Presentation on Projects 1 & 2, Basic FETP, Liberia Prepared by Thompson J. Bainbo Yarwin mehnsonnoh Nimba County

Acknowledgment I will like to acknowledge Ministry of Health AFENET Emory University US CDC WHO My mentors (Drs Justin and Peter)

Expanded Weekly Report, Week 31- 42

Summary During the weeks under review: Mehnla and Zekepa Clinics reported on time Whilekwendin Clinic reported late, wks 31 and 32 All health facilities had zero reporting  All blood specimen collected for EVD were negative Results from blood specimen for measles cases is still pending

Fig 1: Table of Timeliness and Completeness of reporting, week 31-42, 2015 Mehnsonnoh District, Nimba County Health Facility WK 31 WK 32 WK 33 WK 34 WK 35 WK 36 WK 37 WK 38 WK 39 WK 40 WK 41 WK 42 % of Timeliness WK 31-42 % of Completeness WK 31-42 Kwendin clinic L T 83% 100% Mehnla clinic Zekepa Legend This week On Time T Late L NO REPORT RECEIVED NR % Cumulative >=80% >=50_79.9% ON TIME <50% on time

Fig 2: Priority Disease Reports Week 31-42, 2015 Mehnsonnoh District, Nimba County. Cumulative Week 31- 42 Cases Death Case fatality Rate % Acute watery diarrhea (AWD) 6 0% Bloody diarrhea Measles Meningitis Human Rabies Neonatal Tetanus Yellow fever Supested EVD 40 3 7.5% Cholera Lassa fever AFP Maternal Death Neonatal death 1

Timeliness And Completeness of Reporting, Week 31-42, 2015 Mehnsonnoh District, Nimba County Health Facilities

Trend of Suspected EVD Cases And Deaths, Week 31-42, 2015 Mehnsonnoh District, Nimba County No of Cases Week

Epicurve of Measles Outbreak September 2015, Kaynepea, Mehnsonnoh District, Nimba County No of Cases Date of Onset

Project 2 Surveillance Communication Problem Analysis

Introduction Communication in Surveillance system is the flow of information from one level to another level Poor communication in surveillance system prevents the flow of information To have effective surveillance system, there must be good communication system in Yarwin Mehnsonnoh District Therefore, this study was conducted to analyze communication problems in Yarwin Mehnsonnoh District

Method Study Location Yarwin Mehsonnoh district has borders with Bong, Grand Bassa and Rivercess and a population of 33,251 Has only 3 health facilities This analysis was done by using fish bone, critical cause analysis and health workers interview Fish bone can be used to analyze surveillance problems it consist of cause and effect diagram critical cause consists of categorizing problem into three categories: totally within your control to improve (T) partially within your control (P), not in your control (N)

The Results

poor monitoring T Surveillance communication cause and effect Diagram Staff Logistics Poor transportation system P Staff attitude (P) In adequate training(p) No internet services N No coordination(P) No HVF based radio N Poor monitoring No VHF Radio Surveillance communication problem Lack of supervision(P) poor monitoring T Focal person T Bad road condition N Staff behaviour P Traditional healer, gCHVs T LEGEND T- Totally under your control P- Partially under your control N- Not under your control Belief and tradition P Administration Target Population

Recommendations MOH should install HVF base radios to all health facilities   To encourage surveillance focus persons to find location of cell phone network On job training for health facilities staff on the important of surveillance communication. CHT to install VHF base radio to 2 health facilities DSO to encourage focal persons to find coverage area to call DSO to provide case base forms