Overview of the National Measles – Malaria Campaign in Sierra Leone Dr Lynda Foray Coordinator Measles – Malaria Campaign

Country Profile Population of 5.3 Million Population of 5.3 Million Infant Mortality Rate - 115/1000 Infant Mortality Rate - 115/1000 Under five Mortality Rate – 194/1000 Under five Mortality Rate – 194/1000 Maternal Mortality Rate – 1800/100,000 Maternal Mortality Rate – 1800/100,000 Life expectancy – 49yrs Life expectancy – 49yrs Female literacy – 29% Female literacy – 29% ITN usage/U5 before campaign – 12.2% ITN usage/U5 before campaign – 12.2% National Measles Coverage in 2005 – 70% National Measles Coverage in 2005 – 70% Administratively, divided into thirteen districts Administratively, divided into thirteen districts

Rational for an Integrated campaign High infant & U5 mortality rates High infant & U5 mortality rates Malaria and Measles major childhood killers Malaria and Measles major childhood killers 2003: catch up campaign targeting 0-15yrs 2003: catch up campaign targeting 0-15yrs Cost-effectiveness of integrated campaigns, therefore follow up 2006 planned with multiple interventions Cost-effectiveness of integrated campaigns, therefore follow up 2006 planned with multiple interventions Peak Measles transmission Feb-April; campaign planned for November Peak Measles transmission Feb-April; campaign planned for November

National Measles – Malaria Campaign November th, 2006 November th, 2006 Four interventions: Measles, Vitamin A, Mebendazole, LLINs Four interventions: Measles, Vitamin A, Mebendazole, LLINs Targeted all children under five years old- intervention according to age Targeted all children under five years old- intervention according to age

Objectives of the campaign 95% coverage of children 9-59months with Measles vaccine 95% coverage of children 9-59months with Measles vaccine 95% coverage of children 6-59 months with vitamin A 95% coverage of children 6-59 months with vitamin A 90% coverage of children months with Mebendazole 90% coverage of children months with Mebendazole 80% coverage of children 0-59months with LLINs 80% coverage of children 0-59months with LLINs

Major Partners Government of Sierra Leone (GOSL) Government of Sierra Leone (GOSL) The World Health Organization (WHO) The World Health Organization (WHO) United Nations Children’s Fund (UNICEF) United Nations Children’s Fund (UNICEF) Canadian International Development Agency Canadian International Development Agency Canadian and Sierra Leone Red Cross Societies Canadian and Sierra Leone Red Cross Societies West African Health Organization West African Health Organization The Church of Jesus Christ of Latter- day Saints The Church of Jesus Christ of Latter- day Saints Aware – Reproductive Health Aware – Reproductive Health Vestergaard Frandsen/ Universal Logistic Company Vestergaard Frandsen/ Universal Logistic Company The District Councils The District Councils

For proper/efficient implementation the following were done: Integrated technical committee Integrated technical committee Update and support to the ICC/CCM Update and support to the ICC/CCM Sub-committees created with specific tasks Sub-committees created with specific tasks Daily coordination meetings Daily coordination meetings Teleconference facilitated by WHO/CRC Teleconference facilitated by WHO/CRC Support by international consultants from all partners Support by international consultants from all partners Procurement and pre - positioning by logistics sub-committee in collaboration with the district and council members. Procurement and pre - positioning by logistics sub-committee in collaboration with the district and council members.

Results

Challenges Crowd control, especially first days Crowd control, especially first days Net stock-outs Net stock-outs Skilled vaccinators Skilled vaccinators Denominator for planning Denominator for planning Cross border activity Cross border activity Cost-sharing issues & funding gaps Cost-sharing issues & funding gaps

Lessons learnt Leadership and partnership plays a key role in the success of the campaign. Leadership and partnership plays a key role in the success of the campaign. Early planning and coordination made implementation more effective and efficient. Early planning and coordination made implementation more effective and efficient. Involving district councils gave them a sense of ownership and commitment to the campaign. Involving district councils gave them a sense of ownership and commitment to the campaign. Establishment of a coordinating mechanism facilitated better planning Establishment of a coordinating mechanism facilitated better planning Detailed logistics plan and early and appropriate social mobilisation activities contributed to the success of the campaign Detailed logistics plan and early and appropriate social mobilisation activities contributed to the success of the campaign Integration was cost effective- four interventions achieved set targets. Integration was cost effective- four interventions achieved set targets.

The children of Sierra Leone say “Tenki”