SITUATION CHECK

[Lloyd Mtalimanja]

Dear Platform Members,

 

This email comes to request information/evidence from you should you happen to have it; there are unconfirmed reports that rising incidences of measles have been observed in area 18 and its environs; as a Secretariat, we intend to investigate and should you have any information/evidence pertaining to the same (it could be in your area or relating to area 18 in Lilongwe), kindly share that with the MHEN Secretariat.

 

Kind regards,

 

Lloyd

[Edward Phiri]

I will find out today and give you feedback

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[Steve Ndiwo]

Lloyd,

Whats the feedback now from the concerned area

Steve

[Lloyd Mtalimanja]

Dear Steve and all,

 

In short, let me say that checks with the health facility and the EPI national office (based on lab tests) indicate that the cases reported are not measles cases but rubella cases. Edward Phiri checked with the health facility in question; I checked with the EPI national office. However, we should all be on the look out because it may be too early to rule out possibilities. Did you check in your own areas / with your health facilities? Please do

 

Regards,

 

Lloyd

[Peter Kayenda]

Dear Lloyd,
On the qui vivre!

[Lindiwe Matanya]

Dear Lloyd,

As Chirimba 27 and Bangwe 70 had the case of rushes, i got the information from two Nusary schools but the hospital they say its not Measles and even DHO Blantyre  EPI Ms Chisomo, Cell: 0885499814 said its not measles, they are still work on it.

Regards

--

[Steve Ndiwo]

REPORT ON THE VISIT TO ZOMBA DHO ON MEHN COMMUNITY MOBILIZATION SUPPORT TO HARD TO REACH AREA FOR VACCINATION AND IMMUNIZATION

Introduction

MEHN organized a visit to Zomba DHO which was conducted from11-12 September 2014. The visit was meant in a such way as to introduce the Southern region Platform that was initially to be represented by the Chair and Zomba  District forum member Mrs  Boman who is the Executive Director for ………….CBO.  Due to the fact that the Forum Chair Ms Linnah Matanya was buy with other engagements, and communication breakdown to call Mrs Sellina Bomani respectively, the forum was represented by Mr Steve Ndiwo, Executive Director for REFORD forum member and representative from Mulanje District.

Goal of the visit    

The goal of the visit was to meet and discuss with the Zomba DHO especially the EPI department and the CRS Office who is the GAVI fund recipient so that they appreciate how the project is being carried out.

Specifically the visit aimed at achieving the following objectives:-

·        Introduce the GAVI project to Zomba DHO especially EPI department

·        Identify with the EPI a hard to reach area in Zomba and visit the site and test the survey questionnaire

Visit activities plan  

The following were activities to be carried out during the visit:-

·        Introduction and background to MEHN and GAVI project

·        Identification of a hard to reach

·        Going through the baseline questionnaire to be tested in the field

·        Field visit to Howard Parker Sharp Health Center for a community mobilization.

 

Visiting team

The visiting team comprised Mr Lloyd Mtalimanja – Team leader and Project Manager for MEHN, Mr Steve Ndiwo  Executive Director –forum member Southern region and representative of the forum Chair and Mrs…….. Admin –MEHN.

Visited Team members

The visited team members included

·        Mr Kingsley Chisuse- EPI , District Cold chain Technician

·        Ms Hasfa Melisha – MCH Coordinator

·        Mrs Tamara …….     Environmental Health Inspector

·        N S Undani HAS Chilasanje I Health Post

·        C Linje Kasonga  , HSA - Health Post

·        M Juma – HSA Chilasaje ii Health Post

·        H Tanganyika- HAS -Katete Health Post and

·        P Tamala – HSA – William Health  

A visit in brief

The visit which was scheduled for two days started at around 8:00 am.  The first day started with a visit to the DHO – EPI where the visiting team met Mr Kingsley Chisuse , the Cold Chain Technician and Ms Hasfa Melisha, MCH Coordinator who welcomed us.

In her welcome speech the MCH Coordinator stated that the District Environmental Health officer had gone to Mangochi but had but had arranged everything in her hands and welcomed us to be very free.

In his response speech the team leader Mr Lloyd Mtalimanja gave the house, brief objectives of the visit, the background of GAVI project, its set up and activities.

He stated that it was required that the coming was an eye opener where the officials from the CRS  would be present as they are the GAVI –CSO funds recipient and also the fact that they have activities being implemented in the district. Unfortunately there was communication breakdown in terms of invitation for the meeting.  In abs ensure also was the District forum representative member, the Director for ……….Mrs Sellina Boman , who could not be reached as she was being tried for invitation.

Brain storming on identification of a hard to reach area

With the aim of conducting community mobilization support to the hard to reach area for vaccination and immunization, two areas were identified.

 These include

·        Kasonga outreach clinic for Haward Parker Sharp Health Center in TA Malemia in Zomba.

 

 This area was chosen as a hard to reach area because it is a hilly area and has got steep slopes that make travel very difficult and services delivery poor. Looking at means of services provision being carried out by HSAs T

who use bicycle, it tends to be very tough for them to conduct such outreaches as they cannot even afford to travel by bicycles. The Mothers both maternal and lactating also do not afford to visit the health Center ( H Parker Sharp) for vaccination and immunization.

·        …………………………………………………………………………………….

This area was chosen as a hard to reach area because it is an island area and only uses an engine boat as a means of transport. Travel has been very difficult and services delivery area was also been so bad looking at the fact that it is not EPI program that suffers but also others for example Ant retro viral drugs have not been delivered at the Health center for distribution to those on ART. This is a very bad and worrisome situation as the island is an attractive area since people from all walks of life meet buying fish and other commodities for sale.

 

Later looking at affordability to visit the area, Kasonga area was chosen. The combined team (the visiting and the visited decided to go to the area – Kasonga Health post) to mobilize the mothers ready for next day survey. A survey questionnaire was gone through to check areas that is not understood and needs improvement.

 

A visit to Howard Parker Sharp Health Center

On the visit to Kasonga outreach clinic, the team visited H Parker Sharp Health center to pay a courtesy call and found the health center in charge away and found the Nurse instead.

After the H Parker Sharp health center the team went to Kasonga Health Post where it was found that it was an outreach day but it finished and then started mobilized the women to come for the following day scheduled activity which was a baseline study.

1^st day activities ended up and then went back to Zomba.

2^nd day – Baseline survey

13^th September was the 2^nd day and the team arrived and started briefing the antenatal mothers and the village heads that came to attend the meeting The Village heads who attended the meeting  were :-Malonga, Chilasanje ii, Kasonga Buliwa, Michala and Nkoleka.

How the survey was carried out

A simple semi structured questionnaire was administered and each team member was given a minimum of 8 respondents. From observation respondents ages ranged from 16 years to 25 years.

Survey administration reflection

After the administration, the survey team came together to reflect on how they had carried out the survey. According to the team, the following were observed:-

·        The questionnaire needed improvement in some areas as they do not give real meaning ie Zikhulupiliro.

·        Kasonga need mobility especially motor bike that can help efficiency in service delivery in the area.

·        There is a problem in communication as the networks of the mobile phones are very poor.      

Recommendation made by the team based on the community mobilization process

·        The visited team recommended that there is need  for the service providers also to be part of interviewed since they are part of the process

·        The results of the survey be shared

·        If possible these baseline surveys  be carried out time and a gain

·        It is important to mobilize resource that will help smooth service delivery such as support the hard to reach area with fuel and vehicle that will be used to deliver vaccine and immunization

  

  Steve Ndiwo

Executive Director

0999026945/0888707493 

[Steve Ndiwo]

[Lindiwe Matanya]

Dear Steve,

Thank you so much for sharing the Zomba Community Mobilization report. This is suppose to be done in every districts to help the CSO platform  and EPI to put good strategies how the Malawian child can also be at reached with the vaccines in time without having defaults on the campaigns around Malawi. 

[Steve Ndiwo]

Sorry Guys,

Its in bits and pieces i needed Lloyd to fill in those gap to sound good for example an other hard to reach area where there is only boats as only means of transport and also the CBO where Sellina Boman is the Director all i have forgotten. Also i haven't put it as an attachment , guys sorry for this that this explanation would have been a covering letter.

I really thank the chair for Southern region CSO Platform for identifying me to represent her on this trip thanks so much.

Steve Ndiwo

Director - REFORD

[Lloyd Mtalimanja]

Dear All,

 

Thanks to Linnah Matanya and Edward Phiri for giving feedback on the measles-check. Thanks Linnah for the numbers/figures - they help make the communication meaningful. Just one observation: although the cases reported by Linnah were not measles case, I know of once case in Blantyre which was diagnosed as measles case. As such, it would be great if we could hear from the rest of the platform/Network members.

 

Thanks for the report Steve. The report provides a pick-up point for the Southern Region team led by Linnah.

 

Regards,

 

Lloyd 

[Lindiwe Matanya]

Dear Lloyd,
l have just got message from Chirimba primary school reporting that in
class 60 children have been sent back because of Measles symptoms and
the total of 300 children are attach.


Linnah


On 10/7/14, 'Lloyd Mtalimanja' via MHEN Malawi

[Lloyd Mtalimanja]

Dear Steve,

 

I will share the finalized report. Also, on the Lake Chirwa area (where the MoH/EPI has to use boats to reach out to), I was waiting for information/data from Zomba DHO and they emailed the same yesterday.

 

Regards,

 

Lloyd

[Lloyd Mtalimanja]

Dear Linnah,

 

Thank you for this information. Your diligence and effort are greatly appreciated.

 

Regards,

 

Lloyd

[Steve Ndiwo]

Dear Lloyd,

The Chirimba issue is very worrisome , let people verify this and then action has to be done 

Steve 

[Steve Ndiwo]

Loyd ,

Approaching Oxfam on Zomba issue would be helpful much more as you already are working with them

Steve

[Linnah Lindiwe Matanya]

Dear Lloyd
Receive the attached report from Zomba

---

Date: Fri, 24 Oct 2014 00:26:32 +0000
From: mhenm...@googlegroups.com
To: mhenm...@googlegroups.com
Subject: Re: {MHEN Malawi} SITUATION CHECK

[PEFENAP ORG]

thanks

Edward
--------------------------------------------
On Mon, 27/10/14, Linnah Lindiwe Matanya <mata...@hotmail.com> wrote:

Subject: {MHEN Malawi} Community Mobilization in Zomba
To: "mhenm...@googlegroups.com" <mhenm...@googlegroups.com>
Date: Monday, 27 October, 2014, 9:52

Dear Lloyd
Receive the attached report from Zomba

IMMUNIZATIONIntroductionMEHN organized a

visit to Zomba DHO which was conducted from11-12
September 2014. The visit was meant in a such way as to
introduce the Southern
region Platform that was initially to be represented by the
Chair and
Zomba  District forum member Mrs  Boman who is the
Executive Director for
………….CBO.  Due to the fact
that the Forum
Chair Ms Linnah Matanya was buy with other engagements, and
communication
breakdown to call Mrs Sellina Bomani respectively, the forum
was represented by
Mr Steve Ndiwo, Executive Director for REFORD forum member
and representative

from Mulanje District.Goal of the

visit    
The goal of the
visit was to meet and discuss with the Zomba
DHO especially the EPI department and the CRS Office who is
the GAVI fund recipient
so that they appreciate how the project is being carried

out.Specifically the

visit aimed at achieving the following
objectives:-·       
Introduce
the GAVI project to Zomba DHO especially EPI
department·       
Identify
with the EPI a hard to reach area in Zomba and visit the
site and test the

survey questionnaireVisit activities

plan  The following were
activities to be
carried out during the
visit:-·       
Introduction
and background to MEHN and GAVI
project·       
Identification
of a hard to reach·       
Going
through the baseline questionnaire to be tested in the
field·       
Field
visit to Howard Parker Sharp Health Center for a community
mobilization. Visiting

teamThe visiting team

comprised Mr Lloyd
Mtalimanja – Team leader and Project Manager for MEHN,
Mr Steve Ndiwo  Executive Director –forum member
Southern
region and representative of the forum Chair and
Mrs…….. Admin
–MEHN.Visited Team

membersThe visited team

briefThe visit which was

scheduled for two days started at around
8:00 am.  The first day started with a
visit to the DHO – EPI where the visiting team met Mr
Kingsley Chisuse , the
Cold Chain Technician and Ms Hasfa Melisha, MCH Coordinator

who welcomed us.In her welcome

speech the MCH Coordinator stated that the
District Environmental Health officer had gone to Mangochi
but had but had
arranged everything in her hands and welcomed us to be very

free.In his response

speech the team leader Mr Lloyd Mtalimanja
gave the house, brief objectives of the visit, the
background of GAVI project,

its set up and activities.He stated that it

was required that the coming was an eye
opener where the officials from the CRS 
would be present as they are the GAVI –CSO funds
recipient and also the
fact that they have activities being implemented in the
district. Unfortunately
there was communication breakdown in terms of invitation for
the meeting.  In abs ensure also was the District forum
representative member, the Director for
……….Mrs Sellina Boman , who could not
be reached as she was being tried for

invitation.Brain storming on

identification of a hard to reach

areaWith the aim of

conducting community mobilization support to the
hard to reach area for vaccination and immunization, two
areas were identified. These
include·       
Kasonga outreach
clinic for Haward
Parker Sharp Health Center in TA Malemia in
Zomba.  This area was
chosen as a hard to reach area
because it is a hilly area and has got steep slopes that
make travel very
difficult and services delivery poor. Looking at means of
services provision
being carried out by HSAs Twho
use bicycle, it tends to be very tough for them to conduct
such outreaches as
they cannot even afford to travel by bicycles. The Mothers
both maternal and
lactating also do not afford to visit the health Center ( H
Parker Sharp) for vaccination
and immunization.·       

…………………………………………………………………………………….This area

was chosen as a hard to reach area because it is an island
area and only uses
an engine boat as a means of transport. Travel has been very
difficult and
services delivery area was also been so bad looking at the
fact that it is not
EPI program that suffers but also others for example Ant
retro viral drugs have
not been delivered at the Health center for distribution to
those on ART. This
is a very bad and worrisome situation as the island is an
attractive area since
people from all walks of life meet buying fish and other
commodities for sale. Later looking at
affordability to visit the area, Kasonga
area was chosen. The combined team (the visiting and the
visited decided to go
to the area – Kasonga Health post) to mobilize the
mothers ready for next day
survey. A survey questionnaire was gone through to check
areas that is not
understood and needs
improvement. A visit to Howard
Parker Sharp Health

CenterOn the visit to

Kasonga outreach clinic, the team visited H
Parker Sharp Health center to pay a courtesy call and found
the health center in
charge away and found the Nurse

instead.After the H Parker

Sharp health center the team went to
Kasonga Health Post where it was found that it was an
outreach day but it
finished and then started mobilized the women to come for
the following day
scheduled activity which was a baseline

study.1st day

activities ended up and then went back to
Zomba.2nd day
–
Baseline survey13th
September was the 2nd day and the
team arrived and started briefing the antenatal mothers and
the village heads that
came to attend the meeting The Village heads who attended
the meeting  were :-Malonga, Chilasanje ii, Kasonga
Buliwa, Michala and Nkoleka.How the survey was

carried outA simple semi

structured questionnaire was administered and
each team member was given a minimum of 8 respondents. From
observation
respondents ages ranged from 16 years to 25
years.Survey
administration

reflectionAfter the

Lloyd,Whats the feedback now from the concerned

[Lloyd Mtalimanja]

Dear Linnah,

 

As Chairperson of the Southern Region Committee or through you vice can you verify/take up the incidences reported with authorities at the DHOs office. First stop could be EPI and then you could take it from there.

 

Regards,

 

Lloyd

 

On Thursday, October 23, 2014 2:06 PM, Lindiwe Matanya <wof...@gmail.com> wrote:

Dear Lloyd,
l have just got message from Chirimba primary school reporting that in
class 60 children have been sent back because of Measles symptoms and
the total of 300 children are attach.


Linnah

On 10/7/14, 'Lloyd Mtalimanja' via MHEN Malawi
<mhenm...@googlegroups.com> wrote:
> Dear Platform Members,
>
> This email comes to request information/evidence from you should you happen
> to have it; there are unconfirmed reports that rising incidences of measles
> have been observed in area 18 and its environs; as a Secretariat, we intend
> to investigate and should you have any information/evidence pertaining to
> the same (it could be in your area or relating to area 18 in Lilongwe),
> kindly share that with the MHEN Secretariat.
>
> Kind regards,
>
> Lloyd

>
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[Steve Ndiwo]

Lloyd,

Thanks for the report

Steve 

[Lindiwe Matanya]

Lloyd,
we did asked the EPI she said that she did not get any reports of
measles, and it was from your instructions that we should find out
from the community.




On 10/28/14, 'Lloyd Mtalimanja' via MHEN Malawi

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[Lloyd Mtalimanja]

Dear Linnah,

 

Thanks for the response. Maybe I miscommunicated:  What I meant to communicate is that all of us as Platform members should bring to the attention of EPI or any relevant authority in matters of health that such a number of children/people in such a school/place have been affected by a rash or whatever it is; do you have any reports on the same? Have you investigated to establish what ailment it is?

 

The above is what I did for the case of Area 18 in Lilongwe and the EPI was able to say they investigated and established that it is not measles but rebella. Edward Phiri also engaged the health workers in area 18 who also were able to explain that lab tests for measles had proved negative on the said cases. You also did the same as reported in your email and the DHO's office told you that they are working on it. As such, I would request you follow up to see if they have established what ailment it is.

 

I hope all platform members get the point. The point is not just to ask health authorities whether or not there is an out break of measles but to report incidences of some form of rash/symptoms of a disease and ask if they, as health authorities, are aware of the incidence and if they have investigated and established what it is, and what interventions they have undertaken.

 

Thanks Linnah and best wishes,

 

Kind regards,

 

Lloyd

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[Lindiwe Matanya]

A Lloyd i did send DHO and that was response she gave us.

Good day

On 10/30/14, 'Lloyd Mtalimanja' via MHEN Malawi
<mhenm...@googlegroups.com> wrote:
> Dear Linnah,  Thanks for the response. Maybe I miscommunicated:  What I

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[Lloyd Mtalimanja]

Thanks

 

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[Steve Ndiwo]

Linnah,

I am sorry i have't received presentation documents as you earlier on stated to have sent

Steve

[Steve Ndiwo]

Lloyd,

Hope this finds you well, i wish to get you a let that there is a suspected signs of measles in Mulanje District . In the first place i identified two children with signs of the disease and i advised them to go to health facility, when they had come back and made follow ups on them they said that many people we at the H/C with the same problem . This made me have interest to go the H/C . The H/C in  charge has confirmed oh the availability  of the signs which i am yet to contact the DHO and the DHMT on the issue

Steve