National Health Cluster Coordination Online Meeting Minutes 27th August 2020, 10:00 am to 12:00 noon

Agenda Discussions Action points 1. Update on Measles Outbreak- WHO 2. WHO COVID-19 Update 3. HeRAMS Update on Data Contributors 4. Rapid Assessment of COVID-19 Disability Inclusive Health Response in EMR countries-WHO EMRO 5. RFP Election Process 6. AoB Introduction and The meeting was opened by Craig Hampton the Health Cluster Coordinator who welcomed all the participants connecting Questions to be collected and opening remarks online. Participants were encouraged to write in their name and organization name in the comments box and to type in thematically organized for questions in the comments box as the meeting is ongoing; in order to respond as is possible and limit interruptions to the responded to by respective technical presentations. teams

Update on Abdikadir Abdi, WHO Public Health Specialist (Survaillance) based in updated partners on the recent Measles Recommended Action points Measles outbreak in Kismayo. include: Outbreak- WHO Coordination meeting held between WHO and the MoH at state level to identify enhancements to the surveillance system • continue coordination meeting and sample collection identify as many cases as possible to understand the true situation on the ground. The meeting also with other partners discussed case management and cold chain system management as well as aspects of social mobilization and development • To conduct Measles Campaign of an intervention strategy with a costed response plan. including VIT A and Deworming components in . The WHO team visited the Kismayo General Hospital to assess: case management, laboratory capacity, and pediatric • Target population should be department capacity. The team found that the laboratory has 6 lab technicians, working on a daily basis. Further, the ELISA under five. and Bio-chemistry machines donated by WHO ( 2016) are available; but have never been used due to lack of capacity. It is • finalize costed plan and share also unclear whther the equipment is in working condition or not. A measles focal point has been identified; this person will with WHO/UNICEF and MoH. need training. • conduct proper micro-planning Kismayo General Hospital established isolation unit with bed capacity of 20 beds supported by ICRC. The cold chain hub is before the campaign. located in Kismayo General Hospital and supported by local NGO called HIRDA. There is no enough space for the main cold • To boost routine immunization chain including dry supplies store. There is a lack of measles vaccines supply at the moment. through outreach team ( Link to the presentation below: Replication Baidoa experience).

Somalia: Kismayo Measles Outbreak Update – 27-08-2020 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/kismayo_measles_outbreak_update.pdf

Somalia: Measles Outbreak Investigation Report – 27-08-2020 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/measles_outbreak_investigation_report.pdf

1/2 q: Was the measles campaign in last year conducted in Kismayo, if yes what was the coverage reached? a: Yes, the campaign was conducted in Nov 2019, and according to the post-monitoring campaign indicated 94% coverage.

q: What is the distribution of Measles cases by gender. a : 43% are female while 57% are male

q: What is the expected timeframe to have a measles testing capacity in place in Kismayo? a: WHO is planning to bring the measles LAB in Kismayo very soon in Kismayo hospital ELISA machine is available although we are not sure if it is fully functioning or not, therefore next week bio-medical engineer will come and test it, so if the machine has no any technical problem we will plan technical team to be trained and will start testing as much as possible.

q : What is the reason for Kismayo to be out of stock? a: The cold chain manager confirmed that due to COVID-19 flight restriction they did not get the quarter two-supply on time so they used their puffer stock during this time to arrive the supply. They have also sent some supplies to Dhobley since they did not get enough stock.

c: 14% immunisation is very and very depressing. But for context. The national average for full immunisation for children 12-23 months is at 11% (SHDS 2020)

WHO Covid-19 Dr Joan Karanja, Emergency Response Team Lead from WHO presented the COVID-19 update as of epidemiological week 34. Update The number of confirmed cases is declining with a CFR of 0.86%. Only 13 cases were reported across the country during this week. The number of samples collected for testing increased to ascertain the decline in cases, confirming that the number of cases tested positive is indeed declining. No deaths reported during the week 34. The decline of cases was witnessed from week 24. The overall number of people tested positive stands at 3269 cases out of 14, 786 samples collected. By state, Benadir reported the highest number of positive cases. reported 5 new cases, with 2.85% CFR. This shows a 91% decrease in number of cases reported. There are however, 33 districts termed as “silent Districts” because there has been no single case that has been reported from these districts. Rapid response teams (RRTs) were dispatched to 18 of the 33 Districts to collect samples for testing. Results from these tests will be analysed to check for any positive cases. Trends by state and regions indicate that the Benadir Region and Somaliland have the highest attack rate. The cumulative positivity rate by Districts indicate 2.82% CFR with a positivity rate of 20.21%.

Presentation: Somalia: COVID19 weekly update – 27-08-2020 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/covid19_weekly_update.pdf

q: Are there RRTs in these 33 Silent districts? a: RRTs were initially deployed to 18 of the 33 Districts and samples have already been collected from these 18 Districts. RRTs have also recently been deployed to the remaining Districts and samples will soon be received for analysis

q: When and where is the CoVID-19 sero-prevalence study plan?

2/2 a: The sero prevalence study proyocol is being finalised with MOH and Banadir University. The details will be shared in due course. q: Can we get scientific evidence why male COVID-19 cases are more than female? a: It could be related to access issues and health seeking behaviour or maybe the males come out more for testing than the females, but this has not yet been proven. There is also a similar observation in neighbouring countires. There is however a planned sero prevalence study by WHO, FMoH and Benadir University that will hopefully help to explain this observation.

q: Will the study data be disaggregated to capture IDPs a: Yes, it will be easier to target study groupd by location and this way data can be disaggregated by population groups and livelihood conditions

Rapid Dr Hala Sakr in charge of Violence, Injuries and Disabilities at the WHO Eastern and Meditterenean Region(EMRO) Presented The assessment questionnaire will Assessment of on the Assessment of COVID-19 Disability Inclusive Health Response in EMR countries-WHO EMRO. be shared with the partners through COVID-19 Global statistics indicate that 15% the world population consists of people living with disabilities. It is also predicted that this the Disabilities focal point. Disability percentage is likely to increase owing to an expected increase of environmental hazards like road traffick accidents and non- Inclusive Health communicable diseases that are likely to lead to disability. People living with disabilities have the same health needs as the Response in EMR general population as well as special needs like rehabilitation. On the other hand, people living with disabilities are likely to countries-WHO find healt care providers skills and facilities inadequate. They are 3 times more likely to be denied healthcare and four times EMRO more likely to be treated badly in the healthcare facilities. Covid-19 pandemic has been an eye opening experience showing inadequacies towards people living with disabilities in relation to healthcare. We realize that the bottlenecks are not related to lack of awareness but more to lack of attention to their needs. This realization has led to the workstream on Health response and recovery led by WHO and supported by other UN agencies and partners. WHO is therefore undertaking a rapid assessment of disability-inclusive COVID-19 health response. The aim of this assessment is to To better understand: the implications of COVID-19; the degree to which national responses are disability- inclusive and the continuity of rehabilitation services and assistive technology provision during the pandemic. The country expectations from WHO including tools and guidance will also be assessed. The results of the assessment would inform actions at the regional and country level to improve the situation in terms of inclusion in COVID-19 health response (and similar situations) as well as guide the development of WHO guidance for more disability inclusive health services in line with the Global disability action plan. Link to the presentation: Disability Inclusive during COVID19_Rapid Assessment – 27-08-2020 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/disability_inclusive_duri ng_covid19_rapid_assessment.pdf

3/2 HeRAMS Update An analysis of the HeRAMS survey on data contributors indicates that 34 partners have reposnded so far, covering about Partners were invited to re-fill the on Data 20% of Health Facilities. The HCF list so far is up to 1500 HCFs in the country, howerver, this may include duplicates due to data contributors survey incase Contributors spelling issues and CTCs that may not be running at the moment. The listing of health facilities was meant to capture as many there is any change in information health facilities as possible for the drop down in the tool. The distribution across the country indicates that 8 responded on health facilities through the link from Somaliland covering 26 of 400 HF in Somaliland . Puntland had 3 partners responding, who listed 10 health facilities out below: Partner HCF Support and of 60 HFs. Galmudug had 108 facilities listed from 18 partners. Hirshabele on the other hand had 45 % of Health facilities listed while SWS had 32%. Jubaland had one of the highest representation with 48 % as well as Benadir at 92% out of 200 Data Contributors' Survey link health facilities. Partners in Galmudug and Puntland are encouraged to include any more facilities to capture as many as https://ee.humanitarianresponse.info possible health facilities /JV9diP5m

Link to the map: Somalia: Reported HCFs Map – 27082020 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/reported_hcfs_map.pdf

Orientation session has been done before to partners. We are now at the point of collecting information as to wh is collecting data within organization. We will begin to run orientation sessions and we will extend information on how to manage the system. The individual will be matched with a workspace on which they will be reporting. Track services available for the atient and identifies what is not functioning at all and to why the services are not available. 90% of this is not included in tjis as it tracks what was rovided regardless of what services are available to the patient. c: How can a partner know if the registration was successful or not, and which partners were successfully registered and these are not registered? a: The cluster will respond to partners on individual level

q: What about if one facility is run by more than one IP and each is registering same facility in HeRAMs a: The facilities will be identified and the cluster wil reach out to those partners to reach a consensus as to who will be tasked with entering data as well as allowing the other partner to contribute

q: Difference between survey link and HeRAMS portal q: Can we know the partners who are registered as data contributors on HeRAMS a: The survey this is the link from the health cluster to collect data on partners interested on becoming data contributors. This helps the cluster team to know who will feed data into the system. These individual organizations will be contacted for the orientation session and next steps.

RFP’s Election Dayib, Health Cluster Co-coordinator, updated partners on the Regional Focal Points election process ongoing since July. The link for voting as well as voting Process Update The Health Cluster Team received expression of interests from partners and has shortlisted candidates according to the instructions will be shared with criteria shared earlier. The next step will commence in the coming week and a link to the voting portal will be shared with partners the partners. 5 out of 9 Regions will go under election process to include Banadir, Kismayo, Lower Juba Afmadow, Lower Shabellle, . There are regions ie. Bare, ,and Hiran that either had one partner who expressed interest or only one partner qualified based on the selection criteria. Voting will therefore not be done for these Regions. One () with no qualified applicant we are working to resolve it There Bakool, BARI AND Mudug Regions had either one applicant or only one partner shortlisted according to the criteria, hence will not go for elections. c: Partner concerns on the process will be addressed on a case by case basis

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q: Could you please share with the partners any reporting requirements? Reporthub or any reporting requirements. a: Reporting requirements will be shared

Somalia: RFPs election update – 27-08-2020 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/rfps_election_update.pdf

AoB: Evictions in Mogadishu: Partners urged to respond to the situation in Mogadishu There are IDP evictions in Mogadishu. The area affected is Weydow area, . Camps affected includes Daacad, Ciiltire and Suda. Reports indicate that: humanitarian facilities including water points (kiosks) and latrines were reportedly demolished in the process of eviction, affecting approximately 2000 people were evicted. The evicted IDPs resettled new sites where there are no basic services in place. These new sites are located between Kalama Showrto and Afarat, under Garasbaley. These newly evicted IDPs need immediate life-saving assistance are Shelter/NFIs and health services. Partner Updates from the chat: SAMA in collaboration with UNICEF/Global fund has distributed 63,790 Mosquito nets in Dinsor district of Bay region in order to reduce malaria diseases as well as SAMA has conducted Refresher Training on Community Educator and Health Workers from the MCHs in Bay region. SAMA is also planned to distribute mosquito net in Wajid and Hudur in September 2020. In addition in collaboration with UNFPA SAMA also has managed 2712 mother were provided ANC and PNC consultations and 69 mother were delivered out of 3 C-section were conducted in Bayhaaw Hospital in Baida as well as 28 GBV cases were managed in one-stop center within Bayhaaw hospital in Baidoa. The gaps and challenges are: shortage of Malaria supply and GBV supply (PEP kits) in Bay regions Somali Aid in partnership with Medair for the past month worked together to estabilish public hand washing facilities in Kudha,Kamboni and Burgabo for and For Kismayo Abdillabirolle in response to COVID-19 READO with the support of UNFPA, READO ensured PEP kits for GBV survivors are available in both Hudur and Dinsor districts and partners can refer patients to the hospitals in both districts.

Recording of the zoom meeting: https://who.zoom.us/rec/share/7Mx0M-jArjxIHJHwr0-AVbEuFaS4T6a8gyUWrvEEyE15V2E1KuFF3IvZHCdCR8gv Password: *xdT%W

58 Participants from: Aamin Org. AYUUB CWW HIJRA Mercy-USA SAMA STS WVI AAOF BADEF DFID IMC MSF Save the Children TASS Health Cluster ACF BTSC ECHO INTERSOS OSPAD SHO Trocaire Aflax charity. CARE GRT IOM PAC SLO UNICEF ARC CESVI HACDESA Islamic Relief READO Somali Aid WHO ARD CoDHNet HDC Medair SAF UK SOS WRRS

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