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ADAMAWA HEALTH SECTOR WORKING GROUP BULLETIN

JANUARY, 2018

Courtesy of IFRC/NRCS; Kuva Gaya and Kwarhi Health facilities under renovation in Hong LGA

HIGHLIGHTS (JANUARY 2018) OF ADAMAWA STATE HEALTH SECTOR

HUMANITARIAN RESPONSE

Voluntary and dignified repatriation of over 4,500 refugees of Adamawa State extraction from

Cameroon

Farmers/ Herders clash in Numan, Demsa and Song LGAs

HRP for 2018

Epidemiological updates of diseases

Conducted training on Accountability to Affected Population (AAP) capacity building for partners

in conjunction with OCHA

Cluster Coordination Program Monitoring (CCPM)

Adamawa State 2018 response plan

Cash intervention in the Health Sector

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Objective 1: To provide life-saving and life-sustaining humanitarian health assistance

to affected IDPs and host community population.

Objective 2: To establish, expand and strengthen the communicable disease

surveillance, outbreak prevention, control and response.

Objective 3: To strengthen health sector coordination, health information

management and health system restoration leading to improved service delivery with

focus on enhancing protection and increased access to health care.

and basic social services

FUNDING REQUIREMENT FOR NIGERIA

HUMANITARIAN RESPONSE

1.O5 Billion USD HRP 2018 (FTS/OCHA)

FUNDING PROJECTION FOR THE HEALTH

SECTOR 2018 HUMANITARIAN RESPONSE

109.6 USD is required (0 USD for now)

HEALTH SECTOR PARTNERS ACTIVITIES

IRC

IRC-CMAM program.

Within the 4 program supported LGAs of Adamawa state (Hong, Maiha, Michika and Mubi South).

IRC Nutrition has been providing nutrition CMAM support to 31 operational OTP and SC clinics.

In this month of January, the statistical figure indicates that: 27,231 U5 children were

anthropometrically screened using MUAC measurement and Edema checking, among which 1,533

were identified as MAM and 329 as SAM

All identified SAM children have been enrolled into the program and are currently receiving both

therapeutic and pharmaceuticals rehabilitation. 2,297 SAM children have been receiving treatment

NIGERIA HEALTH SECTOR STRATEGIC HUMANITARIAN RESPONSE OBJECTIVES

FUNDING OVERVIEW FOR THE HUMANITARIAN RESPONSE IN NIGERIA

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in the OTP/SC, exit has been carried out to some of these client in the program clinics with 122

children being discharge as cured and 12 defaulters.

IRC- IYCF Program; The activity conducted in the various supported communities of where

sensitization on Infant and Young Child Feeding best practice (IYCF) which include the role and

contribution of early initiation of breast milk, good breast feeding attachment, frequency of

breastfeeding, exclusive breast feeding in the first six months, good hygiene practices and many

others. on these activities, a total number of 3,808 Lactating mothers, 2,236 pregnant mothers,

693 old women, 841 young girls and 869 men beneficiaries were reach.

IFRC/NRC

Operational areas

Gombi LGA, Guyaku and Dzangula Primary Health Care Centres and Gombi C Primary Health

care centre

Hong LGA, Garaha, Kwarhi, Kuva Gaya, Pella and Daksri Primary Health Care Centres and Hong

General Hospital

Achievements

Rehabilitation of Health facilities

Renovation of 2 staff houses completed at Dzangula Health facility in Gombi and have been re-

occupied by the staff

Renovation of Kuva Gaya Health facility in Hong LGA is almost complete with maintenance of

drainage system remaining. The renovation work includes replacement of the ceiling, iron sheets,

maintained of drainage system and painting of the whole building. There is a plan to renovate the

staff quarters as well

Renovation at Kwarhi Health facility in Hong is also at its final stage. The roofing and ceiling has

been replaced. The building drainage system will also be renovated and then painting of the whole

building.

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A total of 7 new solar driven refrigerators have been installed in Gombi and Hong LGA to improve the

vaccination coverage in the area. This came about to address the issue of poor access to Health services.

Most health facilities could drive over 20 kilometers to get vaccines for outreach clinics. The Solar vaccines

have been installed in the following Health facilities:

i. Gombi LGA; Guyaku, Dzangula and Gombi C PHC

ii. Hong LGA; Kwarhi, Pella Women, Kuva Gaya, Garaha PHC

The refrigerators are now functional in all these Health facilities

Nutrition training

This training was done on 6th to 8th December at Duragi Hotel. A total of 52 people were trained. These

trainers are supporting a total of 17 mother groups in Gombi and Hong LGAs. The team will be involved

in mother group activities of teaching mothers on good feeding practices and referral of malnourished

children to Health facilities.

WHO

WHO is currently supporting the joint health sector planning for the repatriation of

refugees from Cameroon; have held 4 meetings so far. Micro-plan has been developed and shared to all partners for the smooth running of the repatriation exercise.

WHO will be supporting the repatriation exercise for about 5,000 refugees of Adamawa

State extraction from Cameroon with HTR mobile teams, surveillance activities,

vaccinations, procurement and stockpiling of commodities, international border screening

activities, ICCM services and mental health services. These services will be provided

throughout the exercise at the border in Sahuda and Mubi transit camp concomitantly

and uninterruptedly.

Supporting the government to develop a response plan for 2018 based on the HRP. This will also guide partners who also have been encouraged to share their individual work

plan and budget for 2018.

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Working with OCHA to facilitate partners to go into cash interventions in the health

sector. The success of this especially with poor support for referral services and minimal

coverage for non-communicable diseases will improve service delivery.

WHO has currently established contact with the authorities of UNHCR in Cameroon to ensure a well-coordinated repatriation exercise.

In the just concluded SIPDs in January, 1,812,000 of children from 0 up to 5years were

vaccinated against polio using OPV.

Surveillance focal sites were reviewed upwards to 207. This is made up of 200 public health facilities and 7 private health facilities.

Capacity Building

65 Participants were trained on IDSR at the State level from 11- 15th January, 2017.

On the 29th January, 2018, 19 doctors, 46 nurses and 18 laboratory scientists the

secondary health facilities, private clinics, and clinics of tertiary institutions were trained

on CSM and Lassa Fever

VSF and CSM sensitization

On the 30th – 31s January, 2018, 73 nurses and 24 paramedical staff from FMC Yola were sensitized/trained on CSM and Lassa Fever.

sensitization of nurses Outbreak Investigations; 4 suspected outbreaks have been investigated. These include

the outbreak of pertussis in Mubi North LGA which affected 71 persons. The outbreak

of measles in Fufore and Gombi LGAs recorded 20 cases with 2 deaths and a suspected

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outbreak of Lassa Fever in Yola North LGA, where sample has been taken and result is

still pending.

HTR MOBILE TEAM

About 7,496 clients were seen by the WHO supported 10 H2R teams in 10 LGAs of Adamawa state. A total of 2,208 children

were dewormed by the teams during the

period. Pregnant women were also

attended to, with 546 of them receiving

Iron folate to prevent anemia in pregnancy,

while 449 received Sulphadoxine

Pyrimethamine as IPTp for prevention of

malaria in Pregnancy.

Nutrition; About 4,014 children

were screened for Malnutrition using

MUAC strap by the H2R teams. Out of

this number, 9 children had MAM, while 6

of them had SAM as demonstrated by Red

on MUAC.

ICCM

Stabilization Care; The 3 WHO Supported stabilization centers in the state managed

a total of 20 children having SAM with medical complications in December 2018. Thirteen (65%) of the patients recovered during the month and were discharged to the OTP

centers for follow up care.

UNICEF

HEALTH UPDATE

Coordination meetings

UNICEF continued to support Health sector humanitarian working group meeting and the monthly

camp coordination meetings. These meetings help brought key Partners together to discuss

implementation and coordination of humanitarian health interventions in the State and at the IDP

Camps

UNICEF participated in planning meetings for the pilot repatriation of 4,650 Refugees from Cameroon

back to Adamawa through Sahuda border. The meeting collated update on the expected number of

returnees and process for the repatriation. UNICEF agreed to support with 1 fixed health team to

run two shifts and supplies for integrated health services delivery at Mubi Transit camp and 5 mobile

teams, 3 in the affected communities in 5 Northern LGAs and 2 at the Sahuda border settlement

clinic/transit

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Service delivery

UNICEF provided logistic support for delivery of integrated PHC services by IDP camp clinics,

host community clinic and outreach medical Teams -in hard to reach and health facility catchment

host communities. A total of 22,367 men, women and children were reached with integrated

PHC in all the UNICEF supported health facilities in the IDP camps and host communities.

A total of 11,618 consultations were reported with Malaria – 1,741, ARI – 6,939, AWD – 634

and other medical conditions – 2,304.

Out of 10,749 preventive medical services recorded during the reporting period, 356 children

6months-15 years were vaccinated against measles, 3,396 children and pregnant women were

reached with various other antigens. Vitamin A supplementation – 2,294, Albendazole for

deworming – 3,966, ANC visits 568 out of which 27 LLIN were given, 83 deliveries and 86 Post Natal Care were recorded during the reporting period.

Mobile medical outreach service at Muchala Duwa Thilbang ward Hong LGA

Supplies in emergencies

Victims of the attack by suspected Herds Men in

2 villages (Kikon and Dowaya) of Numan LGA - 15

females and 7 males (22) received treatment at the

Numan General Hospital with support of UNICEF drugs

and other consumables in stock from the earlier

Numan/Demsa crisis - (1 carton of IV Ceftriaxone 1

carton of 2014 NHK (1/2), 2 cartons of 2014 NHK (2/2),

3 cartons of IVF Normal Saline and 5 cartons of IV

Metronidazole).

Fifteen (15) Persons (11male, 4 female) with varying degree of injury from attack in Imirisa settlement

Gulak ward, Madagali are receiving treatment at Gulak Cottage Hospital, Madagali LGA. UNICEF

provided support of NHK 1 carton of 1/2 and 2/2 and 1 carton of Ceftriaxone through the Executive Secretary Madagali LGA PHC Department to support management of the Victims.

iCCM CORPs Activities

iCCM CORPS ward Supervisors zonal review meeting for quarter 4 held in the 3 zones in the State.

This meeting reviewed ward supervision observations and feedback and other ICCM CORP activities

implementation challenges and discussed way forward. 400 ICCM CORPS Ward Supervisors and 24 LGA Team Members were in attendance

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Supervision of ICCM CORP activities at Ghiri, Garta ward Michika LGA

Refresher training on integrated PHC to IDP Camp Clinic Health workers

UNICEF is supporting refresher training

of 30 Health workers from the IDP Camp

clinics. The first batch of Participants training is

currently on-going. The training is expected to

update the Health care workers and improve

their knowledge and skills on management of Patients and referral.

UNICEF NUTRITION UPDATE

Activities within the reporting month:

Planning Meeting for Joint Monitoring and Supportive Supervision of MNP programme

In order to assess gaps in Micronutrient powder (MNP) programme with a view to strengthen service

delivery at health facility level, UNICEF organized a joint monitoring and supportive supervision across 18

LGAs implementing MNP in Adamawa State including Michika, Madagali, Maiha, Hong, Mubi North, Mubi

South and Gombi. As part of pre-implementation activities, a planning meeting comprising 21 monitors

from FMoH, NPHCDA and APHCDA, was conducted on 27th January to ensure quality of the process prior the exercise slated for 29th January till 3rd February.

ASPHDA State Nutrition Officer facilitating the review of monitoring checklist.

Planning Meeting for

Repatriation of Adamawa Refugees from Cameroon

As a way of ensuring adequate

preparedness of LGA level

stakeholders for the planned

Nutrition response for repatriation of Adamawa Refugees from Cameroon, a planning meeting was

organized on 9th January with Executive Secretaries and Nutrition Focal Persons from 21 LGAs of State,

including those from Mubi North, Mubi South, Michika, Madagali, Maiha, Hong and Gombi.

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A cross section of participants during the Planning Meeting for Repatriation of Adamawa Refugees from Cameroon

Routine Services

Routine services conducted by IDP camps in the reporting month include MUAC screening, CMAM, IYCF and MNP.

MUAC Screening

Within the reporting period, a total of 1658 children 6-59 months were screened across the camps of

which 1573 were green (Normal), 66 were yellow (MAM) and 19 were red (SAM). All the 19 children

identified with severe acute malnutrition were admitted into CMAM programme.

CMAM Programme

Of the 22 discharges across the camps within the reporting period, 18 children were cured, 2 deaths, 0

defaulter and 2 non-recovered. Therefore, cured rate was 82%, defaulters rate was 0%, death rate was 9% and non-recovery rate was 9%.

Infant and Young Child Feeding (IYCF)

Within the reporting period, 678 pregnant and lactating women were counselled on key IYCF messages.

Micronutrient Powder (MNP)

Healthy children 6-23 months in the camps with either a green or yellow MUAC reading and eligible for

micronutrient powder (MNP) were given MNP with accompanying counselling on appropriate usage,

benefits and optimal dietary intake. A total number of 311 children 6-23 months were enrolled in MNP programme of which 211 received the 1st dose while 100 returned for 2nd dose.

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DOBIYAN WOMEN AND YOUTH EMPOWERMENT (DOBIYAN)

Dobiyan Women and Youth Empowerment Initiative, organized a ‘SAY NO TO DRUGS CAMPAIGN’ in

Madagali LGA from December 18, 2017 to January 20 2018, with activities ranging from Advocacy Visit,

Rally, Lecture on Drug Abuse and was rounded up with a Football Tournament to end extremist

activities. 1500 youths were reached in

Vizik and Gulak.

AGUF

AGUF was in Malkohi camp on the12/01/ 2018 for sensitization on personal hygiene. We found out there

were 10 cases of diarrhea and 4 cases of malnutrition on admission. The camp clinic has no HIV test kits.

We made referral to nutrition sector concerning the cases of malnutrition. On 26/01/2018 AGUF went

to Kasuwan katako wuro jebbe to educate IDPs in host community on personal hygiene 77 people were

reached.

AHI

Activities

NHF activities;

1. Supplies of drugs and commodities: we received some maternal life-saving drugs for women& girls

of reproductive age and children from 0-5 years for the current ongoing NHF activities in some

hard to reach location in Fufore, Hong, Madagali, Michika & Mubi North LGA respectively.

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2. Outreaches: The community members especially

women & girls of reproductive age were reached

with key health education messages in the five

targeted LGAs of the state. This is to provide to

increase demand creation and also boost increase

access to reproductive health services both on

field and facilities within the communities. A total

of 4876 targeted populations were reached with

key health messages and 2053 women & girls of

reproductive age directly befitted from emergency drugs supplies (RH kit)

HEALTH PARTNERS FORUM (HPF)

The HPF is currently working round the clock to circumvent the pressing need to adequately plan,

stockpile and mobilize personnel in response to the planned repatriation exercise of refugees of Adamawa

State extraction from Cameroon. ICRC as a member of the HPF has agreed to support areas of

commodities that may end up not been met by organizations. Majority of these areas of concern have

been addressed by the various members of the forum and we are optimistic that with the early planning

put in place by the sector, huge successes will be recorded.

Since the inception of the forum, WHO has been at the helm of affairs. There is therefore the need for

the forum to shift leadership of the secretariat to another organization in the subsequent meeting. The

forum comprises of UN, INGO and NNGO who have demonstrated commitment and capacity to execute

laudable interventions. Of recent only AHI was able to fit into this category and they continue to play a

very important role in the HSWG activities in the state. Key discussions in the forum is building the

capacity of NNGOs to be able to access funds and to also provide avenues for them to be able to serve

as implementing partners to other organizations in the sector.

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DISEASE SURVEILLANCE AND NOTIFICATION

In Epidemiological Week 04 - 2018, a total of 21 out of 21 LGAs (including 06 IDP camps) submitted their

weekly reports as timeliness and completeness of reporting were 100% and 100% respectively at LGA

level (target 80%).

Measles: 04 cases of suspected measles reported with cumulative case count of 036 and 02 deaths

AFP: 16 cases of AFP reported with cumulative case count of 026.

YELLOW FEVER: 02 cases of suspected YF reported and cumulative case count is 03

CSM: 01 case of suspected CSM reported and cumulative case count is 02

LASSA FEVER: 01 case of suspected Lassa Fever reported and cumulative case count is 01 and 01 death

Planned Activities

Continuous surveillance and case detection on IDSR diseases at LGA levels.

Sensitization of clinicians on Cerebrospinal Meningitis (CSM) and Viral Haemorrhagic Fever (VHF)

– HFs level at 2 per 226 Wards, IDP camps at 2 per 7 identified camps to be done in batches for

a period of 2 weeks.

Follow up on Lab results for Measles and Yellow Fever suspected cases.

Note(s)

AWD and ARI only reported monthly from the IDSR003

TRENDS OF DISEASES IN WEEKS

Trend of weekly number of Suspected Measles cases, Week 01 – 04, 2018.

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1314

4

0

4

8

12

16

WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11

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Weekly trend of suspected cases of CSM, Week 01 – 04, 2018.

Weekly trend of suspected cases of Yellow Fever, Week 01 – 04, 2018

Weekly trend of AFP Cases, Week 01 – 04, 2018.

0

1

2

WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11

0

1

2

WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11

3 34

16

0

4

8

12

16

20

WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11

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HEALTH SECTOR COORDINATION

Following the tripartite agreement of UNHCR, Nigeria and the Cameroon Government initiated

sometimes last year, activities are on top gear to repatriate refugees of Adamawa State extraction from

Cameroon in a voluntary and dignified manner. There was an on the spot assessment by a team of

stakeholders including the refugees to ascertain the accessibility of the areas of return. Majority of the

intending refugees are from Madagali LGA. There is a projected 5,000 population expected to start arriving

on the 8th of March. The HSWG has drawn up micro-plan along thematic areas to support the health

issues as it affects the refugees. Commodity stockpiles and personnel mobilization has commenced in

earnest. The State Ministry of Health has given all the necessary assistance and cooperation to enhance

the success of the exercise.

The ISWG meetings resolved that a picture of the

displacement status in Numan, Demsa and Song

LGAs should be sorted from IOM and other

relevant authorities to inform the need for an

initial assessment of the needs of these affected

areas following farmers and herdsmen clashes.

This concern was brought up by the Health sector

who have received complaints from various

quarters. Currently the Victim Support Fund has

provided a displacement of 4,600 people in Song

LGA, we are still awaiting the updates of

displacement from IOM.

The HRP 2018, will be launched in Abuja in the first week of February. Thematic areas in the HRP, are

the need for the scale up of mental health interventions in the humanitarian response and the need to

enhance protection mainstreaming into the overall activities of partners. These are in line with the

transformative agenda of the humanitarian response that hinges on partnership, Accountability to Affected

Populations (AAP) and protection.

The CCPM exercise has commenced and compliance by partners is gradually improving. This is a very

important accountability tool that seeks to identify gaps and to give rooms for improvements in the various

sectors. Currently 19 partners have participated in the process that is ongoing and certain fillers have

been identified and appropriate measures are being put in place to improve coordination.

OCHA in conjunction with the WHO carried out training on AAP to 56 partners in the HSWG. The

issues of accountability were well spelt out to partners. A template will be developed and given to all

partners to capture AAP issues in their reporting routinely.

The Adamawa State HSWG has 37 non-government partner organization (United Nations, International

NGOs and Local NGOs) and 12 Government partners. The HSWG operates under the leadership of the

Honorable Commissioner of Health and the co-leadership of W.H.O. The Health Sector Working Group

meetings hold every fortnight.

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The map below is a graphical presentation of the presence of partners by LGA and the

frequency of reporting the 5Ws for the month of December, 2017.

Available at; https://www.humanitarianresponse.info/system/files/documents/files/adamawa_health_sector_partners_presence_dec_a4.pdf

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IMPORTANT UPCOMING ACTIVITIES

Weekly all joint sectors meeting for the repatriation of refugees of Adamawa State extraction

from Cameroon is ongoing

WHO will be carrying out sensitization of healthcare workers on epidemic prone diseases across

the senatorial zones of the state

UNFPA will be distributing RH-KITS to 11 LGAs in Adamawa State

UNICEF will be carrying out integrated joint assessment in Malkohi IDP camp and host

communities with chief of health and team

Bimonthly joint supervision and mentoring visits by a team of three from the HSWG will

commence by the third week of this month

IMPORTANT HUMANITARIAN RESPONSE LINKS SITES

PRIME WHO; https://primewho.org/marketplace/map

Adamawa State Ministry of Health; http://adsmoh.org.ng/

Relief Web; https://reliefweb.int/country/nga

Relief Web; https://reliefweb.int/report/nigeria/nigeria-humanitarian-response-plan-

january-december-2018

Development Initiative; http://devinit.org/themes/humanitarian/#

WHO| Nigeria crisis; http://www.who.int/emergencies/nigeria/en/

Nigeria |Health Sector Response Strategy -

2017/2018;https://www.humanitarianresponse.info/ru/operations/nigeria/document/n

igeria-health-sector-response-strategy-20172018

Humanitarian Response; https://www.humanitarianresponse.info/

NHF CONTACTS (OCHA); http://www.unocha.org/country/nigeria/nigeria-

humanitarian-fund/contacts

Nigeria/Humanitarian Response ;http://reliefweb.int/country/nga

Health Sector response to the north east Nigeria

emergency;http://www.who.int/health-cluster/news-and-events/news/north-east-

nigeria/en/

NIGERIA| FUNDING OVERVIEW;http://reliefweb.int/report/nigeria/nigeria-

humanitarian-funding-overview-03-july-2017

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PCNI; https://pcni.gov.ng/

NEMA; http://nema.gov.ng/

HEALTH SECTOR PARTNERS

GOVERNMENT; ADSMOH, FMOH, ADPHCDA, PCNI, NEMA, ADSEMA, SMS, ADSPC,

MOENV, ADEDP, SSH, FMCY, ADHIS, LMCU

LOCAL NGOs; Nigeria Red Cross (NRCS), Centre For Women and Adolescents

Empowerment (CWAE), Global Palliative Care, Education,& Development Initiative (GPCEDI),

Action Health Incorporated (AHI), First Step Action For Children Initiative, Life Saving Grassroots

Outreach (LESGO), Agaji Global Unity Foundation (AGUF), Women Orphans and Vulnerable

International (WON), Centre for Health & Development In Africa (CHEDA), Vatidava Foundation

(VAF), Centre For Islamic Thought (CIT), Against All Odds Foundation (AGAOF), Destitute

Children In Education and Health Initiative (DCEHI), Hope and Rural Aid Foundation (HARAF),

Child Protection and Peer Learning Initiative (CPPLI), Janna Health Foundation (JHF), Grace and

Hope Youth Emancipation (GHYF), DOBIYAN, Binta Mercy Foundation (BMF), KAPDA, PARE,

NEPWAN, ROHI, CFI, WHEAHI, Bege House Foundation (BHF),Spring of Hope

UN/INGO; WHO, UNICEF, UNFPA, IOM, PLAN, IRC, ICRC, IFRC, FHI360, SFH

CONTACT PERSONS

DR. FATIMA ABUBAKAR

HON. COMISSIONER OF HEALTH ADAMAWA STATE

Email; fatimaatiku@yahoo.co.uk

Mobile; +23408178663638

PHARMACIST IGBINOVIA F. IYOBOSA

ADAMAWA STATE COORDINATOR

WORLD HEALTH ORGANIZATION

Email; igbinoviaf@who.int

MOBILE; +23408035976029

DR. ADIEL ADAMU APAGU

PUBLIC HEALTH OFFICER (HEALTH SECTOR-

COORDINATION)

WORLD HEALTH ORGANIZATION

Email; adamua@who.int

MOBILE; +23408066828347

MR. KENEDY BARTIMAUS

PERMANENT SECRETARY

ADAMAWA STATE MINISTRY OF HEALTH

Email; dbartimaus@gmail.com

MOBILE; +23408034481176