Reproductive and Child Health (R&CH) Presented by: Dr. Mariam J. Bakar & Mr. Yusuph Haji

RCH The integrated Reproductive and child health programme comprises of four units 1.Reproductive and child heath 2.Integrated management of child hood illnesses 3.Expanded programme on immunization 4.Prevention of mother to child transmission

Introduction IMCI stands for: ‘’Integrated Management of Childhood Illness’’ The IMCI strategy focuses on 1.Improving case management skills of health care providers 2.Improving overall health systems 3.Improving family and community health practices

Top ten Cause of death for Under 5 yrs

Top ten cause of death for Zanzibar Hospitals in 2013

TDHS Child Mortality Trend

INTERVENTIONS Implementation of IMCI at primary facilities Sustained high coverage of immunization among under 5 years Implementation of malaria prevention measures (ITN, IRS etc) Use of effective malaria treatment (ACTs

Achievements 2013 cont.. Key planned interventionsAchievements Adaptation, TOT training and training for the new WHO GROWTH standards NGSTD adopted, printed and piloted in three district Train dIMCI to HCP for three encounters in all districts Achieved Finalization of ICATT training toolTraining tool finalized

Planned activities, Assessment of provision of essential newborn and child health services. Essential Newborn Care including HBB training to health care providers. Distance learning IMCI training to health care providers. Supportive supervision and mentoring

Challenges in 2013 Shortage of technical staff all levels Inadequate of funds for implementation other planned activities Inadequate working tools (e.g. weighing scale) and IMCI drugs in health facilities Implementation of c-IMCI

Recommendation Train, allocation and retention of staff Government to release more funds Procurement of drugs(e.g. dispersable Amoxycillin, co pack ORS and Zinc) Implementation of c-IMCI

IMCI plans Prioritized interventions for ; 1.Training of HCP on IMCI and introduction of Computerized IMCI to CHS 2.Training of new WHO growth standards and scale up of implementation (at least one district in Unguja and 2 district in Pemba) 3.Conduct Supportive supervision and mentoring to trained HCP 4.Dissemination of newborn assessment results and work on the recommendations 5.KMC training and establishment of KMC sites 6.Implementation of PDSR

IMCI Finances finances Source of fundsPlanned financesFunds receivedExpenditure RGOZ50,902,966 CONTRIBUTED IN OFFICE CONSTRUCTION WHO260,913,000 62,738,400 Source of fundsPlanned financesFunds receivedExpenditure RGOZ373,577,000 WHO136,200,000 UNICEF142,311,000

IMMUNIZATION

Introduction The role of immunization is widely recognized as critical to achieving Millennium Development Goals (MDGs). Immunization programme Zanzibar aims to maintain high national vaccination coverage at above 95% Hepatitis B vaccine introduced in 2002, Hib vaccine was introduced in (PCV13) and rotavirus introduced in 2013 as well as Measles Second Dose in 2014.

Planned activities 2013 Support routine immunization services – Procurement of bundled vaccines – Community mobilization on RI – supportive supervision – African vaccination week – fuel for outreach, distribution of vaccines and quarterly evaluation meetings on Supplies & gas for vaccine refrigerators Introduction of PCV13 and Rotavirus Vaccines

BCG COVERAGE

PENTA 3 COVERAGE

Measles coverage

Fully Immunized

Challenges in 2013 Shortage of technical staff all levels Lack of funds for cold chain equipment Lack of funds for surveillance services Inadequate working tools (e.g. weighing scale & cold chain equipment ) in health facilities Knowledge gap among service providers

Suggested Solutions MOH to increase No of technical staff at all levels focusing at service delivery points. MOH and partners to support procurement of working tools and cold chain equipment Technical and financial support in knowledge updating (trainings) of RCH service providers

Planned activities 2013/2014 Support routine immunization services – Procurement of bundled vaccines – Community mobilization on RI and SIAs – supportive supervision – African vaccination week Introduction of Measles second dose Completion of immunization service guideline

Finances 2013 cont.. Source of fundsPlanned finances (Tsh) Funds received (Tsh) Expenditure (Tsh) RGoZ 281,187, ,298, ,298,914 GAVI/WHO 219,575, ,464,100 UNICEF 551,838, ,522,450

Thank you