NAME DESIGNATION ORGANIZATION PHONE NO E-MAIL 1 Dr

ADAMAWA STATE HEALTH SECTOR WORKING GROUP

VENUE: Ministry of Health Conference Hall, State Secretariat Yola. DATE: 6th of February, 2018

ATTENDANCE NAME DESIGNATION ORGANIZATION PHONE NO E-MAIL 1 Dr. Fatima Abubakar HCH SMOH 08178663638 [email protected] 2 Dr. Adiel Apagu HEC/PHO WHO 08066828347 [email protected]

3 Hussaini Hamman WASH OFFICER NRCS 08069115167 [email protected]

4 Jeremiah Thomas Asst prog officer BMG 08100966910 [email protected]

5 Zirra Mathias B LMCU COOED SMOH 08060231187 [email protected]

6 Amos Daniel Member Kinjir Foundation 07084809418 [email protected]

7 Ruth Bitrus Prog. officer AHI 08032845149 [email protected]

8 Raihana Bello Furo Intern AHI 08038236541 [email protected]

9 Esther Helda I NUTRITION OFFICER IRC 08039707848 [email protected]

10 Nympha A Dubo Fin sec AGUF 08165437446 [email protected]

11 Dennis Z Kwagga CHEO SMOH 07033066059 [email protected]

12 Gbenga Obanewo Prog consultant AHI 08066886600 [email protected]

13 David Birdling P OFFICER SMOH 08067803620 [email protected]

14 Yakubu Titus M&E OFFICER LESGO 08063267680 [email protected]

15 Tobi Osunkentan Nutrition cons UNICEF 08067418765 [email protected]

16 Ayuba Reuben HMIS Officer SMOH 08039658241 [email protected]

17 Ashiru Lawan M&E Officer CPPLI 07036423686 [email protected]

18 Fanta Sulaiman N.D.Officer SMOH 08036120589 [email protected]

19 William kogi CCHO SMOH 08022340626

20 Damba D. Kwinke CNO SMOH 08082763709 [email protected]

21 Oluwafemi E. Ooju IMO WHO 08034412280 [email protected]

22 Dr. Olatunde Olotu PHO WHO 08036054579 [email protected]

23 Moseray Sesay HSO OCHA 07031718734 [email protected]

24 Emmanuel Usiju Haman EO ECF 07034661323 [email protected]

25 Abubakar Mohammed I O SMOH 07036677314 [email protected]

26 Hungopwa B. Yuniyus SHN SMOH 08034639038

27 Abana Abubakar M&E CRI Yola 08055085832 [email protected]

28 Lazarus Gideon DMIC SMOH 07033350017 [email protected]

29 Nuhu Yahaya MOHH/EDU SMOH 08056187059 [email protected]

Queen I. Bem Team Leader First step Action for 08036741770 [email protected] 30 children initiative

31 Eneh Pius C.M SARO NEMA 08061276693 [email protected]

32 Zubaida Bukar FP NEMA 08039641112 [email protected]

33 James Peter ujulu P.O SPRING OF HOPE 08130714242 [email protected]

34 Ibrahim Yerim Prog officer ROHI 08136742371 [email protected]

35 Tobi Matin PM 1 Bege House 08032806579 [email protected] Foundation 36 Hopson Haruna Accountant Bege House 07033118640 [email protected] Foundation 37 Saleh Kinjir Founder Kinjir Foundation 08036080099 [email protected]

38 Nancy Durkwa CS SMOH 07066102049 [email protected]

39 Daniel Seth Prog. officer DOBIYAN W.Y.E.I 08031176029 [email protected]

40 Salamatu Abdullahi FO ADPWDVSI 08063898924 [email protected]

41 Anas Mohammed Bala Asst M&E Officer DCEHI 07034470929 [email protected]

42 Kambajaya James Waida M&E Officer WYEAHI 08036049553 [email protected]

43 Sunday Andrew ACPO SMOH 07055563676 [email protected]

44 Farah James Coordinator NEPWHAN 08035989924 [email protected]

45 Ahmed Abdulbagi Secretary GEESI 07067162161 [email protected]

46 Adamu Usman DOH SMOH 08032072577

47 Kindiyo Karniyus SECRETARIAT HSWG SMOH 07063895586 [email protected]

ABSENT WITH APOLOGY

 UNFPA  VSF

ABSENT WITHOUT APOLOGY

 ADSEMA  ICRC  IOM  ADPHCDA  DOBIYAN  FMCY  IFRC  FHI360  PHS  SSHY  ADSPC  SMS  SFH

AGENDA  Opening prayers  Adoption of the meeting agenda  Introduction  Welcome address by the Chairman  Reading, correction and adoption of the minutes of last meeting  Matters arising from the minutes of the last meeting  Deliberations  Sector updates  AOB  Closing Remark

HIGHLIGHTS

 The meeting was chaired by SMOH (Hon. Com) and co-chaired by WHO

ACTION POINTS

 WHO to contact IOM on the emergency displacement data from Numan and Demsa LGAs following the Framers/Herders clash and to follow up with NRC/ ADSEMA who are expecting information on displacement from executives of the LGAs.  The secretariat to write to the DSS as suggested by NEMA to get regular security briefings for the sector  The SMOH as a matter of urgency to quickly wade into the shady practices of charging patients for HIV test after deliberately frustrating the utilization of free test kits from FHI360.  The Hon. Commissioner has recommended the expulsion from the state and to notify planning commission on non-compliance of submission of work plan and Budgeting by organizations who are yet to do that. A grace of another week was given by the Hon. Commissioner of Health.  WHO/ Secretariat to share the work plan and budget template to all partners for strict compliance as a matter of urgency.  WHO to share the mail concerning the GMS and NHF funding as requested by OCHA  The Hon. Commissioner of Health will meet next week in a tripartite arrangement with the SMOH, ADSEMA and VSF to fine tune a more transparent arrangement of supporting the referral services by VSF.

 The Hon. Commissioner of Health to resubmit the request to the orthopedic surgeon on the list of 5 amputees for measurement, as against the earlier line of communication which the doctor gave quotation of the cost for the 3D prosthesis.

ISSUES ACTION RESPONSIBLE POINTS PERSON

1. Opening prayers Individual prayers based on faith

2. Introduction All

i. Welcome address by Hon. Com of Health SMOH She thanked all for the meeting and requested sustained commitment to the sector. She highlighted the outbreak of Lassa fever and other diseases and requested for enhanced reporting from all. She also commended the planning for the repatriation of refugees from Cameroon.

3. Matters arising from the minutes of the last meeting ii. Submission of individual partner’s work plan and budgeting for the 2018 humanitarian response has

been postponed to next Friday for the remaining partners to comply; The Hon. Commissioner was very upset with organizations who have not submitted their work plan for the year. She has recommended expulsion from the state and to notify planning commission on non-compliance. A grace of another week was given by the Hon. Commissioner. iii. Partners who are participating in the repatriation planning for refugees from Cameroon should quickly

pursue for commodities and preposition before the exercise commences; UNICEF, WHO, ADPHCDA have some level of prepositioned commodities for the exercise. NEMA presently has a mobile clinic and are expecting an ambulance from Abuja. JHF also have some prepositioned commodities and will notify the HSWG in the next meeting. So most of the issues with the organizations are administrative.

iv. WHO to share the itinerary for the joint supervision and monitoring of partner’s activities based on the 5Ws; This has been done by WHO v. Secretariat to remind the Hon. Commissioner on the issue of engaging VSF concerning referral services for IDPs; the HON. Commissioner met the executive director of VSF. A tripartite arrangement with the SMOH, ADSEMA and VSF has been scheduled for next week to discuss this particular matter. vi. Preparedness and response plan for CSM to be shared to all partners by WHO; This has been done by WHO. vii. Secretariat were again asked to follow up with the Hon. Commissioner and ADSEMA on the issue of 5 amputees for the 3D prosthesis as requested from the office of the vice president; list was compiled by SMOH and ADSEMA and sent to the orthopedic surgeon who mistakenly gave the quotation for the 3D prosthesis instead of the measurements. viii. Partners in the HSWG are encouraged to be attending the all partners weekly meeting for the repatriation of refugees from Cameroon in the PCNI office every Tuesday by 2;00 pm; This has been conveyed

 DELIBERATIONS

1. UPDATES ON THE REPATRIATION OF REFUGEES FROM CAMEROON

Due to the disconnect between the Abuja level and the State level, the state is finding it difficult to adjust so as to meet up with the datelines. Also the statistics of the of the refugees to be repatriated is yet to be received as this will enhance planning. timelines have been postponed due to these reasons. The simulation exercise is now going to be on the 15 of February and the repatriation exercise to commence on the 8th of March. HSWG has started prepositioning commodities via partners who signified interest to participate in the response.

2. BRIEFING ON THE MODIFIED 5WS FOR 2018 HUMANITARIAN RESPONSE

The modified 5Ws template for the 2018 response was projected to the partners in the HSWG for step by step way of populating it by Mr. Femi from WHO. Guidelines on how to use the new version of the 5Ws was also shared to all partners. The current version will be used with effect from January this year.

3. EPIDEMIOLOGICAL UPDATES ON SUSPECTED CASES OF DISEASES

. Trend of AFP on the rise because of improved detection following introduction of Audio Visual AFP Detection and Reporting (AVADAR) a community based electronic reporting system. . 3 cases of suspected meningitis have been so far reported as compared to no case by same period of 2018. . 1 suspected case of Lassa Fever was reported by FMC Yola as against no case reported in same period of 2017. Case was investigated but negative. . Despite measles campaign in late 2017, 56 cases of measles with a case fatality of 5% have been reported in 2018. Although slightly lower than what was reported in 2017, the pattern is similar. 10 LGAs have so far reported suspected cases. 5 of the LGAs (Fufore, Gombi, Jada, Yola North, Yola South) have already crossed the outbreak threshold. . Yellow fever reporting is still very low in the State despite the many diseases that can present with fever and jaundice . 71 suspected cases of whooping cough were reported in Mubi North LGA in January. Investigation revealed immunity gaps in communities once ravaged by the insurgency.

4. GMS TRAINING

 Emphasis was on the importance of the GMS and NHF trainings as easier ways of getting funding for the execution of projects by the local NGOs as compared to the OPS. So partners were encouraged to always key into these kind of opportunities.  The previously shared mail was an online training for organizations that have already passed the NHF Eligibility Assessments and wish to train additional staff in GMS access, as well as new organizations wanting to start the NHF Eligibility Assessments. The training package (distribution on 02/02/18) consists of documents and videos for self-directed learning, followed by FAQ’s sessions between 05-09 February 2018 that can be attended via WebEx, or in-person at the NHF office  OCHA said in the next 2 weeks a trench of NHF will be rolled out to the NE states to address pressing issues.  AGUF and FIRSTSTEP complained to OCHA that they were yet to get response from the NHF office as they are stocked at the certification for the due diligence.

5. FARMERS-HERDSMEN CLASH AND THE HSWG RESPONSE PLAN

 WHO suggested that an initial assessment should be done to know the needs of the displaced communities in Numan and Demsa LGA who have experienced clashes in recent times.  FISRTSTEP/AGUF/NRC brought up the recent clash in Song LGA with displacement of individuals in schools and communities.  OCHA felt more displacement records should be explored and will support an initial assessment moving forward.  The HSWG resolved that WHO be mandated to get the facts and get back to the sector in the next meeting

4. REPORTS FROM IMPLEMENTING PARTNERS AND AGENCIES FOR THE MONTH OF JANUARY. UNICEF UNICEF NUTRITION UPDATE Planning Meeting for Joint Monitoring and Supportive Supervision of MNP programme; a planning meeting comprising 21 monitors from FMOH, NPHCDA and APHCDA, was conducted on 27th January to ensure quality of the process prior the exercise slated for 29th January till 3rd February.  MUAC Screening; Within the reporting period, a total of 1658 children 6-59 months were screened across the camps of which 1573 were green (Normal), 66 were yellow (MAM) and 19 were red (SAM). All the 19 children identified with severe acute malnutrition were admitted into CMAM programme.

 CMAM Programme; Of the 22 discharges across the camps within the reporting period, 18 children were cured, 2 deaths, 0 defaulter and 2 non-recovered.

 Infant and Young Child Feeding (IYCF); Within the reporting period, 678 pregnant and lactating women were counselled on key IYCF messages. Micronutrient Powder (MNP) Healthy children 6-23 months in the camps with either a green or yellow MUAC reading and eligible for micronutrient powder (MNP) were given MNP with accompanying counselling on appropriate usage, benefits and optimal dietary intake. A total number of 311 children 6-23 months were enrolled in MNP programme of which 211 received the 1st dose while 100 returned for 2nd dose.

UNICEF HEALTH;

Coordination meetings

 UNICEF continued to support Health sector humanitarian working group meeting and the monthly camp coordination meetings. These meetings help brought key Partners together to discuss implementation and

coordination of humanitarian health interventions in the State and at the IDP Camps  UNICEF participated in planning meetings for the pilot repatriation of 4,650 Refugees from Cameroon back to Adamawa through Sahuda border commencing 1st week in February 2018.

Service delivery

 UNICEF provided logistic support for delivery of integrated PHC services by IDP camp clinics, host community clinic and outreach medical Teams -in hard to reach and health facility catchment host communities. A total of 22,367 men, women and children were reached with integrated PHC in all the

UNICEF supported health facilities in the IDP camps and host communities. A total of 11,618 consultations were reported with o Malaria – 1,741 o ARI – 6,939 o AWD – 634 and

o Other medical conditions – 2,304

Out of 10,749 preventive medical services recorded during the reporting period,  356 children 6months-15 years were vaccinated against measles  3,396 children and pregnant women were reached with various other antigens.

 Vitamin A supplementation – 2,294  Albendazole for deworming – 3,966  ANC visits 568 out of which 27 LLIN were given.  83 deliveries and  86 Post Natal Care were recorded during the reporting period

Mobile medical outreach service at Muchala, Duwa Thilbang ward Hong LGA

Supplies in emergencies

 Victims of the attack by suspected Herds Men in 2 villages (Kikon and Dowaya) of Numan LGA - 15 females and 7 males (22) received treatment at the Numan General Hospital with support of UNICEF drugs and other

consumables in stock from the earlier Numan/Demsa crisis - (1 carton of IV Ceftriaxone 1 carton of 2014 NHK (1/2), 2 cartons of 2014 NHK (2/2), 3 cartons of IVF Normal Saline and 5 cartons of IV Metronidazole).

 Fifteen (15) Persons (11male, 4 female) with varying degree of injury from attack in Imirisa settlement Gulak ward, Madagali are receiving treatment at Gulak Cottage Hospital, Madagali LGA. UNICEF provided support of

NHK 1 carton of 1/2 and 2/2 and 1 carton of Ceftriaxone through the Executive Secretary Madagali LGA PHC Department to support management of the Victims.

iCCM CORPs Activities  iCCM CORPS ward Supervisors zonal review meeting for quarter 4 held in the 3 zones in the State. This

meeting reviewed ward supervision observations and feedback and other ICCM CORP activities implementation challenges and discussed way forward. 400 ICCM CORPS Ward Supervisors and 24 LGA Team Members were in attendance

Refresher training on integrated PHC to IDP Camp Clinic Health workers

 UNICEF is supporting refresher training of 30 Health workers from the IDP Camp clinics. The first batch of Participants training is currently being on-going. The training is expected to update the Health care workers and improve their knowledge and skills on management of Patients and referral.

January 2018 SNIDS  UNICEF provided logistics and technical support in monitoring and supervision of polio vaccination in the State.

UNICEF-NUTRITION

Latest Activity: Planning Meeting for Repatriation of Adamawa Refugees from Cameroon; As a way of ensuring adequate preparedness of LGA level stakeholders for the planned Nutrition response for repatriation of Adamawa Refugees from Cameroon, a planning meeting was organized on 9th January with Executive Secretaries and Nutrition

Focal Persons from 21 LGAs of State, including those from Mubi North, Mubi South, Michika, Madagali, Maiha, Hong and Gombi.

Highlight of the meeting was to plan and strategize on the nature of nutrition response that will be accorded to the returnees upon arrival at Mubi transit camp, based on the available information. Key nutrition services discussed include MUAC screening, linkage of SAM children with OTP sites in host communities, MNP distribution and IYCF counselling. Human resources and logistics of commodities and supplies needed to facilitate response were also discussed.

Routine Services

Routine services conducted by IDP camps in the reporting month include MUAC screening, CMAM, IYCF and MNP. MUAC Screening Within the reporting period, a total of 891 children 6-59 months were screened of which 848 were green (Normal), 34 were yellow (MAM) and 9 were red (SAM). All the 9 children identified with severe acute WHO malnutrition were admitted into CMAM programme. CMAM Programme Of the 12 discharges across the camps within the reporting period, 11 children were cured, 0 death, 0 defaulter and 1 non-recovered. Therefore, cured rate was 91.7%, defaulters rate was 0%, death rate was 0% and non-recovery rate was 8.3%.

Infant and Young Child Feeding (IYCF) Within the reporting period, 237 pregnant and lactating women were counselled on key IYCF messages. Micronutrient Powder (MNP) Healthy children 6-23 months in the camps with either a green or yellow MUAC reading and eligible for micronutrient powder (MNP) were given MNP with accompanying counselling on appropriate usage, benefits

and optimal dietary intake. A total number of 175 children 6-23 months were enrolled in MNP program of which 114 received the 1st dose while 61 returned for 2nd dose.

WHO  Supporting the joint health sector planning for the repatriation of refugees from Cameroon; have held 4

meetings so far.  Supporting the government to develop a response plan for 2018 based on the HRP. This will also guide partners who also have been encouraged to share their individual work plan and budget for 2018.  Working with OCHA to facilitate partners to go into cash interventions in the health sector

 Working with the authorities of UNHCR in Cameroon to ensure a well-coordinated repatriation exercise.  Surveillance focal sites were reviewed upwards to 207. This is made up of 200 public health facilities and 7

private health facilities.  Capacity Building  65 Participants were trained on IDSR at the State level from 11- 15th January, 2017.  On the 29th January, 2018, 19 doctors, 46 nurses and 18 laboratory scientists the secondary health facilities, private clinics, and clinics of tertiary institutions were trained on CSM and Lassa Fever WHO  On the 30th – 31s January, 2018, 73 nurses and 24 paramedical staff from FMC Yola were sensitized/trained on CSM and Lassa Fever.  Outbreak Investigations; 4 suspected outbreaks have been investigated. These include the outbreak of pertussis in Mubi North LGA which affected 71 persons, the outbreak of measles in Fufore and Gombi LGAs with 20 persons and 2 deaths and the suspected outbreak of Lassa Fever in Yola North LGA, where sample has been taken and result is still pending.  About 7,496 clients were seen by the WHO supported 10 H2R teams in 10 LGAs of Adamawa state. A total of 2,208 children were dewormed by the teams during the period. Pregnant women were also attended to, with 546 of them receiving Iron folate to prevent anemia in pregnancy, while 449 received Sulphadoxine Pyrimethamine as IPTp for prevention of malaria in Pregnancy.  Nutrition; About 4,014 children were screened for Malnutrition using MUAC strap by the H2R teams. Out of this number, 9 children had MAM, while 6 of them had SAM as demonstrated by Red on MUAC. Stabilization Care; The 3 WHO Supported stabilization centers in the state managed a total of 20 children having SAM with medical complications in December 2018. Thirteen (65%) of the patients recovered during the month and were discharged to the OTP centers for follow up care.

IRC IRC-CMAM program.  Within the 4 program supported LGAs of Adamawa state (Hong, Maiha, Michika and Mubi South). IRC Nutrition has been providing nutrition CMAM support to 31 operational OTP and SC clinics. In this month of January, the statistical figure indicates that: 27,231 U5 children were anthropometrically screened using MUAC measurement and Edema checking, among which 1,533 were identified as MAM and 329 as SAM IRC  All identified SAM children have been enrolled into the program and are currently receiving both therapeutic and pharmaceuticals rehabilitation. 2,297 SAM children have been receiving treatment in the OTP/SC, exit

has been carried out to some of these client in the program clinics with 122 children being discharge as cured and 12 defaulters.

 IRC- IYCF Program; The activity conducted in the various supported communities of where sensitization on Infant and Young Child Feeding best practice (IYCF) which include the role and contribution of early initiation of breast milk, good breast feeding attachment, frequency of breastfeeding, exclusive breast feeding in the first six months, good hygiene practices and many others. on these activities, a total number of 3,808 Lactating mothers, 2,236 pregnant mothers, 693 old women, 841 young girls and 869 men beneficiaries were reach.

AGUF AGUF AGUF was in Malkohi camp on the12/01/ 2018 for sensitization on personal hygiene. We found out there were 10 cases of diarrhea and 4 cases of malnutrition on admission. The camp clinic has no HIV test kits. We made referral to nutrition sector concerning the cases of malnutrition. On 26/01/2018 AGUF went to Kasuwan katako wuro jebbe to educate IDPs in host community on personal hygiene 77 people were reached.

IFRC/NRC Operational areas Gombi LGA, Guyaku and Dzangula Primary Health Care Centres and Gombi C Primary Health care centre Hong LGA, Garaha, Kwarhi, Kuva Gaya, Pella and Daksri Primary Health Care Centres and Hong General Hospital IFRC/NRC

Achievements Rehabilitation of Health facilities - Renovation of 2 staff houses completed at Dzangula Health facility in Gombi and have been re- occupied by the staff AGUF - Renovation of Kuva Gaya Health facility in Hong LGA is almost complete with maintenance of drainage system remaining. The renovation work includes replacement of the ceiling, iron sheets, maintained of drainage system and painting of the whole building. There is a plan to renovate the staff quarters as well - Renovation at Kwarhi Health facility in Hong is also at its final stage. The roofing and ceiling has been replaced. The building drainage system will also be renovated and then painting of the whole building.

A total of 7 new solar driven refrigerators have been installed in Gombi and Hong LGA to improve the vaccination coverage in the area. This came about to address the issue of poor access to Health services. Most health facilities could drive over 20 kilometres to get vaccines for outreach clinics The Solar vaccines have been installed in the following Health facilities: - Gombi LGA; Guyaku, Dzangula and Gombi C PHC - Hong LGA; Kwarhi, Pella Women, Kuva Gaya, Garaha PHC The refrigerators are now functional in all these Health facilities Nutrition training This training was done on 6th to 8th December at Duragi Hotel. A total of 52 people were trained. These

trainers are supporting a total of 17 mother groups in Gombi and Hong LGAs. The team will be involved in mother group activities of teaching mothers on good feeding practices and referral of malnourished children to Health facilities.

DOBIYAN;

 Dobiyan Women and Youth Empowerment Initiative, organized a ‘SAY NO TO DRUGS CAMPAIGN’ in Madagali LGA from December 18, 2017 to January 20 2018, with activities ranging from Advocacy Visit, Rally, Lecture on Drug Abuse and was rounded up with a Football Tournament to end extremist activities. 1500 youths were reached in Vizik and Gulak.

AOB:  SMOH; Director laboratory services met with the head of FHI 360 concerning charges for the HIV testing and found out that the SSHY laboratory scientist were not sincere. They frustrate the efforts deliberately and leave the supplied kits intact without making use of them and that has to stop supplies and allowed them to  OCHA; the local launching for the HRP will be in Abuja on the 8th of February.

 NRC; NRC in conjunction with IFRC will be carrying out a step down training on malnutrition in Gombi and Hong in the coming week. They are currently in Abuja for the TOT.  NEMA; suggested that the HSWG should partner with the DSS to be getting regular security briefings that will enhance service delivery and the protection of sector members.  SMOH; Hon. Commissioner reported a successful outreach services where over 100 general surgeries were one in Mubi North. This was the initiative of the PCNI in conjunction with ProHealth International.  WHO; has reached out to NCDC for response kits for CSM and deliveries are being expected. IPC kits are being expected from the Borno State WHE to the state to enhance disease prevention.

Closing Remark

The Hon. Com. Of Health emphasized the need for information sharing and really warned that sanctions will be placed on any defaulter.