CGP-GHS , Somalia as of Q4—Week 3 Project Implementation (03/07/2020– 20/07/2020)

POLIO UPDATES GHSA UPDATES KENYA SOMALIA GHSA Key updates HIGHLIGHTS • National Non-polio AFP rate and stool ade- • A total of 202 AFP cases ( 92 Females & 110Males) have been reported in • A total of 17 new animal alerts received quacy for 2020 are 1.51 and 85% respec- 2020. Of these 176 (87%) have lab result and 26 (15%) cases are in the this week with 9 Cluster of abortions or deaths of young animals, 4 aggressive ani- tively. The -Non polio Enterovirus (NPENT) lab for processing. Of the cases with lab results, five cases had SL isola- mal bite, 3 cluster of animal deaths, and 1 isolation rate is 9.6% tion, one cases positive for cVDPV1 and 1670cases were negative. progressive lose of weight • - One hundred and fifty six (156) suspected • Of the 350 stool samples from 175 cases with lab results in 2020, 59 • Cumulatively, over the reporting period AFP cases have been reported in 2020 from (17%) samples have EV isolation. (01/04 to 20/07/2020), aggressive animal 40 (85%) counties. bites leads with 38 alerts with Turkana • A total of 44 ES samples were collected and sent to the lab in 2020. County still leading with 23 alerts.

Twenty (20) samples are negative, Two (2) SL, four (4) NPEV and Eleven • 12 new human diseases alerts reported (11) cVDPV2. Four (4) ES samples are in the lab for processing. this week: 4 acute watery diarrhea cases. 3 cluster of unusual illnesses or death of peo- ple and 3 hotness of the body and rash cas- es and 2 sudden paralysis • 294 zero reports as well 6 rumor reports received from the community volunteers this week. N/B: Zero reports means community volun- teers are active but no alerts picked. Rumor reporting is the hearsay reporting of unconfirmed diseases conditions in the commu- nity by community volunteers/community members. Source: WHO Kenya week 28 2020. Source: WHO Somalia week 28 Community Based Disease Surveillance

AFP Active case search by Country (03/07/2020 – 20/07/2020) County Region # HH visited # Suspected AFP

KENYA 98 0 537 0 381 2 Marsabit 517 0 2342 0 Turkana 3941 0 147 1 SOMALIA Bakool 50 0 Gedo 6310 0 Lower Juba 937 0 Total 15260 3

County Acute Cluster of Sudden Death of a Fever, Hotness Watery unusual paralysis child btw 3-28 cough and of the Diarrhoea illness or days of age breathing body deaths of with un- problem and people known cause rash

TURKANA 1 1 0 2 0 1

MARSABIT 8 0 0 1 6 6 MANDERA 3 0 2 0 0 0

WAJIR 3 0 1 2 2 1 GARISSA 0 0 0 0 0 2

LAMU 0 0 0 0 0 0

KAMKUNJI 43 22 0 3 7 10

LOWER JUBA 8 0 0 0 0 0

TOTAL 66 23 3 8 14 20 Strengthening of immunization systems: Outreach services to hard to reach border, nomadic pastoralist. (03/07/20 - 20/07/2020)

County/Region Zero Dose Birth Dose OPV 3 IPV Penta 1 Penta 3 Measles

Outreach Outreach Static Outreach Static Outreach Static Outreach Static Outreach Static Outreach Static

KENYA Garissa 4 8 68 13 120 12 140 9 116 16 120 119 232 Lamu 5 4 20 3 13 3 13 0 8 0 6 4 11 Mandera 32 43 77 71 135 75 166 84 151 56 143 73 119 Marsabit 31 37 47 42 93 42 88 40 87 32 88 62 123 Nairobi (Kamukunji) 0 0 26 0 34 0 39 4 30 2 34 6 59 Turkana 0 0 34 0 37 2 45 6 77 4 46 9 39 Wajir 7 27 66 45 98 42 76 53 108 39 99 52 105 SOMALIA Bakool 0 0 0 0 0 0 0 0 0 0 0 0 0 Gedo 0 0 208 0 676 0 659 0 670 0 696 0 648 Lower Juba 0 0 37 0 38 0 36 0 29 0 41 0 40 Total 79 119 583 174 0 176 1262 196 1276 149 1273 325 1376 Source: CGPP program data

Total outreach sessions conducted/supported = 37 Total # of children Defaulted =635 Total # of children traced= 413 (65%) Social Mobilization Activities

• Social mobilizations is to sensitize communities on the importance of personal hygiene, regu- Summary- Social Mobilization Activities lar handwashing, physical distancing and wearing of masks (especially in this period of SOMALIA: COVID-19) in disease prevention at community level. Also community mobilizers & Commu- nity Disease Reporters (CMs/CDRs) are looking for suspected AFP & Zoonotic cases us- • # of times HH visited in Somalia = 6,764 ing simplified lay case definitions to identify suspected AFP cases and other disease condi- • # of persons reached through group meetings = 1,219 tions ( e.g. measles, Acute Watery Diarrohea—AWDs). This is done through one to one KENYA: meeting at household level or group meeting organized at the community level. The commu- • # of times HH visited in Somalia = 9,693 nity mobilizers are required to generate reports to the project supervisors and also CHAs or border health facility in-charges. • # of persons reached through group meetings = 4,211 • The CMs engage in community mobilization for RI services especially during outreach clinic sessions and in RI defaulter tracing. Community Based Disease Surveillance on Priority Zoonotic Diseases.

Rumour and Zero Reports as from 01/04/2020-20/07/2020

County/Region Rumour Zero KENYA Garissa 0 103 Lamu 4 153 Mandera 1 81 Marsabit 9 110 Nairobi 49 136 Turkana 2 2056 Wajir 13 516 SOMALIA Gedo 1 0 Lower_Juba 0 37 Total 79 3192

County Cluster Deaths Abortion in Aggressive Cluster of Progressive Animal with late pregnan- animal abortions or loss of Deaths unusual cy; retained bite deaths of weight bleeding placenta; young ani- swelling of mals testicles

Turkana 6 0 0 25 11 17

Marsabit 2 0 1 5 4 1

Mandera 8 1 0 0 3 3

Rumour Alerts Reported by the Community Volunteers: Wajir 3 1 1 5 17 15

• The virus is for rich people. Garissa 1 1 0 2 2 1

• Corona virus is a disease for adults only. Lamu 0 0 0 0 0 0

• Those who are HIV positive , if tested for corona virus it detects positive. Nairobi 1 0 0 5 0 0

Total 21 3 2 42 37 37 COORDINATION MEETINGS (13/07/2020 - 20/7/2020)

Participants venue Type of Meeting Date Objective # Male s # Females Marsabit (Mansile) Community dialogue 2020-07-17 1. To provide Information awareness creation on Rift Val- 10 5 ley Fever, COVID 19 and AFP Marsabit (Anona) Community dialogue 2020-07-18 1. To provide AFP & RI awareness 12 4

Kamkunji Social hall (Kamkunji) Community dialogue 2020-07-16 1. To Identify challenges to immunisation during COVID- 7 12 19 pandemic.

TRAINING (13/07/2020 - 20/7/2020) County / Venue Date Title Objective Participants CHVs CDR HCW # Males # Females # Males # Females # Males # Females Wajir (Biyamathow) 2020-07-15 On job training for facility in charges 1. To capacity build the facility in charges 2 0 0 0 2 0 and community mobilizers and CMs on CGPP reporting tools

Garissa (Nomads) 2020-07-15 Refresher Training for CDRs/CMs 1. Train CM/CDRs on to use the reporting 8 1 8 1 0 0 AHAs and SCDC. tools. 2. Familiarise our partners and build synergy 3. Address on reporting gaps noticed

Nairobi (Kamukunji 2020-07-17 Defaulter tracing during COVID-19 1. To train CHVs 5 12 0 0 0 0 social hall) pandemic SUPPORT SUPERVISION (13/07/2020 - 20/7/2020) Sub County Type of supervision Date (Period) Key findings Key Recommendations Districts # District # Facilities Marsabit Integrated (MoH , 20/07/2020 - Most facility in charges have not been trained on EPI. - To always update their vaccine ledger 1 8 Vets & CGPP IP) - Surveillance posters were displayed in all of the dispensaries. books because with that they can keep () - Most of the health facilities had their immunization monitoring track of their balances charts updated. - Most fridges temperatures were within range 2 to 8 degrees - Most ledger books were not updated

Turkana Integrated (MoH , 20/07/2020 - Availability of isolation centres, screening point and 3 quarantine - To strengthen surveillance of COVID 1 6 Vets & CGPP IP) 19 and other notifiable diseases focus- (Turkana facilities ing on AFP in the sub county. West) - All facilities border facilities had Surveillance structures and were - Ensure routine service are continuing at the midst of COVID 19 offering Immunization services except new facility in border OTHER DISEASE OUTBREAK SITUATION

Kenya Somalia

COVID-19 OUTBREAK COVID-19 OUTBREAK A total of 13,353 confirmed cases with 234 deaths (CFR 1.8%) since March Confirmed cases= 3,111. 2020 with 5,122 case recoveries and majority of cases are local transmission Male cases: 2276 (93%). Female cases: 835 Male cases: 8,929 Death = 93 (fatality rate = 2.99%). Female cases: 4,424 Recoveries & discharges = 1,410 A total of 238,920 covid-19 tests have been conducted. All 6 states and capital territory (Banadir region) affected.

Counties supported by CGPP Confirmed cases.

Nairobi 7744 Regions supported by CGPP Confirmed cases. Mandera 20 Lower Juba 162 Wajir 19 Gedo 34 Bakool 8 Garissa 36 Turkana 22 Source: WHO Somalia Marsabit 6 Lamu 24

Source: MoH Kenya

PICTURE SPEAK (ACTIVITIES CONDUCTED DURING THE WEEK)

Right: On Job Training dur- ing support integrated field support supervision at Biyamadhow health facility. Photo credit: Hujale -WVK

CHVs covid-19 field training in Kamkunji . Photo credit Moses -CRS

CGPP Deputy Director , Somane during the just concluded Refresher Training for CDR's/CM's AHA's and SCDC in . Photo credit: Hassan – ARC Integrated Support Supervision in Moyale. Photo credit Jenipher-CRS KEY ACTIVITIES OF THE WEEK CHALLENGES • GHSA Team check-in meeting,. Agenda: Updates on how CBS is going, Updates on the status of Priority Zoonotic Disease risk • Poor network connectivity in some parts

communication materials Discussion on FY21 work planning. of the project areas affecting smooth com-

• USAID Mission & Secretariat GHSA monthly meeting. The meeting reviewed the GHSA quarterly calendar of activities, imple- munication. mentation progress, challenges and lessons learned. Progress on Integration of COVID-19 was also discussed. • Kenya Somali border closure by the Gov- • Communities in were provided with information and awareness creation on Rift Valley Fever, AFP (Acute ernment of Kenya affecting movement of Flaccid Paralysis), COVID-19, and Routine Immunization awareness during 2 different community dialogue sessions. people • Community dialogue also held in to identify the challenges faced for immunization during the COVID-19 pan-

demic on 16th July with 19 people reached. • Government lockdown in CGPP counties

• Joint support supervision is ongoing with the presence of Ministry of Health counterparts, Department of Veterinary Services (Nairobi and Mandera).

as well as IPs in both Marsabit and Turkana. • Inter clan clashes in Marsabit county

• Participate in covid-19 screening and sensitization of the communities on sign and symptoms as well as preventive measures in affecting planned activities.

the project areas. • Disruption of planned activities as a result • Active case search (AFP, other Priority conditions & Zoonotic Priority disease). of the Covid-19 pandemic e.g. Care Group • Community Mobilizers/Community Health Volunteers active participation in tracing children who have defaulted in Immuniza- Model. tion in the project areas.