Family clinic 17. D.Enkhtuvshin Family clinic 18. P.Bayanjargal Family clinic 19. S.Ariuntugs Provincial Veterinary Service 20. Ts.Dulamjav Provincial Veterinary Service 21. L.Munkhtsetseg Provincial Hospital 22. B.Tuvshinjargal Provincial Veterinary Service 23. Sh.Ganhuyag Provincial Veterinary Service 24. T.Tsolmon Provincial Emergency Management Division 25. B.Erdenetsolmon ED 26. Ts.Ariunaa Òransportation agency 27. D.Burmaa Provincial Border Specialized Inspection Department 28. A.Enkhbileg GAO 29. B.Nyamdulam CIDNF

32 Aimag, the capital city and districts’ IPPA

17. Tuv province

# Participants’s name Organization 1. Ts.Аleksandr Local Emergency Management Agency 2. D.Byambadorj Local Emergency Management Agency 3. N.Мungunkhulugг Local Emergency Management Agency 4. P.Аltantsetseg Provincial Health Department 5. S.Erdenechimeg Provincial Specialized Inspection Department 6. D.Narantsetseg Provincial Specialized Inspection Department 7. J.Rentsenbaatar Provincial Veterinary Service 8. N.Enkhchimeg DFASMI 9. N.Enkhtuya DFASMI 10. Ch.Purevsuren Provincial Health Department 11. S.Nansalmaa Provincial Health Department 12. D.Аriuntuya Telecommunication Agency 13. N.Gantsetseg Provincial Health Department 14. О.Khishigchuluun Provincial Hospital 15. А.Tserendulam Epidemiologist 16. А.Тumendemberel Provincial Health Department 17. G.Nanjiddulam Family clinic 18. B.Enkhjargal Family clinic 19. Yo.Мunkh-Erdene Provincial Hospital 20. А.Chuluuntsetseg Family clinic 21. Ts.Аltantsetseg Family clinic 22. D.Unur Family clinic 23. Ch.Мunkh-Оd Family clinic

18. Uvs province

# Participants’s name Organization 1. N.Batbayar DFASMI 2. D.Ulziit Provincial Emergency Management Division 3. М.Jargal Family clinic 4. К.Оyunchimeg Family clinic

33 Aimag, the capital city and districts’ IPPA

5. D.Bayanjargal Education Culture 6. G.Оyun Provincial Hospital 7. S.Tseveen Provincial Hospital 8. Ts.Budjav Provincial Specialized Inspection Department 9. B.Baterdene Provincial Specialized Inspection Department 10. М.Оsor DET 11. М.Оyunchimeg CIDNF 12. S.Yanjinkhorloo Provincial Hospital 13. D.Batbold CIDNF 14. О.Surenjav “МKhS “ LLC 15. P.Javzan Provincial Hospital 16. G.Аltantsoo Provincial Health Department 17. Sumya Family clinic 18. В.Тuuruul Provincial Health Department 19. Sh.Tsolmon Provincial Hospital 20. E.Baatarsan GAO 21. Т.Dolgorsuren Family clinic 22. D.Purevjav Provincial Emergency Management Division 23. Ya.Chuluunbaatar Provincial Emergency Management Division

19. Khovd province

# Participants’s name Organization 1. J.Ganbayar DMH 2. Ts.Nanjid DFASMI 3. B.Khashbat Provincial Specialized Inspection Department 4. B.Мunkhbaatar DFASMI 5. Z.Tsooj Family clinic 6. S.Nina Family clinic 7. D.Urtnasan Family clinic 8. N.Lunchuluun Family clinic 9. А.Lkhagvadorj Provincial Police Division 10. N.Tsgaach Family clinic

34 Aimag, the capital city and districts’ IPPA

11. R.Enkhsuren ED 12. D.Battulga GAO 13. S.Batulzii Provincial Health Department 14. S.Dorj GAO 15. J.Bayanmunkh Provincial Emergency Management Division 16. B.Мieedorj Provincial Emergency Management Division 17. J.Тоgoojargal Provincial Emergency Management Division 18. Оyunchimeg CIDNF 19. М.Dungaamaa RDTC 20. G.Оyuntsetseg RDTC 21. Ts.Мyagmarsuren RDTC 22. Ch.Nodilkhan RDTC

20. Khuvsgul province

# Participants’s name Organization 1. S.Narantuya Provincial Health Department 2. B.Batdorj Provincial Health Department 3. M.Batsaikhan Provincial Hospital 4. Ch.Otgontsagaan CIDNF 5. D.Erdenechimeg CIDNF 6. J.Altantsetseg Family clinic 7. U.Oyuntugs Family clinic 8. Kh.Tsend-Ayush Family clinic 9. Sh.Nergui Provincial Emergency Management Division 10. B.Battsengel Provincial Emergency Management Division 11. L.Ariunaa Provincial Veterinary Laboratory 12. S.Erdenetsetseg Provincial Veterinary Service 13. B.Jargalsaikhan DMH 14. Ts.Batdelger Provincial Police Division 15. A.Sharavjamts Land department 16. S.Davaasuren Provincial Emergency Management Division 17. Yo.Purevsuren Provincial Emergency Management Division

35 Aimag, the capital city and districts’ IPPA

18. D.Lkhagvasuren Provincial Specialized Inspection Department 19. B.Ganhuyag Provincial Specialized Inspection Department 20. B.Erdenedalai Provincial Specialized Inspection Department 21. M.Nyamaa Provincial radio 22. B.Nergui Provincial Emergency Management Division 23. N.Ganbat Provincial Emergency Management Division 24. B.Odgerel Provincial Emergency Management Division

21. Khentii province

# Participants’s name Organization 1. M.Altantuul Provincial Hospital 2. B.Enkhbolor Provincial Specialized Inspection Department 3. B.Erdenechimeg Family clinic 4. D.Ochirhuyag Family clinic 5. M.Doljinsuren DMH 6. G.Lkhamaa Provincial Veterinary Service 7. N.Ankhbayar Provincial Veterinary Service 8. Tserenchimed DFASMI 9. Ch.Erdenechimeg CIDNF 10. G.Gantsetseg CIDNF 11. G.Tsend Family clinic 12. D.Baasandorj Provincial Health Department 13. D.Dashnamjil Provincial Health Department 14. N.Orkhonchimeg Provincial Health Department 15. G.Baatarchuluun GAO

36 Aimag, the capital city and districts’ IPPA

IPPA PARTICIPANTS LIST OF CAPITAL DISTRICTS

1. Bayangol district

# Participants’s name Organization 1. A.Galsanjav Governor office 2. U.Khaliunaa Governor office 3. G.Amartuvshin State Clinical Hospital #3 4. S.Tuul District Health Department 5. D.Chuluun District Health Department 6. R.Radnaa DVS 7. B.Tserennadmid Capital Specialized Inspection Agency 8. Ts.Gantulga Capital Emergency Management Agency 9. Ts.Unurbat District Emergency Management Division

2. Bayanzurkh district

# Participants’s name Organization 1. B.Puntsag District Health Department 2. L.Erkhembayar District Health Department 3. B.Oyunchimeg District Health Department 4. B.Oyun District Health Department 5. G.Yura District Health Department 6. E.Ononchimeg District Health Department 7. Sh.Orgodol Private Veterinary 8. U.Erdenechuluu GAO 9. Sh.Davaajav District Emergency Management Division 10. T.Sainbayar GAO 11. S.Tuvshinbayar District Emergency Management Division 12. B.Oyunchimeg Capital Health Department 13. N.Jantsan District Hospital 14. D.Delgerjav Private Veterinary 15. Sh.Ariunaa “MEG” LLC 16. Ts.Uyanga State Clinical Hospital #2

37 Aimag, the capital city and districts’ IPPA

17. G.Uda District Health Department 18. D.Oyun Military hospital

3. Songinokhairkhan district

# Participants’s name Organization 1. J.Batsaikahan Land department 2. J.Baasanjargal Power station 3. G.Javzandulam Red Cross Community 4. L.Zorigoo Road Police Division 5. U.Baasansuren GAO 6. D.Tumurbaatar GAO 7. J.Jambaldorj GAO 8. E.Tungalagtuya GAO 9. G.Gerelt-Od District Health Department 10. O.Oyungerel District Health Department 11. M.Amgalanbaatar GAO 12. Ya.Khandsuren Telecommunication Agency 13. A.Amarbayan Veterinary 14. B.Shatarbal GAO 15. R.Khadbaatar GAO 16. D.Dugar District Emergency Management Division 17. Ts.Altantsetseg GAO 18. Ts.Gantulga Capital Emergency Management Agency 19. T.Dulamjav NCIDNF 20. U.Narmandakh NCIDNF 21. Galsantseren District Hospital 22. E.Tumenjargal Statistical Division

4. Sukhbaatar district

# Participants’s name Organization 1. E.Tungalag District Health Department 2. D.Erdenechimeg District Health Department

38 Aimag, the capital city and districts’ IPPA

3. S.Jargalsaikhan District Hospital 4. T.Marziya District Health Department 5. L.Bayarkhuu DVS 6. D.Shinechuluun GAO 7. Amarbaysgalan District Emergency Management Division 8. B.Lkhagvasuren GAO 9. D.Dulamsuren GAO 10. B.Jargal GAO 11. J.Munkhtuya GAO 12. Ts.Gantulga Capital Emergency Management Agency 13. S.Khatanbaatar Capital Emergency Management Agency 14. G.Buyannaran District Hospital 15. E.Narantungalag District Hospital 16. J.Unugerel GAO

5. Khan-Uul district

# Participants’s name Organization 1. Ch.Oyun “Gangan buga” IF 2. J.Khuyag “Tuul tosgon” hospital 3. S.Tsevelmaa District Hospital 4. Kh.Chingerel District Health Department 5. D.Oyungerel District Health Department 6. I.Oyunchimeg District Health Department 7. D.Munkhbat District Emergency Management Division 8. G.Zoya Capital Specialized Inspection Agency 9. B.Delgermaa Capital Specialized Inspection Agency 10. Sh.Janchiv GAO 11. L.Baasangaram GAO 12. M.Tumennast DVS 13. N.Namshir DVS 14. Unenbat GAO 15. Bolor District Hospital

39 Aimag, the capital city and districts’ IPPA

6. Chingeltei district

# Participants’s name Organization 1. D.Baasankhuu DVS 2. J.Bayasgalan HOO 3. G.Enkhbat HOO 4. Kh.Davaadorj GAO 5. I.Munkhbat UBP DJSC 6. Ts.Gantulga Capital Emergency Management Agency 7. Chinbat GAO 8. Kh.Ganhuyag Telecommunication agency 9. D.Ganbold District Emergency Management Division 10. E.Erdenebaatar District Emergency Management Division 11. Lkhagva District Health Department 12. T.Baljinnyam District Health Department 13. B.Battsetseg District Health Department 14. B.Javzan GAO

7. Baganuur district

# Participants’s name Organization 1. E.Ulziibat NCIDNF 2. G.Garamjav NCIDNF 3. Sh.Bolormaa District Health Department 4. Ts.Khandtsoo Epidemiologist 5. E.Od Family clinic 6. Kh.Unurjargal Family clinic 7. Yo.Tsetsgee Family clinic 8. D.Burenjargal District Health Department 9. Ch.Erdenechimeg Family clinic 10. D.Tuya HOO 11. Sh.Otgonbayar GAO 12. B.Enkhtuul HOO 13. J.Munkhtsetseg HOO

40 Aimag, the capital city and districts’ IPPA

14. A.Namjirmaa Veterinary 15. T.Saranchimeg Veterinary 16. N.Regzedmaa “Ein nast” LLC 17. Sh.Sarantuya Department of Speciallized Inspection 18. B.Erdenechimeg Department of Speciallized Inspection 19. S.Gereltsetseg District Health Department 20. G.Erdenechimeg Veterinary 21. Kh.Batbayar GAO 22. D.Tserennadmid GAO 23. Batmunkh GAO 24. D.Batnasan CFDF 25. Sh.Bayanmunkh Power station 26. N.Dugersuren GAO 27. G.Tugsuu District Emergency Management Division 28. S.Tseelbaatar District Emergency Management Division 29. P.Batsaikhan District Emergency Management Division 30. J.Erdenebayar District Emergency Management Division 31. S.Tsendsuren District Emergency Management Division

8. Bagakhangai district

# Participants’s name Organization 1. O.Gombosuren District Police Division 2. A.Batbaatar District Emergency Management Division 3. B.Tsogbadrakh District Emergency Management Division 4. Sh.Otgonjargal District Emergency Management Division 5. D.Bat-Ochir District Emergency Management Division 6. G.Otgonbaatar District Emergency Management Division 7. Ch.Gankhuu District Emergency Management Division 8. D.Dashzeveg District Health Department 9. B.Bolormaa DVS 10. B.Suvd-Erdene DVS 11. S.Baatarkhuu Khangai complex

41 Aimag, the capital city and districts’ IPPA

12. D.Munkhtaivan CFDF 13. B.Uugantsetseg HOO 14. Kh.Bayanjargal Power station 15. Sh.Byambaa GAO 16. O.Sodovjamts GAO 17. Ts.Densmaa GAO 18. Bayardorj Hospital 19. T.Ichinnorov District Emergency Management Division 20. D.Khurelbaatar District Emergency Management Division 21. D.Gantulga District Emergency Management Division

9. Nalaikh district

# Participants’s name Organization 1. Kh.Damdin District Emergency Management Division 2. T.Bayraa District Emergency Management Division 3. D.Chuluuntsetseg Family clinic 4. D.Nergui District Health Department 5. B.Bayarkhuu District Health Department 6. S.Khishgee Family clinic 7. G.Khuderchuluun Veterinary 8. B.Tserennadmid Capital power station 9. D.Baatarkhuu CFDF 10. D.Tumenbayar Capital electricity supply network 11. B.Ulziisaikhan District Health Department 12. B.Oyunchimeg District Health Department 13. Yo.Dulmaa Veterinary 14. N.Altantuya Veterinary 15. Kh.Yanjinlkham Family clinic 16. B.Ikhbayar Family clinic

42 Aimag, the capital city and districts’ IPPA 0 0 0 0 0 0 1 3 3 3 3 1 3 2 ND 2,38 1 0 0 1 2 2 1 3 3 1 2 1 3 2 0.8 BHD 0 0 0 0 0 0 1 2 3 2 2 1 1 2 1,75 BND 0 0 0 0 0 0 2 1 2 3 3 2 1 2 2 BGD 1 1 1 1 1 1 2 3 3 3 3 1 2 2 team 2,38 KhUD th 5 0 0 0 0 0 0 1 2 3 2 2 1 2 2 SHD 1,88 0 0 0 0 0 0 1 2 3 2 2 0 1 2 SBD 1,63 1 1 1 1 3 1 3 3 2 2 1 1 2 1,4 ChD 1,88 0 0 0 0 0 0 1 3 3 2 2 0 0 0 BZD 1,38 1 0 3 1 2 2 1 1 2 3 1 2 2 1,8 1,5 UV 1 0 2 2 1 1 1 1 2 3 1 1 1 1,4 BH 1,25 1 1 2 1 1 2 2 1 2 3 2 1 1 team 1,6 1,5 UМ th 4 1 0 2 3 1 1 1 1 2 3 2 1 1 1,6 DU 1,37 2 2 2 1 2 2 2 3 2 2 1 1 0 1,8 1,6 ТU 1 1 2 1 2 1 1 2 0 1 0 2 0 1,4 KhU 0,87 1 0 0 1 1 1 1 1 3 1 1 1 0 0 0,6 BUL 1 0 0 1 1 1 3 3 3 2 0 3 3 team 0,6 2,2 ОR rd 3 1 1 0 1 1 2 3 3 2 2 0 0 0 SE 0,8 1,5 1 1 1 2 1 0 1 3 3 3 2 0 1 0 1,6 DА 2 1 1 1 2 1 1 1 1 2 1 0 0 1,4 GS 0,87 2 1 2 2 2 2 1 2 2 2 1 0 0 1,8 DG 1,25 0 0 0 1 2 1 1 2 1 1 0 0 0 team 0,6 SU 0,75 nd 2 1 1 1 0 1 2 1 1 2 1 1 0 0 0 DО 0,75 1 1 1 0 1 2 1 1 2 1 1 0 0 0 KhE 0,75 1 1 2 1 2 1 1 1 3 1 1 1 0 0 1,4 АR 1 1 1 0 1 2 1 3 2 0 1 1 3 0 1,3 KhО 0 0 0 0 0 0 1 1 1 2 1 1 1 1 0 ZА team st 1 2 1 2 1 2 1 2 2 3 0 1 1 0 0 1,6 UV 2 2 0 1 2 1 3 3 1 1 0 0 0 1,4 1,1 BU 2 1 2 1 2 1 1 2 1 1 0 0 0 1,6 0,7 GА THE FINAL SUMMARY ON INFLUENZA PANDEMIC PREPAREDNESS ASSESSMENT PREPAREDNESS PANDEMIC ON INFLUENZA SUMMARY THE FINAL QUALITY QUALITY CAPABILITY COMPILED (F.2). WHETHER (F.2). REQUIREMENTS FOOD RESOURCES ARE IN ADEQUATE ADEQUATE ARE IN COUNTRY PLANNING of PLAN (A) STATUS (B) DISSEMINATION TRAINING AND (C) EXERCISES THE PLAN (D) IMPLEMENTATION A ACTIVITIES, THE PLAN (D) IMPLEMENTATION ACTIVITIES, B СROSS SECTOR COOPERATION (A) COOPEATION OF COUNTERPARTS IN PANDEMIC PREPAREDNESS ACTIVITY SUPPLY WATER (A) (С) POWER (D) HEATING (E) ROAD, TRANSPORTATION WHETHER (F.1) FOOD RESOURCES’ IN CASE CREATION OF EMERGENCY ARRANGED WAS TO ACCORDING THE SCHEDULE (PLAN) (THE STORAGE REQUIREMENTS OF RESOURCES) (J). ON REPORTS OF LOCAL SUPPLY RESOURCES’ 1 2 A B 1.A 1.B 1.C 2.A 2.B 2.C 2.D 2.F.1 2.F.2 1.D- 1.D- 2.E 2.J ANNEX 2. 43 Aimag, the capital city and districts’ IPPA 3 2 3 2 2 2 2 2 2 2 1 0 3 3 3 2 3 1,5 2,29 2,75 2,67 3 3 2 3 2 2 2 2 2 2 1 0 2 2 3 3 3 1,5 2,5 2,43 2,33 3 2 1 2 2 2 0 2 1 1 0 3 2 3 1 3 1,5 0,5 1,71 2,25 2,33 3 3 2 3 2 2 1 1 2 0 1 0 3 3 3 3 3 2 3 0,5 2,29 2 3 2 2 2 2 2 1 1 2 0 2 1 3 3 2 3 3 3 2,75 2,33 2 2 2 3 1 2 1 2 2 2 2 2 2 3 3 3 3 3 2 3 1,86 3 2 3 2 2 2 1 2 1 1 0 3 3 3 3 3 3 1,5 0,5 2,14 2,33 3 2 2 3 2 2 2 2 3 1 1 0 2 2 3 3 2 0,5 2,5 2,29 1,67 3 2 2 1 3 2 0 3 0 3 3 3 3 3 3 3 3 2 3 1,5 1,86 1 1,57 2.0 2 2 1 2 1 1.0 2 0 0,5 1 0 2,25 2 2 3 2 1,66 2 1 1,4 1.0 2 2 2 1 1 0,5 1 0 0,5 1 0 2.00 2 3 2 1 1,66 2 0 1,1 1.0 2 1 2 1 1 1.0 2 0 0.0 0 0 1,75 2 2 2 1 1,66 2 0 1,4 2.0 2 2 2 1 1 1,5 1 2 0,5 1 0 2.5 3 2 3 2 2.0 2 2 2 1 2 2 2 1 1 1 1 1 0 2 2 3 2 1 1,7 0,5 1,3

2,25 1 2 2 2 3 2 3 1 2 0 1 2 0 2 2 2 0 2 3 1,5 2,14 0 1 2 1 1 2 1 1 2 0 1 0 1 0 2 0 1 2 1,1 0,5 0,75 0 2 3 2 3 2 1 3 0 2 1 2 3 3 1 2 3 1,8 1,5 1,5 2,25 2 2 2 1 2 2 1 1 2 0 1 2 0 2 2 2 3 1 2 3 1,7 1 2 2 1 3 2 1 1 0 1 0 2 1 3 1 3 1,7 0,5 0,5 1,75 1,66 3 2 2 3 2 2 1 1 2 0 1 0 2 2 2 3 1 2 0,5 2,14 1,66 3 2 2 3 2 2 1 3 0 1 0 3 2 3 2 2 1,5 0,5 2,5 2,14 1,66 1 2 1 1 1 2 0 1 0 1 0 1 1 1 1 1 2 0,5 0,5 1,3 1,14 2 1 1 1 1 2 1 1 2 0 1 0 1 2 2 1 2 0,5 1,5 1,28 1,66 1 3 3 3 2 2 1 1 2 0 0 0 0 1 1 2 1 2 1,3 2,14 1,25 1 1 1 1 2 1 1 0 1 2 1 2 0 1 2 2 1 3 1,5 1,5 2,3 1 1 2 2 1 1 0 0 1 0 1 2 0 2 1 3 1 1 0,5 1,6 1,75 2 1 2 1 1 1 0 1 0 1 2 0 2 2 2 3 1 2 2 1,1 0,5 1 2 1 2 2 2 0 1 0 1 2 0 2 2 2 1 1 1,4 0,5 1,3 1,75 2 3 2 2 2 3 2 0 2 2 2 1 2 0 2 2 2 3 1 2 2,3 0 2 2 1 1 2 0 1 0 1 2 0 2 3 1 3 1 2 1 1,1 0,5 1 DISASTER DATA DISASTER DATA DISASTER COMMUNICATION AIMAG (А). COMMUNICATION AGENCY (A). INFORMATION NETWORK (С). RADIO COMMUNICATION (D). COMMUNICATION OF (E). SUPPLY COMMUNICATION AND INFORMATION EQUIPMENT (F). STRUCTURE (J). DATABASE EPIDEMIOLOGIC CAPABILITY (A) EPIDEMIOLOGISTS (A) PROFESSIONAL SKILLS OF EPIDEMIOLOGISTS LABORATORY CAPABILITY (A) NATIONAL INFLUENZA LABORATORY NETWORK (B) BIO-SAFETY (BS)-LEVEL ROUTINE INFLUENZA SURVEILLANCE (A) INFLUENZA LIKE ILLNESS 2 /THE FIRST DATA MONTHS OF 2008- 2009/ SUBMISSION (B) DATA DISTRIBUTION TIMELINESS (C) (D) FEEDBACK NATIONAL RESPIRATORY DISEASE SURVEILLANCE AND REPORTING (A) INVOLVEMENT AND IN REPORTING TRAININGS 3 4 5 6 7 3.J 3.F 3.E 3.A 3.B 3.C 4.A 4.B 5.A 5.B 6.A 6.B 6.C 7.A 3.D 6.D

44 Aimag, the capital city and districts’ IPPA 2 3 2 2 3 3 1 0 1 0 3 1 1 1 2 2 2 2 2 1 1 2,5 1,25 1 3 2 1 0 3 1 0 1 0 3 1 1 1 2 1 0 1 1 1,5 0,6 1,25 0,67 1 3 1 1 0 3 1 0 2 0 2 1 1 1 1 1 1 1 2 2 1,4 1,25 1,33 1 2 1 1 1 3 0 1 0 2 1 1 1 1 1 1 1 3 2 1,5 1,2 0,75 1,67 1 3 2 1 0 3 1 0 1 0 3 1 1 1 2 3 2 3 2 1,5 1,2 1,25 2,67 0 3 1 1 0 3 0 1 0 2 1 1 1 1 1 2 2 3 1 1,2 1,25 0,75 2,33 1 3 1 1 0 3 0 1 0 2 1 1 1 1 1 3 2 3 1 0,8 1,25 0,75 2,67 0 3 2 1 2 2 3 0 1 0 2 1 1 1 2 2 1 2 0 0,6 0,75 1,25 1,67 0 3 2 1 0 3 0 1 0 2 1 1 0 0 3 2 2 0 1,5 0,5 2,3 0,8 0,75 1 2 1,5 1 1 1 3 0,25 0 1 0 0 0,5 0 1 0 1 1.0 1 0 2 0,6 0 1 2 1,5 2 2 1 1 0,25 0 1 0 0 1.00 1 1 1 1 1,3 1 1 2 1,2 1 1 2 1,25 1 0 2 2 0,5 0 1 1 0 1.0 0 1 0 3 1.0 1 0 2 0,2 0 1 3 1,25 1 1 1 2 0,75 0 1 1 1 1.0 1 1 1 1 1,33 1 1 2 0.8 1 1 2 2 1 1 3 0 1 0 1 1 1 1 1 1 0 1 1 0,5 1.0 1.0 1,75 0,66 1 2 1 1 1 2 0 1 1 1 2 1 1 3 3 1 1 2 0 0,5 1,25 0,75 1,33 0 1 1 2 1 2 0 1 0 2 2 1 1 3 3 1 2 2 0 1,5 0,5 0,75 1,66 0 3 3 0 1 3 0 1 1 3 2 1 1 3 3 1 1 2 0 0,5 1,75 1,25 1,33 0 3 3 1 1 2 0 1 3 2 0 1 2 2 1 2 2 2 1,5 1,7 1,75 1,25 1,66 0 2 1 2 0 0 2 0 1 0 2 2 1 1 3 3 1 1 0 2 1 0,4 0,75 0 3 1 1 1 3 1 0 1 1 1 1 1 1 2 1 1 1 1 1 1,5 0,6 1,25 1 2 1 1 1 2 0 1 2 2 1 1 1 2 1 2 1 2 1,2 1,25 1,25 1,25 1,33 0 2 1 1 1 0 2 0 0 0 1 1 1 1 0 2 1 1 1 1 0 0,4 0,25 1 2 1 1 1 2 0 1 0 0 1 1 0 1 1 1 1 1 0 0,6 1,25 0,25 0,75 1 1 1 1 0 1 2 0 1 0 1 1 1 1 0 2 1 1 1 1 1 0,5 0,6 1 3 1 1 1 2 0 1 2 0 1 1 0 0 1 1 1 1 1 0,5 0,6 1,25 0,75 2 2 1 1 1 0 2 1 0 1 1 2 1 1 1 0 2 1 1 0 2 1 0,6 1 3 1 1 1 2 0 1 0 1 1 1 0 0 1 1 2 1 0,5 0,5 0,8 1,25 1,33 0 3 2 1 1 2 1 0 1 2 1 1 1 1 2 1 3 1 0 1,5 0,8 1,25 1,66 2 3 1 2 0 0 2 0 1 0 1 1 1 0 1 1 1 1 1 2 0,5 0,6 0,75 2 3 1 1 1 0 2 0 1 0 1 2 1 0 0 0 1 1 2 0,5 0,8 0,75 0,66 2 HUMAN LOGISTICAL LOGISTICAL OF ACTIVATION RAPID RESPONSE (B RUMOR REPORTING TIMELINESS (C) OUTBREAK RESPONSE (A) RESOURCES ( TEAM ) (B) RESOURCES FOR RAPID RESPONSE TEAM (C) EXERCISES 2 /THE FIRST MONTHS OF 2008- 2009/ (D) TEAM RESOURCES FOR CONTAINMENT AVAILABILITY (A) ANTIVIRALS OF (B) STORAGE FACILITIES AND (C) EXERCISES PRACTICE (D) OF DISSEMINATION MATERIALS COMMUNITY- BASED TO INTERVENTIONS SPREAD PREVENT OF INFLUENZA (A) SOCIAL DISTANCING (B) CRITICAL INFRASTRUCTURE VOLUNTARY (C) AND ISOLATION QUARANTINE OF (D) PERCENT SOUM/DISTRICTS WITH PLANS INFECTION CONTROL (A) HUMAN RESOURCES (A) LOGISTICAL RESOURCES (C) INFECTION TEAM CONTROL SECTOR HEALTH PANDEMIC RESPONSE (A) HUMAN RESOURCES 8 9 11 10 12 7.B 7.С 8.A 8.B 8.C 9.A 9.B 9.C 8.D 9.D 10.D 11.В 11.С 10.A 10.B 10.C 12.A 11.А 45 Aimag, the capital city and districts’ IPPA 2 1 1 0 3 2 2 3 3 1 1 2 1 3 1 1 2,6 1,5 1,33 1,77 1 0 0 1 3 1 3 1 3 1 1 1 1 1 3 1 1 2,2 1,5 1,55 2 1 2 0 2 2 3 1 1 3 1 1 1 1 1 3 1 2 1,75 1,38 2 1 1 0 3 1 3 2 2 1 1 1 1 1 3 1 1 2,2 1,5 1,45 1 1 2 0 3 2 3 2 3 1 1 2 1 3 1 1 2,6 1,5 1,33 1,76 1 1 3 0 3 3 3 2 2 3 1 1 1 3 1 1 2,6 1,5 1,67 1,66 1 1 1 0 2 2 1 2 3 2 1 2 1 1 3 1 1 1,5 1,33 1,49 1 0 1 1 3 2 1 3 3 1 1 2 1 3 1 1 2,4 1,5 1,33 1,58 1 1 1 1 3 1 1 0 2 1 1 1 1 1 3 1 1 1,4 1,5 1,48 1 1 1 0 1 1 1 1 0 2 1,3 3 1 1,5 1 3 1 1 1,2 1 1 2 1 1,2 0 1 1 1 3 1,3 1 2 1 1,25 1 2 1 1 1,2 0 0 1 0 0,6 0 1 1 0 1 2 2 3 1 1,5 2 3 1 1 1,1 1 1 0 1 0,4 0 0 0 0 2 1 1 1 1 1 1 1 1 1 1,2 1 1 1 1 1 1 0 1 1 2 1 1 1 1 1 1 1 1 1 1,2 0 0 2 0 1 2 3 2 3 2 2 3 1 1 3 1 1 2,2 1,5 1,4 0 0 2 0 1 2 2 1 2 2 1 1 2 3 0 0 1,6 1,3 1,2 1.08 1 0 1 0 3 0 2 1 3 1 1 1 1 2 3 1 0 1,8 1,5 1,5 1 1 3 0 1 2 2 1 3 2 1 1 2 1 3 2 2 1,8 1,3 1,53 0 0 1 0 2 0 1 1 2 1 2 1 1 3 1 1 1,2 1,3 1,5 1,18 1 0 1 0 2 1 2 1 3 2 3 2 1 1 2 1 1 1,8 1,25 1,34 2 1 1 0 1 1 1 1 2 2 2 3 1 2 1 3 2 2 1,2 1,5 1 1 0 0 1 2 1 0 2 2 1 1 1 1 2 1 0 1,2 1,33 0,85 1 1 1 0 1 2 1 1 2 1 2 1 1 2 1 1 1,4 1,33 1,25 1,03 1 0 1 0 1 2 2 0 1 3 1 3 1 1 3 0 0 1,2 2,33 1,07 2 0 0 0 1 2 1 3 0 1 1 1 1 1 3 1 1 1,4 1,5 1,18 1 0 1 0 0 2 1 1 2 1 1 1 1 1 2 0 0 1,2 0,75 1,05 2 1 0 0 1 2 2 0 2 1 1 0 1 3 1 1 1,4 1,5 0,66 1,03 1 3 0 0 2 1 1 0 3 0 1 1 1 2 1 1 1,4 1,2 0,66 1,25 1 0 0 0 3 2 2 1 3 2 2 1 1 2 1 1 2,2 1,66 1,25 1,38 1 0 1 0 0 2 2 1 1 1 1 1 1 2 0 2 1,2 1,0 1,25 1.07 FAMILY FAMILY SURVEILLANCE INVOLVED INVOLVED SURVEILLANCE (B) PHYSICAL (B) PHYSICAL AND FACILITIES EQUIPMENT (C) CLINICAL MANAGEMENT GUIDELINES (D) CARE FOR DECEASED VETERINARY PANDEMIC SECTOR RESPONSE AVAILABILITY (А). VETS OF ACTIVE (В). OF SURVEILLANCE INFLUENZA AVIAN (С). PASSIVE OF SURVEILLANCE INFLUENZA AVIAN (D). COMPENSATION AND RESTOCKING (Е). DISINFECTION CHEMICALS RESERVE EMERGENCY PANDEMIC SECTOR RESPONSE (А). HUMAN RESOURCES (В).TRAINING (С). SUPPLY CLINIC FAMILY PREPAREDNESS (А). HOSPITAL CAPACITY SURVEILLANCE (В). TERRITORY COMMUNITY SURVEILLANCE (С). ON MOBILIZATION OF COMMUNITY AND ORGANIZATIONS IN CASE OF PANDEMIC INFLUENZA (D). ON EXTRA RESOURCES NEEDED IN CASE OF INFLUENZA AVERAGE 14 15

13. 12.D 13.А 13.D 14.А 15.А 15.D 13.Е 12.B 12.C 13.В 13.С 14.В 14.С 15.В 15.С 46 Aimag, the capital city and districts’ IPPA ASSESSMENT TOOLS OUTLINE TOOLS ASSESSMENT INFLUENZA PANDEMIC PREPAREDNESS PREPAREDNESS PANDEMIC INFLUENZA ANNEX 3 47 Aimag, the capital city and districts’ IPPA Part 1 to ensure Influenza Pandemic Preparedness Assess aimag, capital and district’s plan which Assess aimag, capital and district’s

48 Aimag, the capital city and districts’ IPPA 3 Advanced 12 months the assessments financial resources Mechanism for sustainability of The structure closely collaborates organizations in charge of the issue in charge organizations Plan disseminated to all subordinate with national level centres and other 1 training has been arranged for past organizations and households. At least and households. organizations The plans are updated routinely based on Follow-up actions were conducted based on the results of testing, tabletop exercises/demonstration practices 2 necessity organizations of the territory organizations methodology on the activities which has an approved standard Utilize budget resources in case of The activity coordination structure administrative unit (soum, khoroo) Plan is published in local press and aimag, the capital city, and districts aimag, the capital city, Plan has been adopted from the lower widely disseminated to all subordinate Tabletop exercises/demonstration Tabletop practices were conducted LEVEL LEVEL 1 planned exists at government Plan is disseminated to lower Plan has been reviewed within the budget, it hasn’t been withdrawn budget, it hasn’t administrative units, trainings are The activity coordination structure implementation of plan included in Although the financial resources for with human and financial recources) aimags/the capital city/districts level Testing of plan preparation (provided Testing (committe, counsel, working group etc)

1 0 No plans are arranged implementation of plan No allocation of resources No testings were conducted Plan is not disseminated, no trainings No structures for plan implementation (B) (A) (Е) (C) (D) THE PLAN THE PLAN EXERCISES TRAININGS ACTIVITIES, В ACTIVITIES, А IMPLEMENTATION IMPLEMENTATION IMPLEMENTATION CAPABILITY 1: CAPABILITY DISSEMINATION AND DISSEMINATION

COUNTRY PLANNING COUNTRY STATUS of PLAN STATUS INDICATORS INDICATORS Plan approved by the aimags, the capital city and districts’ governors according to the government decree 110/2007 on approval of avian influenza prevention main direction, 2007 decree 61 on the activity plan 2007 decree main direction, of avian influenza prevention on approval 110/2007 to the government decree governors according by the aimags, capital city and districts’ Plan approved 1 49 Aimag, the capital city and districts’ IPPA 3 level facilities Advanced Paved road and airway Centralized power system Centralized heating system Resources for drinking water The resources had been created The cross sector working group storage and preservation procedures according to the plan. The resources according to the plan. Exchange of information at the state requirements. Store according to the are being refreshed and has standard recommendation and disseminated Storages and warehouses in adequate conducted more than 2 meetings for the past 12 months and developed 2 stations adequate quality requirements From centralized water syste m been created (logistics and cash) Warehouse and storages are not in Warehouse Upgraded and paved road network Recyclable power, diesel and water Recyclable power, Power and steam combined heating The plan is in place and resources had Exchange of information at local level Established a cross-sector working group of obliged counterparts in pandemic influenza preparedness supply and conducted meeting at least once for past 12 months LEVEL 1 By steam station reports at local level charge of the issue charge in the particular cases From running water or well Dirt and upgraded road network Involved counterparts at aimag, the capital city and districts’ level the capital city and districts’ colloborate at specialist’s level in colloborate at specialist’s The privates’ solar or wind propellers The privates’ withdraw from the necessary resources Altough the resource creation plan was developed, it hasn’t been implemented developed, it hasn’t No warehouses and storages. Agreed to No warehouses and storages. Altough reports on supply of local food resources’ are compiled, no exchange of resources’ 0 resources’ resources’ By firewood colloborate No resources resource creation No water resources No power resources The counterparts at aimag, the No attempts were conducted upon capital city and districts’ level don’t level don’t capital city and districts’ No compiled reports on supply of local Local road on quarterlyl basis (E) (B) (C) (D) (G) (F1) (F2) (A) (PLAN) POWER HEATING WATER SUPPLY WATER OF RESOURCES) REQUIREMENTS COOPEATION OF COOPEATION CREATION IN CASE OF CREATION OF LOCAL RESOURCES’ OF LOCAL ROAD, TRANSPORTATION ROAD, CAPABILITY 2: CAPABILITY PREPAREDNESS ACTIVITY ACTIVITY PREPAREDNESS ARE IN ADEQUATE QUALITY QUALITY ADEQUATE ARE IN WHETHER FOOD RESOURCES (NEMA, MOH, MoFALI, SGIA) (NEMA, MOH, MoFALI, WHETHER FOOD RESOURCES’ WHETHER FOOD RESOURCES’

EMERGENCY WAS ARRANGED WAS EMERGENCY

COUNTERPARTS IN PANDEMIC IN PANDEMIC COUNTERPARTS (THE STORAGE REQUIREMENTS (THE STORAGE ACCORDING TO THE SCHEDULE THE SCHEDULE TO ACCORDING COMPILED REPORTS ON SUPPLY ON SUPPLY COMPILED REPORTS СROSS SECTOR COOPERATION СROSS SECTOR INDICATORS

50 Aimag, the capital city and districts’ IPPA 3 Advanced sustainable timely manner international level information exchange influenza data is accustomed Disaster data exchange at the which are ensured by testing constant use of avian pandemic The disaster database is in place, contacting the particular area and All types of radio are available for Internal network is available. Have a head computer, permanent access a head computer, to high-speed internet. Activities are to high-speed internet. of determinations, and reporting the Have announcement plans and sirens computer access; satellite connection Cellular and basic phone connections; all types of radio; internal and external plan exists and accustomed amendment Avian pandemic influenza preparedness Avian disasters to the relevant organizations in disasters to the relevant organizations 2 resources are available all types of radio; low speed internet access accustomed, deficiency of human to disaster database, utilization isn’t to disaster database, utilization isn’t Have announcement plans and sirens Internal network, and non-permanent, Cellular and basic phone connections; Although avian influenza data included Disaster data exchange at the state level Ultra-Short-Wave and short wave radios Ultra-Short-Wave Avian pandemic influenza preparedness Avian plan exist and determinations were amended on particular matters LEVEL 1 acces territory plan is in place for short distance included to disaster database Disaster dataexchange only at The avian influenza information Cellular and basic phone connections; Only internal network or only internet Ultra-Short-Wave radios only available Ultra-Short-Wave departments, agencies of the particuLar Avian pandemic influenza preparedness Avian Announcement plans and emergency Announcement plans and emergency call outlines are existing. No announcent equipment (sirens) 0 N/A accesses channels departments preparedness No database for disaster No information network and internet No communication plans and outlines to pass the message in case of disaster No plans on avian pandemic influenza Only applicable at particular agencies, Impossible to organize any type of radio Impossible to organize (F) (E) (B) (C) (A) (D) (G) AGENCY AGENCY COMMUNICATION DISASTER DATABASE RADIO COMMUNICATION INFORMATION NETWORK INFORMATION AIMAG DCOMMUNICATION AIMAG DCOMMUNICATION DISASTER DATA STRUCTURE DISASTER DATA COMMUNICATION SUPPLY OF COMMUNICATION OF COMMUNICATION SUPPLY

AND INFORMATION EQUIPMENT INFORMATION AND INDICATORS INDICATORS CAPABILITY 3: CAPABILITY 51 Aimag, the capital city and districts’ IPPA 3 3 virus degree Advanced constantly Advanced ≥6 practicing public health >91% of public health practicing epidemiologists with professional Able to isolate seasonal influenza Human and animal influenza virus epidemiologist per 50 000 population epidemiologist per 50 000 population isolation analyses are being conducted 2 2 tests professional degree practicing epidemiologists with Up to 50-90% of public health Laboratory with bio-safety level 2 Identify influenza virus using rapid either in human or veterinary sectors 3-5 practicing public health epidemiologist per 50 000 population where influenza analyses are available LEVEL LEVEL LEVEL 1 1 in next 5 years professional degree national laboratory 1-2 practicing public health Up to 26-49% of public health practicing epidemiologists with Influenza specimens are submit to epidemiologist per 50 000 population epidemiologist per 50 000 population Plan to establish influenza laboratory per 50 000 2 0 0 degree establishment e for Diagnosis and Prophylaxis, central hospitals, State Professional Inspection Agency and Centre of Infectious Diseases with Natural Foci by the and Centre Agency Inspection central hospitals, State Professional e for Diagnosis and Prophylaxis, population cant’ reach one population cant’ Number of practicing public ≤ 25% of public health practicing epidemiologists with professional health epidemiologist No plans for influenza laboratory Influenza specimens are not taken 3 ) В ( (А) (B) (A) NETWORK EPIDEMIOLOGISTS EPIDEMIOLOGISTS CAPABILITY 5: CAPABILITY CAPABILITY 4: CAPABILITY BIO-SAFETY (BS)-LEVEL (BS)-LEVEL BIO-SAFETY PROFESSIONAL SKILLS OF PROFESSIONAL

LABORATORY CAPABILITY LABORATORY NATIONAL INFLUENZA LABORATORY LABORATORY INFLUENZA NATIONAL

EPIDEMIOLOGIC CAPABILITY EPIDEMIOLOGIC CAPABILITY

INDICATORS INDICATORS Epidemiologists working at the Health Departments, Regional Centr assessed together. Human and veterinary sectors are 2 included are profession 3 52 Aimag, the capital city and districts’ IPPA 3 and distributed to time 4 Advanced decision makers units on weekly basis. Data analyzed ≥95% of data are submitted on Data distribution to administrative for Influenza is distributed to aimag Тhe feedback from National Centre centres and other administrative units 2 sector on time units on quarterly basis organizations at aimag centre. organizations Data distribution to adminidtrative for Influenza is distributed to other Тhe feedback from National Centre Data involves all units of the health Up to 81-95% of data are submitted LEVEL 1 on time weekly submitted units at least twice for year organizations at aimag centre organizations Data distributed to administrative Тhe feedback from National Centre Data on Influenza Like Illnesses is for Influenza is distributed to health Up to 51-80% of data are submitted 0 time districts Influenza Like Illnesses Incomplete data submitted on data at aimag/city level to soums/ Тhe feedback from National Centre Up to 50% of data are submitted on No distribution structure for analyzed for Influenza is not distributed further for Influenza is not distributed further

(B) (C) (A) (D) FEEDBACK TIMELINESS SUBMISSION DATA DISTRIBUTION DATA CAPABILITY 6: CAPABILITY INFLUENZA LIKE ILLNESS DATA LIKE ILLNESS DATA INFLUENZA

/THE FIRST 2 MONTHS OF 2008-2009/ /THE FIRST ROUTINE INFLUENZA SURVEILLANCE ROUTINE INFLUENZA INDICATORS The aimag/capital city/district’s analysis on their own reports. The aimag/capital city/district’s 4 53 Aimag, the capital city and districts’ IPPA 3 public Advanced implemented. quarterly basis and informed the Informal reports are analyzed on prior to influenza season. It is being Planned trainings for health and other relevant organizations and community relevant organizations Respiratory outbreaks of significance or clusters of severe r disease reported within 24 hours of occurrence at aimag/the capital city territory 2 season the informal reporting. aimag/the capital city territory Trainings are being arranged for Trainings and community prior to influenza within 24-48 hours of occurrence at Respiratory outbreaks of significance health and other related organizations health and other related organizations Structure for registration and ensuring or clusters of severe r disease reported LEVEL 1 prior to influenza season aimag/the capital city territory Trainings are being arranged for Trainings Informal reportings are registered within 48-72 hours of occurrence at Respiratory outbreaks of significance or clusters of severe disease reported health and veterinary sector specialists 0 reporting No surveillance structure for informal No sustainable structure for reporting and training Respiratory outbreaks of significance or clusters of severe disease reported within more than 72 hours of occurrence at aimag/the capital city territory (B) (С) (A) TRAININGS TIMELINESS RUMOR REPORTING RUMOR REPORTING CAPABILITY 7: CAPABILITY INVOLVEMENT IN REPORTING AND IN REPORTING INVOLVEMENT

SURVEILLANCE AND REPORTING SURVEILLANCE NATIONAL RESPIRATORY DISEASE RESPIRATORY NATIONAL INDICATORS

54 Aimag, the capital city and districts’ IPPA 3 Advanced are trained. emergency. emergency. simultaneous use Equipment accessible for ≥ 2 to laboratory within 24 hours hours and submits specimens teams at aimag/soum level for of notification public health Emergency response teams are Emergency soums and districts. ALL teams ALL soums and districts. Response is delivered within 12 appointed to aimags/capital city, appointed to aimags/capital city, Demonstrated practices to The results of 50% of soums. practices had been discussed and supplies such as human power etc have been determined 2 response at administrative units aimag and soum level Demonstrated practices to all Equipment accessible for 1 team at 1 team in charge of the emergency of the emergency 1 team in charge bagh, aimag/capital city/district level. notification of public health emergency Response is delivered within the day of LEVEL 1 level response at practices per year 1 team in charge of the emergency of the emergency 1 team in charge ≥1 team at aimag/capital city level Response is delivered within 2 days of notification of public health emergency Equipment accessible for 1 team at aimag bagh, aimag/the capital city/district level 0 response emergency emergency Response is delivered within 3 Absence of necessary equipment No exercises were conducted at all days of notification public health No teams in charge of the emergency of the emergency No teams in charge (B) (C) (A) (D) EXERCISES RESPONSE TEAM RESPONSE HUMAN RESOURCES ACTIVATION OF TEAM OF ACTIVATION CAPABILITY 8: CAPABILITY RAPID RESPONSE TEAM ) RAPID RESPONSE ( OUTBREAK RESPONSE

/THE FIRST 2 MONTHS OF 2008-2009/ /THE FIRST

LOGISTICAL RESOURCES FOR RAPID LOGISTICAL INDICATORS

55 Aimag, the capital city and districts’ IPPA 3 months Advanced within 24 hours population of th territory facilities at aimag/capital city preparations enough for 20-day The resources for antivirals and containment involving 26-50 % of Government had formal agreement Materials for containment can reach with licensed pharmaceutical storage 90-100% of country’s geographic area 90-100% of country’s More 2 than practices within past 12 2 exist in aimag/ 5 months population of the territory preparations enough for 20-day The resources for antivirals and At least 1 practice within past 12 containment involving 11-25 % of containment involving 11-25 Special storage facilities in aplliance with requirements capital city Materials forcontainment can reach geographic 50% - 89% of country’s area within 24 hours LEVEL

1 past 12 months population of the territory containment involving 10% of preparations enough for 20-day The resources for antivirals and Table top exercise (or similar) within Table Storage facility exists in aimag; the particular parts of this can be used for this purpose. Materials for containment can reach geographic 25% - 49% of country’s area within 24 hours 0 antivirals preparations within 24 hours No resources of antivirals and No special warehouses for storing No activities in the past 12 months <25% of country’s geographic area <25% of country’s Materials for containment can reach (B) (C) (A) (D) STORAGE FACILITIES FACILITIES STORAGE CAPABILITY 9: CAPABILITY EXERCISES AND PRACTICE EXERCISES AVAILABILITY OF ANTIVIRALS OF AVAILABILITY DISSEMINATION OF MATERIALS DISSEMINATION

RESOURCES FOR CONTAINMENT INDICATORS Requirements upon adequate security, temperature, inventory tracking, and rotation of stock inventory tracking, and rotation temperature, upon adequate security, Requirements 5 56 Aimag, the capital city and districts’ IPPA . 3 Advanced and communities early and contained the 7 100% of aimags and districts. available and has been widely Clear written criteria staged by severity of pandemic are publicly Written mititgation plans in 90- Written disseminated to schools, workplaces, Clear written criteria staged by severity of pandemic is publicly available, has been widely disseminated to and tested by essential service providers. Isolation and quarantine have been applied outbreak. 2 of pandemic. aimags and districts. Some experiences in applying staged by severity of pandemic. Clear written criteria for closing/ voluntary isolation and quarantine. re-opening schools and workplaces and cancellation of public gatherings Clear written criteria for maintenance Written mitigation plans in 50-89% of Written of essential services staged by severity LEVEL 1 isolation and quarantine. Some plans or guidance and 49% of aimags and districts. resolutions for appointement of Some plans for social distancing. essential human power and services. Some recommendations for voluntary Written community mitigation plan in Written 0 N/A N/A preparations. No plans and preparations No or limited planning and None of soum/districts with own plans

6 (B) (C) (A) (D) PLANS QUARANTINE SOCIAL DISTANCING DISTANCING SOCIAL CAPABILITY 10: CAPABILITY VOLUNTARY ISOLATION AND ISOLATION VOLUNTARY CRITICAL INFRASTRUCTURE CRITICAL PERCENT OF SOUM/DISTRICTS WITH OF SOUM/DISTRICTS PERCENT

PREVENT SPREAD OF INFLUENZA SPREAD OF PREVENT INDICATORS INDICATORS COMMUNITY- BASED INTERVENTIONS TO TO BASED INTERVENTIONS COMMUNITY- Related vacancies and appointed units (team, working group, committees) in the relevant agencies and committees) in the relevant Related vacancies and appointed units (team, working group, In the past 5 years. 6 7 57 Aimag, the capital city and districts’ IPPA 3 Advanced except aimag centers. arranged every 3 years. logistics and equipment. with necessary infection control organizations of soums and districts organizations All administrative units are provided Staff trained exists in ALL the health ALL trained exists in Staff The staff is renewed and trainings are The staff 2 centers. Committee / human and veterinary hospitals. control logistics and equipment. Infection control committee at all All administrative units and up to provided with necessary infection 51-89% of veterinary hospitals are Staff trained in up to 50% of soums Staff and districts’ hospitals except aimag and districts’ /Infection Control Committee, Quality LEVEL 1 and the capital city. and the capital city. central/tertiary hospitals. control logistics and equipment. All administrative units and up to provided with necessary infection 26-50% of veterinary hospitals are Staff trained in standards, skills, and Staff leadership for infection control in all Infection control committee at Health and Veterinary Departments of aimags Veterinary and 0 control. Committee/ the hospitals. HD, CH, RCDP HD, CH, RCDP logistics and equipment. Epidemiologists in charge of Epidemiologists in charge with necessary infection control No infection control team in any of of veterinary hospitals are provided nosocomial infection exist at aimag No specialists in charge of infection No specialists in charge /Infection Control Committee, Quality All administrative units and up to 25% to up and units administrative All 8 (В) (С) (А) HUMAN RESOURCES CAPABILITY 11: CAPABILITY LOGISTICAL RESOURCES LOGISTICAL for disinfection and sterilization/ INFECTION CONTROL TEAM INFECTION CONTROL INFECTION CONTROL /have centralized sterilization and unit,

disinfection, relevant chemicals and resources equipment work normally. Have auto-mask for equipment work normally. INDICATORS INDICATORS Human and veterinary sectors are assessed together Human and veterinary sectors are 8 58 Aimag, the capital city and districts’ IPPA 3 ≥51% of projections of ≥51%

created created. Advanced past 3 years. staff is trained staff ≥50 of the resources had been 90-100% of resources had been Plan and resources for retrieval, The plan for human mobilization identification, temporary storage, and culturally appropriate disposal exists and resources meet ≥90% of personnel had been involved in the clinical management training in the ≥90% of aimag, soum and districts’ ≥90% of aimag, soum and districts’ projected surge capacity needs. The capacity needs. projected surge of bodies meets bodies of 2 up to 50% projections.

surge capacity needs surge meets Plan and resources for retrieval, to 50% of resources had been created.

identification, temporary storage, and and up to 50% of soums’ and districts’ and districts’ and up to 50% of soums’ 50-89% of resources had been created The plan for human mobilization exists private hospitals’ doctors and personnel private hospitals’ personnel had been involved in clinical culturally appropriate disposal of bodies and resources meet 50-89% of projected management training in the past 3 years. management training in the past 3 years. 51-89% of aimags’ and districts’ state and and districts’ 51-89% of aimags’ Up LEVEL . 1 needs; in the past 3 years Plan for care of deceased exists projection of needs based on data. exists, and includes current capacity Plan to increase bed capacity or home care The plan for human mobilization exists and private hospitals’ doctors and personnel had private hospitals’ Up to 50% of aimags and districts’ state and Up to 50% of aimags and districts’ been involved in clinical management training resources meet 49% of projected surge capacity resources meet 49% of projected surge The plan exists and resources created up to 49% 0 4-6; influenza. capacity or home care. suspect breath deficiency. suspect breath deficiency. prophylaxis management. No or limited planning for deceased during pandemic No staff trained by pandemic No staff No plans for increasing human limited planning to increase bed Number of beds unknown; no or resources during pandemic phases No or limited care for patients with (B) (C) (A) (D) EQUIPMENT EQUIPMENT GUIDELINES /in the past 3 years / RESPONSE HUMAN RESOURCES CARE FOR DECEASED CAPABILITY 12: CAPABILITY CLINICAL MANAGEMENT MANAGEMENT CLINICAL PHYSICAL FACILITIES AND FACILITIES PHYSICAL

HEALTH SECTOR PANDEMIC PANDEMIC SECTOR HEALTH INDICATORS INDICATORS

59 Aimag, the capital city and districts’ IPPA 3 organizations avian influenza preparations in the resources and wild birds on quarterly basis ≥3 vets per every 30000 livestock Report on monthly basis. Conduct analysis and Established an adequate legal basis and financial developed reports are handed over to the relevant exist, financial resources are created every year, ≥3 exist, financial resources are created every year, Guidelines for sterilization in case of avian influenza Active surveillance by taking specimens from poultry resources for reimbursement flock destruction during 2 (0 report) LEVEL created every year 2 vets per every 30000 livestock. specimens from poultry and wild birds The cases of poultry and wild birds’ loss and The cases of poultry and wild birds’ basis for reimbursement flock destruction during avian influenza, no financial resources suspicious cases are reported on monthly basis suspicious cases are reported on monthly basis influenza, and necessary financial resources are Guidelines for sterilization exist in case of avian Although has been established an adequate legal At least 2 active surveillances per year by taking surveillances 2 active At least 1 poultry and wild birds Although guidelines for Established an legal basis reported in timely manner for reimbursement flock The cases of poultry and wild year by taking specimens from At least1 active surveillance per influenza, no financial resources sterilization exist in case of avian destruction during avian influenza birds’ loss and suspicious cases are birds’ 1 vet per every 30000 livestock. 0 birds No guidelines avian influenza avian influenza doesn’t reach 1. doesn’t and resources for destruction during No reimbursement by taking specimens mechanism for flock A number of vets per A sterilization in case of from poultry and wild every 30000 livestock No active surveillance No reporting structure for poultry loss and wild birds’ and suspicious cases’ registration (E) (B) (C) (A) (D) RESERVE RESTOCKING AVIAN INFLUENZA INFLUENZA AVIAN INFLUENZA AVIAN RESPONSE COMPENSATION AND COMPENSATION AVAILABILITY OF VETS OF AVAILABILITY

CAPABILITY 13: CAPABILITY

DISINFECTION CHEMICALS ACTIVE SURVEILLANCE OF ACTIVE SURVEILLANCE PASSIVE SURVEILLANCE OF SURVEILLANCE PASSIVE INDICATORS INDICATORS VETERINARY SECTOR PANDEMIC PANDEMIC SECTOR VETERINARY

60 Aimag, the capital city and districts’ IPPA 3 ≥50% Advanced budget are approved. capital city are involved in case of avian influenza. The in case of avian influenza. Appointed and ensured personnel personnel are trained and plan 80% of personnel who supposed to Transportation, tools and PPE’s for tools and PPE’s Transportation, attend the training at aimags and and spare personnel for mobilization special unit to work at foci can reach 2 30% capital city are involved in case of avian influenza Appointed and ensured personnel 50% of personnel who supposed to Transportation, tools and PPE’s for tools and PPE’s Transportation, attend the training at aimags and and spare personnel for mobilization special unit to work at foci can reach LEVEL 1 to work at foci avian influenza capital city are involved and (PPE) personal protection work for mobilization in case of Approved number of personnel to Deficiency of transportation, tools 30% of personnel who supposed to attend the training at aimags and equipment for appointed special unit 0 the duty influenza No personnel to work for No trainings were arranged mobilization in case of avian No tools and equipment to perform (C) (B) (А) SUPPLY SUPPLY TRAINING HUMAN RESOURCES CAPABILITY 14: CAPABILITY

/THE FIRST 2 MONTHS OF 2008-2009/ /THE FIRST INDICATORS INDICATORS EMERGENCY SECTOR PANDEMIC RESPONSE PANDEMIC SECTOR EMERGENCY

61 Aimag, the capital city and districts’ IPPA Part 2 (To be assessed at each hospital) (To Assessment on Family Clinic preparedness level

62 Aimag, the capital city and districts’ IPPA 3 ≥50% by phases Advanced advises constantly and demonstrate practices to of the group vulnerables and are in place. Specific registration The resources had been created to involving them in check-ups and organizations with accommodation organizations and State Khural implementing are constantly involved in trainings, and transportations for mobilization The surveillance and determinations by Governor’s Administration Office by Governor’s The specialists for extra mobilization Family hospitals have developed plan for next 5-10 years which is approved 2 acquiring reimbursement hospitals started acquainting the been acquainted by Governor’s been acquainted by Governor’s Based on the surveillance family The surveillance of resources had of specialists, accommodation and An estimation on extra mobilization Administration Office and approved transportation had been approved by State Khural with the extra needs and the Governor’s Administration Office the Governor’s Governor’s Administration Office and Governor’s Conduct the surveillance and amend determinations on yearly basis LEVEL 1 The surveillance exists and amend determinations and amend determinations and determinations are amended Conduct surveillance on yearly basis Conduct surveillance on yearly basis Conduct surveillance on yearly basis 0 N/A N/A N/A N/A a ) А (B) (C) ( (D) SURVEILLANCE SURVEILLANCE SURVEILLANCE CAPABILITY 15: CAPABILITY FAMILY HOSPITAL CAPACITY CAPACITY HOSPITAL FAMILY CASE OF PANDEMIC INFLUENZA INFLUENZA CASE OF PANDEMIC NEEDED IN CASE OF INFLUENZ INVOLVED TERRITORY COMMUNITY COMMUNITY TERRITORY INVOLVED COMMUNITY AND ORGANIZATIONS IN AND ORGANIZATIONS COMMUNITY SURVEILLANCE ON MOBILIZATION OF ON MOBILIZATION SURVEILLANCE SURVEILLANCE ON EXTRA RESOURCES ON EXTRA SURVEILLANCE

FAMILY CLINIC PREPAREDNESS FAMILY INDICATORS INDICATORS

63 Aimag, the capital city and districts’ IPPA

ANNEX 4 IPPA TIMETABLE 1st team – Route 1

# Province’s name Timetable 1. Gobi-Аltai 7, March 2. Khovd 9, March 3. Bayan-Ulgii 11, March 4. Uvs 13, March 5. Zavkhan 15, March 6. Arkhangai 17, March

2nd team – Route 2

# Province’s name Timetable 1. Khentii 10, March 2. Dornod 12, March 3. Sukhbaatar 13, March 4. Dornogobi 16, March 5. Gobisumber 17, March

3rd team – Route 3

# Province’s name Timetable 1. Darkhan -Uul 10, March 2. Selenge 11, March 3. Îrkhon 12, March 4. Bulgan 12, March 5. Khuvsgul 14, March

64 Aimag, the capital city and districts’ IPPA

4th team – Route 4

# Province’s name Timetable 1. Tuv 5, March 2. Dundgobi 7, March 3. Umnugobi 9, March 4. Bayankhongor 11, March 5. Uvurkhangai 13, March

5th team – Route 5

# Capital district’s name Timetable 1. Bayanzurkh 5, March 2. Chingeltei 6, March 3. Sukhbaatar 9, March 4. Songinokhairkhan 10, March 5. Khan-Uul 11, March 6. Bayangol 12, March 7. Baganuur 13, March 8. Bagakhangai 14, March 9. Nalaikh 15, March

65 Aimag, the capital city and districts’ IPPA

ANNEX 5 IPPA PHOTOS

Figure1. IPPA participants of Arkhangai Figure 2. Governor’s ordinance of province Gobi-Altai province on “To ensure Influenza Pandemic Preparedness”

Figure 3. Health Department plan of Figure 4. IPPA participants of Uvs Gobi-Altai province on “To ensure province Influenza Pandemic Preparedness”

Figure 5. Family clinics’ plan of Figure 6. IPPA participants of Darkhan-Uul Kovd province on “To ensure province Influenza Pandemic Preparedness” 66 Aimag, the capital city and districts’ IPPA

Figure 7.IPPA report aggregating team Figure 8. “Action plan of quarantine on avian influenza”, LEMA, Darkhan-Uul province

Figure 9. Implementation plan of Figure10. IPPA participants of Gobi-Altai National Strategy on Avian Influenza province and Pandemic Influenza Control”, Khuvsgul province

Figure11. IPPA participants of Zavkhan Figure 12. Activity picture on “To control province Avian Influenza” of Erkhel lake, Khuvsgul provin

67 Aimag, the capital city and districts’ IPPA

Figure 13. Central Hospital of Zavkhan Figure 14. Veterinary laboratory of province Gobi-Altai province

Figure15. “Diagnostic Center for viral Figure15. “Diagnostic Center for viral animal diseases” (BSL-3 Lab), SCVL animal diseases” (BSL-3 Lab), SCVL

Figure 17. IPPA participants of Arkhangai Figure 18. IPPA participants of Uvs province province

68 Aimag, the capital city and districts’ IPPA

Figure 19. IPPA participants of Khovd Figure 20. IPPA participants of Zavkhan province province

Figure 21. IPPA participants of Bulgan Figure 22. IPPA participants of Sukhbaatar province province

Figure 23. IPPA participants of Dornogobi Figure 24. IPPA participants of Gobisumber province province

69 Aimag, the capital city and districts’ IPPA

Figure 25. IPPA participants of Tuv Figure 26. IPPA participants of Selenge province province

Figure 27. IPPA participants of Orkhon Figure 28. IPPA participants of Bayankhongor province province

Figure 29. IPPA participants of Khentii Figure 30. IPPA participants of Dornod province province

70 Aimag, the capital city and districts’ IPPA

Figure 31. IPPA participants of Dundgobi Figure 22. IPPA participants of Umnugobi province province

Figure 33. IPPA participants of Uvurkhangai Figure 34. IPPA participants of Bayan-Ulgii province province

Figure 35. IPPA participants of Khuvsgul Figure 36. IPPA participants of Bayanzurkh province district

71 Aimag, the capital city and districts’ IPPA

Figure 37. IPPA participants of Chingeltei Figure 38. IPPA participants of Sukhbaatar district district

Figure 39. IPPA participants of Figure 40. IPPA participants of Songinokhairkhan district Khan-Uul district

Figure 41. IPPA participants of Figure 42. IPPA participants of Bayangol district Baganuur district

72 Aimag, the capital city and districts’ IPPA

Figure 43. IPPA participants of Figure 44. IPPA participants of Bagakhangai district Nalaikh district

Figure 45. IPPA team training Figure 46. IPPA team training

Figure 47. IPPA report meeting Figure 48. IPPA report meeting

73 Aimag, the capital city and districts’ IPPA

74