Shanmugam Subramanian’s Updates

Week 1 Community Assessment

Part 1. Data analysis

Task 1. Flag all the suspicious values. (Outliers, repetitions, etc.) (spend max 15 minutes)

Week_201_20Community_20Assignment.docx

Task 2. Review the national and subnational coverage for MR1. Your data manager produces the following tables. What can you conclude from the administrative data?

  • From the year 2011 onwards, the National MR1 coverage is maintained above 90%
  • The surviving infants gradually decreased since 2015. But seeing the data since 2011 to 2015 it shown increasing trend

  • Subnational like Nemo, Chell & Westtan MR1 Coverage is consistently below national average 90%

  • Subnatational like Alu, Grandtan & Remo the MR1 Coverage is consistently showing more than 100%

  • Over all the national vaccination average is 91% meeting the national standards

  • Most of the data is seem some errors and not updated or over reporting.

Task 3. Review coverage evaluation survey data. You remember that in 2013, there was a coverage evaluation survey. You pull up the data for that. Does this change your view about coverage at national level? For any of the regions?

  • The coverage evaluation survey has large differences compared with the reported data.
  • At national level there if no differences but at subnational levels there are areas with data which is not updated and errors found be seen.
  • At Alu, Grandtown, Nemo, Remo & Westtan it shows high coverage and not matching with evaluation survey data. Nemo, Chello, westtan shows low coverage and seen with high coverage evaluation in survey. Easttan, Grandtan are seen proper coverage and evaluation survey.

4. Review the chart with the age distribution of measles cases. Does that tell you anything additional about coverage?

The age distribution chart has measles cases from < 1 year to > 30 years. Children 9 months <15 years who are our target beneficiaries, but cases reported <15 year are 56% either they are unvaccinated or vaccinated with Measles one dose low level of vaccination coverage are also resulting into more measles cases.

Part 2. Brief the Minister

Task 5. Brief the Minister (spend max 1/2 hour on this section). Summarize the situation in three bullet points.

  • Measles cases in the country is on rise and needs an intervention to increase the coverage.
  • Compared to National Level and Sub national level large differences compared with the reported data is more concerned at this stage of disease occurrence.
  • Occurrences of confirmed Measles cases are from age group between 1-4 years (37%), either they are unvaccinated or vaccinated with Measles one dose low level of vaccination coverage are also resulting into more measles cases.

Task 6. Brief the Minister. Propose three actions to respond to the outbreak.

  • Strengthening Routine Immunization and an outbreak response immunization activity must be implemented in the outbreak area
  • Intensified monitoring need to be planned to access the gaps.
  • Measles Immunization campaign should be implemented in most effected age group between 9 months – 15 years

Task 7. Formulate recommendations. List your top 3-5 recommendations specific to data strengthening you would prioritize as the EPI and surveillance teams in Vacciland

  • Detailed Micro plan and revalidation of all High risk areas
  • Implementing of head count survey to get exact targets
  • Training of all health workers, cold chain handler and data handlers.
  • All concerned should be involved and responsibilities to be fixed in case of lapses.
  • Formation of data validation committee at facility level which compiles the data