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ADAMAWA HEALTH SECTOR WORKING GROUP BULLETIN

JULY, 2018

Oral Cholera vaccine being administered to a person in Mubi North during round 1 OCV campaign in 3 LGAs in Adamawa state

HIGHLIGHTS (JULY 2018) OF ADAMAWA STATE HEALTH SECTOR

HUMANITARIAN RESPONSE

National Human Rights Commission (NHRC) stakeholders workshop on protection violation in

Adamawa State humanitarian response

Final reports of Initial Rapid Need Assessment (IRNA) for Numan and Demsa LGAs

Ongoing Cholera outbreak response in Mubi North and Mubi South LGA of Adamawa State;

Oral Cholera Vaccine (OCV) 1 campaign

Visit of the head of OCHA Nigeria to Adamawa State

Updates on the Humanitarian hub in Gulak Madagali LGA

Updates on the Operational Health Sector Working Group meeting (OHSWG) and MOFCOM

Meeting in Mubi North LGA

Worsening humanitarian crisis in Adamawa State; 130,000 displacement recorded in 9 LGAs due

to the farmers herders clash

Epidemiological updates of diseases

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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)

Available at; https://fts.unocha.org/appeals/642/summary

NIGERIA HEALTH SECTOR STRATEGIC HUMANITARIAN RESPONSE OBJECTIVES

FUNDING OVERVIEW FOR THE HUMANITARIAN RESPONSE IN NIGERIA

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HEALTH SECTOR PARTNERS ACTIVITIES

IRC

IRC-CMAM update

Routine CMAM program activities in the four supported LGA of state were successfully carried out. In

the 30 supported program OTP/SC clinics, the IRC were able carried out MUAC screening of 20,232

(M=10,112, F=10,120) under 5 children, with 354 (182M, 172F) identified SAM cases and admitted into

program. 1,253 (624M and 629F) MAM whom their caregivers received nutrition education and

participated in community cooking demonstration. For the program discharges, 211(101M and 110F)

were exited as cure, 5(2M and 3F) as died and 30(12M and 18F) defaulting clients. Currently, 717 (358M,

361F) SAM children are on admission receiving treatment. Overall program performance for the month were 85.8% cured rate, 2.0% death rate and 12.2% default rate

IRC- IYCF Update

IRC infant and young child feeding awareness and sensitizations seasons; these activities has been

carried with the support of program and community partners. The daily activities conducted in the

month are the routine breastfeeding related topic and issues which include early initiation of

breastfeeding, exclusive breastfeeding and weaning diet. As part of the people reach and benefit from

the activity seasons included; 1,558 Pregnant mothers, 3,388 Lactating mothers, 833 old women, 610 young girls and 693 men beneficiaries were reach.

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WHO

Initial Rapid Needs Assessment (IRNA) in Demsa and Numan; from 3rd to 5th of July, WHO led the

health sector on IRNA which was carried out in Numan and Demsa LGA due to farmers’ herders clash.

130,000 displaced individuals have attributed to this crisis in 9 LGAs.

Cholera Outbreak Response; continued monitoring of cholera cases in the State; 210 cases were

reported in July, 2018. Total case count stands at 1731Monitored the implementation of OCV in

prioritized wards in Mubi North, Mubi South and Maiha LGAs; A total of 377,935 people were

vaccinated.

Capacity Building; trained 83 clinicians drawn from health facilities in Hong, Maiha, Mubi North and

Mubi South LGAs on surveillance, management and prevention

IDSR revitalization; Conducted a review meeting with 27 focal persons, 5 DSNOs and 8 WHO

personnel from all eIDSR implementing health facilities. Surveillance performance through eIDSR

reporting was reviewed, major challenges with eIDSR implementation were identified and actionable

next steps were agreed upon.

WHO Health Operations in Adamawa State July 2018

Highlights

WHO provided technical support to the SMOH, ADPHCDA and other partners to implement the

1st round of Oral Cholera Vaccination (OCV) as part of strategies to interrupt the transmission and

end the ongoing Cholera outbreak. The campaign which targeted persons 1 year and above (96% of

the population), was implemented in high risk wards in Mubi North, Mubi South and Maiha LGAs.

The House to House campaign, achieved coverage of 100% with 377,935 persons vaccinated.

WHO continues to support the Cholera outbreak in Mubi and Maiha in Adamawa state. This

involves the provision of technical support and supplies for case management at the 2 CTCs and in

deployment of Hard to reach mobile teams for active case search in the affected communities.

The Quarterly H2R team review meeting was conducted during the month. Highlights of the

meeting includes; the review of the last quarter’s routine immunization and health delivery

performance of the teams, Sensitization of the teams on the ongoing cholera outbreak including

surveillance, case management and preventions. Provision of supplies and commodities to the teams.

ICCM

In the month of June 2018, 2,928 children were treated for malaria, diarrhea and Pneumonia by 123

CoRPs in 14 LGAs of the state. 2,392 of the children were screened for malnutrition using MUAC. 245

(10%) of the children screened had MAM and were counseled on proper nutrition, while 11 (0.5%) of

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them had SAM demonstrated by Red on MUAC and were referred to CMAM sites for proper

management.

HTR

In July 2018, 26,999 clients were seen by WHO supported 20 H2R teams providing services in 20 LGAs

of Adamawa state. The teams treated 9,410 persons with minor ailments and dewormed a total of

13,287 children during the month. Pregnant women were provided FANC services with 1,823 of them

receiving Iron folate to boost their hemoglobin concentration while 330 received Sulphadoxine

Pyrimethamine (SP) as IPTp for prevention of malaria in Pregnancy.

Nutrition

Screening

In July 2018, 17,672 children were screened for Malnutrition using MUAC by WHO supported 20 H2R

teams. Of this number, 203 (1.1%) children had MAM and their caregivers were counseled on proper

nutrition, while 93 (0.5%) of them had SAM as demonstrated by Red on MUAC. The SAM cases were

referred to the Outpatient Therapeutic Program (OTP) centers across the state for proper

management.

Stabilization Care

WHO Supported 3 stabilization centers in the state managed a total of 48 children having SAM with

medical complications in July 2018. 40 (83.3%) of the patients recovered during the month and were

discharged to the OTP centers for follow up care.

WHO supported H2R team providing basic health services in Shelleng LGA

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UNICEF

HEALTH SECTOR

Coordination meetings

UNICEF continued to support the monthly Humanitarian Health sector working group and IDP

camp coordination meetings (Malkohi and Fufore)

UNICEF has participated at the Humanitarian Health Sector and Inter Sector Working Group

meeting, key issues raised at the meetings include Cholera situation update and the outcome of the

Oral cholera vaccine campaign, nutrition sector coordination, NGOs support on Health in the State

to register with the SMOH, Gulak humanitarian hub proposed site secured and accessing HRP fund

by NGOs

UNICEF has continued to participate at the EOC meetings for the suspected Cholera in the State

to contribute in reviewing trend, progress and following up on key action points

Cholera outbreak response

UNICEF has continued to provide support for the cholera outbreak in the State with reported as at

22nd July, 2018 stands at 1718 cases with 27 deaths (CFR=1.6%), 4 LGAs are affected (Hong, Maiha,

Mubi North and Mubi South 1433 and 25 deaths (CFR 1.7%) affecting 4 LGAs (Mubi North, Mubi

South, Hong and Maiha).

The State Ministry of Health was supported to conduct a Cholera vaccination campaigns, in the high-

risk wards of Mubi North, Mubi South and Maiha local government areas (LGAs), 10th – 14th July

2018 through planning, training, community mobilization, monitoring and supervision. The

administrative results received after mop-up showed that the house-to-house team reached a total

of 377,935 eligible persons, representing coverage of 100% of the target population.

Social mobilization

UNICEF supported the meeting of social mobilization technical working group in the State to

discuss issues regarding community mobilization and awareness creation.

The journalist against polio (JAP) a partnership between Adamawa State Primary Health Care

Development Agency and for media executives and journalist review meeting supported by UNICEF

held. Areas of support by the media in health were discussed and strategies of reaching the

community with information to reach informed decision suggested.

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Cross section of media executives discussing Polio Eradication and other Health emergencies

Supplies:

For the response to the

1. Farmers/Herders clashes - 10 Cartons NHK (2017 version)

Service delivery in IDP Camps and host communities

A total of 59,984 Persons, including women and children were reached with integrated PHC

services in UNICEF supported health facilities in the IDP camps and host communities in the State.

A total of -16,031 (Other age: 1,583 and Under 5 years: 14,448) consultations were reported,

A total of 59,984 (Under 15 years: 56,818 and Women: 3,166) prevention services were recorded

A total of 60 deliveries and 37 postnatal visits were recorded during the reporting period.

UNICEF supported the review medical outreach Team intervention with integrated PHC

services in hard to reach and host communities in 12 LGAs. The State was supported to

host the review meeting for activities conducted in the quarter. The teams achievement in

summary:

o 12 LGAs covered

o No of settlements planned 600 reached 512 (85%)

o TP of settlements covered 470,945

o Target WCBA 52,813 Reached 33,969 (64%)

o Target <5yr 91,189 Reached 75,248 (83%) - <1yr 17,855

o < 5yrs reached with Birth registration 7,141

o Screened MUAC 66,014

o Supported cholera treatment centre 5weeks

o OPV first contact 680

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Cross section of service delivery session in a host community in Adamawa

UNICEF supported the introduction of Client Oriented Provider Efficient (COPE) services in 4

LGAs in the State. This is to improve the community and Service provider participation in

improving quality of care and client satisfaction.

UNICEF is supporting training of Health workers at PHC on IMCI as part of capacity building for

improved quality of care. 806 Health workers are expected to be trained across 403 PHCs

UNICEF supported ADSPHCDA through services of 26 ICCM CORPS, and 5 PHCC to provide

integrated PHC service delivery to over 14,000 IDP as a result of communal clash affecting 14

communities in 6 wards of Mayo Belwa. This was through provision of MNCHN commodity to

support service delivery in the community by ICCM CORPS and outreach Teams, at the transit

camping sites and at the health facilities closest to affected communities.

Monitoring and supervision

iCCM CORPs Activities

ICCM CORPS have continued to provide support in community management of Malaria, Diarrhea

and cough in hard to reach and host communities in 21 LGAs of the State. 2,700 CORPS are being

supported by UNICEF with commodities, monitored and supervised to provide these services. In

March the ICCM CORPS attended to 9,388

Review meeting for ICCM CORPS and Supervisors was supported at cluster level

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ICCM CORP being supervised and session of review meeting of CORPS and Supervisors

State team ISS in 7 LGAs

UNICEF supported the conduct of ISS in 7 LGAs by the State Team Members to complement the

LGA Team efforts in providing on the job supervision and mentoring to the Health workers and

LGA Team at service delivery points. The State Team reviewed the findings in each LGA and

proposed way forward on the unaddressed gaps.

Initial Rapid Needs Assessment (IRNA)

UNICEF participated at the Inter agency Rapid Needs Assessment in Numan and Demsa between

3rd & 5th of July. This was aimed at establishing the severity of needs, confirm the numbers of people

affected, identify and prioritize humanitarian needs and sector needs were

identified.

NUTRITION UPDATES

Routine Services

UNICEF provided nutrition service support in Malkohi camp and host

community, Fufore camp, St Theresa’s camp, Mubi transit camp, Daware host

community and the transit camp in Mubi. Routine services conducted at IDP

camps and host community through Hard to reach Mobile Medical Team services

in the reporting month include MUAC screening, CMAM, IYCF and MNP.

1. IDP Camps

MUAC Screening

A total of 1012 children 6-59 months were screened across the camps of which 928 were green

(Normal), 55 were yellow (MAM) and 29 were red (SAM). All the 29 children identified with

severe acute malnutrition were admitted into CMAM programme.

CMAM Programme

Of the 7 discharges across the camps within the reporting period, 7 children were cured, 0

deaths, 0 defaulter. Therefore, cured rate was 100% defaulter’s rate was 0%, death rate was 0%

and non-recovery rate was 0%.

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Infant and Young Child Feeding (IYCF)

544 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 or

eligible for micronutrient powder (MNP) were given MNP with accompanying counseling on

appropriate usage, benefits and optimal dietary intake. A total number of 41 children 6-23

months were new enrollees in MNP program.

2. Integrated medical Outreach services in host communities and hard to reach settlements

UNICEF also supported the integrated package of care provided by outreach Teams from Health facility

Teams.

The package of services includes MNP, IYCF counseling and MUAC screening, with CMAM at

the Health facility post.

The client reach in this intervention is

MUAC screening total – 560

Green – 495

Yellow - 22

Red - 43

MNP – 34 received

IYCF – 357 Pregnant and lactating Mothers counseled/informed (Hard to reach Team data only)

The Hard to reach Teams conducted review meeting for quarter 2 performance, challenges and

way forward in the quarter were discussed.

INTERNATIONAL FEDERATION OF RED CROSS (IFRC)/NIGERIA RED CROSS (NRCS)

The complex emergency operation aims at reaching out to vulnerable population affected by the

insurgency. The operation is working in an integrated manner to reach the affected population,

therefore the IFRC Health team in Adamawa has initiated psychosocial interventions in Gombi and Hong

Local Government Area with the aim of improving psychosocial status of the insurgency affected

communities. From the 29TH June to 3rd July 7, 2018, 21 Red Cross Red Crescent Staff and Volunteers

from NHQ Abuja, Yola branch office, Gombi and Hong LGAs participated on PSS training. The

objectives of the training were to;

Facilitate psychosocial Support.

Increase awareness of psychological reactions during disasters or social disruption.

Promote the restoration of community networks and coping mechanisms.

Enable staff and volunteers to understand and better respond to the psychosocial needs of

vulnerable groups.

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Promote care for the carers; emotional assistance for staff and volunteers.

AGUF

AGUF was in Kwapale community Tumbara Gabili ward on the 13 /07/18 and carried out awareness and

sensitization on cholera preventive methods. There were 8 cases of Hepatitis B and 33 non profile cases

33 attended to. People mostly affected were the reproductive age 14 to 49 years. So sensitization was

carried out for primary 5 and 6 pupils. The school is need of WASH facilities. Total people reached

were 1826.

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On 14/7/18 in Jiddel community under minkisu/wurogiki ward, awareness on personal hygiene cholera

awareness and preventive mechanism through pictorial messages was conducted and a total of 1429

people were reached. On 15/7/18 Viboka primary school awareness on hepatitis, sign and symptoms to

staff and pupils was done. 238 were reached. 24/7/18 in Yola South kasuwan katako IDPs host

community where we did health education on personal /environmental hygiene, 5 women complain of

vulva itching Aguf referred them to a consultant and also foot the bill, total people reached with

hygiene materials were 63.

Janna Health Foundation (JHF)

JHF is implementing a Challenge Facility Civil Society Round 8 project which started in June, 2018. The

project targets 12 LGAs LGAs in the Northern and Central Senatorial Zones of Adamawa State. The

intervention focused on NOMADIC school children and their host communities with much emphasis on

childhood Tuberculosis/HIV.

The LGAs involved includes; Madagali, Michika, Maiha, Mubi South, Mubi North, Hong, Gombi, Song,

Girie, Yola North, Yola South and Fufore.

All activities planned in the month under review were successfully implemented among the target

population except for Madagali LGA where there still exist some security challenges in some

communities. Activities implemented include:

Active screening for HIV and TB in the Nomadic schools and surrounding Communities

Active transportation of presumptive TB Case sputum samples and retrieval of results to the

presumptive TB cases

Transportation of children under 5years to the facilities where childhood TB cases can be

diagnosed by Medical Officers

Active linkage of HIV positive and diagnosed TB cases to identified HIV/TB service delivery

points for treatment, care and support

Awareness creation among target population on HIV and TB

Community outreach targeting school children and their immediate Host Communities.

These activities were implemented by Community Volunteers under the supervision of Janna Health

Foundation, the State TB programme Team and the State Project Team headed by the Agency for

HIV/AIDS Control.

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JHF Volunteers accessing a Nomadic school and Community in Yola South LGA

Supervision & Monitoring by JHF staff in one of the DOTS in Mubi

Results:

In the 12 targeted LGAs for this intervention, 517 presumptive TB cases were identified, sputum

samples were collected from 482, out of which 16 new TB cases were detected. All 482 presumptive

cases that submitted sputum had HCT out of which 7 were found to be HIV+.

All TB and HIV cases detected were linked to treatment, care and support services.

Key challenges encountered include:

Difficulties in managing childhood presumptive TB cases

Inadequate numbers of CVs

The following are recommendations proposed to meet the stated challenges:

JHF to liaise with medical officers in the diagnosis of childhood TB/HIV

JHF to advocate for increase in the number of CVs

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PLAN INTERNATIONAL

REPORT OF ACTIVITIES FROM PLAN INTERNATIONAL MUBI FIELD OFFICE

a. A 5-day Clinical Care for Sexual Assault Survivor (CCSAS) training was conducted for health

workers, case workers and staff of Plan International Nigeria, Mubi office. The objectives of the

training were to equip participants with the basics of clinical care for rape victims, how to treat

a sexual assault survivor in the health facility, share relevant work tools and resources available

globally and in-country to assist with the management and care for sexual assault survivors and

emphasize the health workers’ role and guide in handling rape cases. Methodologies adopted

include: role play, brainstorming, presentations and breakout sessions. A total of 18 females and

6 males were in attendance. On the average, pre and post test conducted indicated an increase

in knowledge.

b. Community sensitization:

A total 419 beneficiaries were reached with sensitization activities for the period under review

at Shuwa, Garaha, Hildi, Sabon-gari (Askira/Uba) and Michika.

Sensitization and mass MUAC screening was conducted in Gulak. A total of 17 children were

screened. Out of the figure screened, 6 SAM cases were recorded and referred. In Garaha, 6

children were screened and 1 MAM case was identified.

On 24th July, 2018, sensitization and awareness creation on cholera control was conducted by

engaged nurses and nutritionists. In attendance were 30 lactating mothers. The participants

were enlightened on the possible control measures such as washing hands with soap or

detergent after defecation and before eating as well as regular use of antiseptic and hand

sanitizer.

c. Referral

A case was referred, for psychosocial support services, to the psychiatric department of

Specialist Hospital, Yola. This referral constitutes a major part of the case management

processes in line with standard procedures.

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GOGGOJI ZUMUNCHI INITIATIVE

A Successful home visit, Contact tracing on presumptive was done in Girei and Song LGA respectively.

During the reporting period support group meeting was conducted in Girei PHCC with 10 presumptive

and their treatment supporters (TS) from both Girei and Song LGA, Also in attendance where some

CBO Staff, LGTBLS, DOT Officers and some health workers.

Discussion was done on adherence and other sensitive issue.

Sensitization was conducted in Madagali LGA, Shuwa community on Hygiene promotion, Hand washing

procedure, regular cleaning of toilets with disinfectants, regular washing of food products/ utensils,

clearing of refuse, proper covering of cooked food and fetch water from good sources, eg boreholes

and protected wells, this will prevent cholera infection and some food and water borne diseases . People

reached were 100 Male 76 Female 24.

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DISEASE SURVEILLANCE AND NOTIFICATION

SUMMARY

Performance indicators (Epi Week 30):

In Epidemiological Week 30 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% timeliness, 90% completeness).

Measles: 01 case of suspected measles reported with cumulative case count of 388 and 06 deaths. CFR

is 1.6%

AFP: 01 case of AFP reported with cumulative case count of 165.

YELLOW FEVER: No case of suspected YF reported and cumulative case count is 10

CSM: No case of suspected CSM reported and cumulative case count is 31 with 10 deaths. CFR stands

at 32%

Cholera 07 cases of suspected Cholera reported and cumulative case count is 1729 with 27 deaths.

CFR stands at 1.6%

LASSA FEVER: No case of suspected Lassa fever was reported, cumulative case count is 15 and 05

deaths. CFR stands at 33.3%

MONKEY POX: No case of suspected monkey pox reported and cumulative case count is 06 with 01

death. CFR is 16.7%

NNT: No case of suspected neonatal tetanus reported and cumulative case count is 06.

Activities Done

Detection and surveillance on IDSR diseases in 21 LGAs of the State through DSNOs and network of

surveillance focal sites

Monitoring of cholera situation in the State. 8 new cases with no death were reported in week 31. Total

case count now stands at 1735 with 27 deaths.

WHO continuous to provide operational support to the CTC’s especially that of Maiha as the number

of cases declines. We support active case search of suspected cholera patients in the hotspot

communities in Maiha by the H2R team and provide supplies for cholera case management.

Conducted supportive supervisory visit to PHCC Lokuwa and New Life Hospital in Mubi North LGA.

Facilitated the training of 83 health workers to support cholera surveillance at health facilities; sensitize

the clients on cholera prevention; manage and refer suspected cholera cases appropriately

Cholera EOC Meeting at Mubi North LGA

Planned Activities

Continuous surveillance and case detection on IDSR diseases at LGA levels

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Contact tracing, active case search and risk communication on Lassa fever and Cholera.

eIDSR supportive supervision in 27 selected HFs across 5 LGAs of Adamawa State.

Case distribution by Cases and Deaths per disease, 2018

WEEKLY TREND ANALYSIS, WK 30 2018

Trend of weekly number of Suspected Measles cases, Week 01 – 30, 2018.

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Disease Week 30 Cumulative

2018

# cases # deaths # cases # deaths

AFP 1 0 165 0

Suspected Measles 1 0 388 06

Suspected CSM 0 0 31 10

Suspected Cholera 7 0 1729 27

Suspected VHF - Lassa Fever 0 0 15 05

Suspected Yellow Fever 0 0 10 0

Suspected Monkey Pox 0 0 06 01

Guinea worm 0 0 0 0

Suspected NNT 0 0 06 0

Human Influenza 0 0 0 0

Immediately notifiable diseases | IDSR WK 30

Trend of Epidemic prone diseases |Suspected Measles

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Trend of weekly number of Suspected Lassa Fever cases, Week 01 – 30, 2018.

Weekly trend of suspected cases of CSM, Week 01 – 30, 2018

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Trend of Epidemic prone diseases | Suspected Cerebrospinal Meningitis (CSM)

Trend of Epidemic prone diseases |Suspected Lassa fever

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Weekly trend of suspected cases of Yellow Fever, Week 01 – 30, 2018

Weekly trend of suspected cases of Cholera, Week 01 – 30, 2018

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Trend of Epidemic prone diseases | Suspected Yellow fever (YF)

Trend of Epidemic prone diseases | Suspected Cholera

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Weekly trend of AFP Cases, Week 01 – 30, 2018

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CSM Cholera VHF Measles YF GW Others AFP

WK1 to WK30, 2018 WK30, 2018

Trend of Diseases Targeted for Elimination| AFP Cases

Weekly and Cumulative Disease Graph | IDSR 002 WK 01 – 30 2018

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HEALTH SECTOR COORDINATION

National Human Rights Commission (NHRC) stakeholders meeting on protection violation in

Adamawa State humanitarian response

The NHRC organized a workshop in conjunction with UNHCR on protection issues cutting

across the sectors in the State. Key deliberations in the workshop were the mandate of NHRC,

structure and functions of the commission and relevant collaboration or link with other sister

organizations and commissions. The humanitarian crisis in the north eastern part of the country

poses a new challenge to the commission, hence the need for to properly understand the

emergency response by the commission to improve the human dignity by enhancing the

protection values across the sector wide approach. Cases of abuse, neglect, exploitation and

rape has been reported widely across the affected states as it affects IDP and this workshop was

designed to address these shortcomings.

Although in terms of structuring and balanced participation from all sectors was lopsided, having

more of protection sector, it is a welcome idea and a positive step in the right direction to

address these priority issues. In future it will be appropriate to have a sector approach rather

than organization based submissions from individuals so as to have a wider picture.

W.H.O. on behalf of the health sector looked at service delivery as a key protection issue that

needs to be delivered as a right to the vulnerable population. Accountability to affected

population was highlighted which appears to be a gray area to most organizations present. A

strong recommendation was made to develop this interactive workshop to be consistent and

periodic, so as to offer a platform for continuous engagement of stakeholders on how to

improve service delivery in a safe and dignified manner to vulnerable individuals in line with the

transformative agenda of the humanitarian response as spelt out by OCHA.

Final reports of Initial Rapid Need Assessment (IRNA) for Numan and Demsa LGAs

The farmers’- herders clash in Adamawa State is shown to worsen the humanitarian response in

the State in recent times. At the moment, 9 LGAs are affected with Numan and Demsa LGA

being worse affected. Huge displacement of 130,000 by IOM has been recorded in these LGAs,

further jeopardizing the already existing crisis due to insurgency. This necessitated the IRNA to

accessible communities in the two worse hit LGAs so as to mobilize support to alleviate human

suffering. The findings are as follows;

The prevalent infectious diseases noticed were Malaria (45%), diarrhea (30%) and acute

respiratory infections (22%) in the communities visited.

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Although there were no rumors for impending disease outbreak, the predisposing conditions

that cut across WASH, Shelter and nutrition exist.

IRNA Team in Dung Demsa LGA

In all the locations visited, health facilities were not damaged and are located within the

communities but the levels of functionality were sub-optimal (100% sub-optimal service

delivery). The most contributing factor was the security concerns, driving the health care

workers to safe locations.

Skilled Birth Attendance (SBA) is a major constraint in the communities visited, as only 25% of

deliveries were attended by SBA. Most of the facilities (75%) have no records of deliveries in the

last 7 days because of industrial action by healthcare workers and insecurity.

In all (100%) the facilities visited the stocked essential drugs were not going to last for more

than a week.

NUTRITION

There is no staff with capacity to identify feeding problems within the community. So CMAM,

IYCF, MNP does not exist in the facilities and communities except for PHC Dong that runs

CMAM program as an OTP site.

Ongoing Cholera outbreak response in Mubi North and Mubi South LGA of Adamawa State;

Oral Cholera Vaccine (OCV) 1 campaign

The cumulative total number of cases as at date is 1,724 and the CFR is 1.56%. Under the

support of WHO, active case search, coordination, commodities and logistics supplies in all the

3 LGAs is ongoing. The EOC is held thrice a week and the Sitrep is now weekly. MSF has

secured funding for referral services in Maiha due to some HTR locations and the LGA

Executive Secretary have offered to provide a vehicle for referrals. They will be responsible for

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the fueling and allowances for the driver. Any driver outside this arrangement that conveys a

patient to the CTC in Maiha will be paid on arrival by MSF. IRC is supporting the CTC with

diesel and water (5,000 liters of water daily).

The IM also highlighted key challenges as follows; WASH only 40 out of 101 water points have

been chlorinated, Lack of aqua tablets and no household residual spraying going on since the

withdrawal of Solidarity International.

The OCV 1 campaign was successfully carried out and the following coverage rates were

recorded; Mubi North 111%, Mubi South 90%, Maiha 109%. The coverage for the State is 100%.

Campaign started from 10-14 July, 2018.

Visit of the head of OCHA Nigeria to Adamawa State

On the 17/7/18 head of OCHA paid a visit to the State. A meeting with the country head of

OCHA was held in IOM office with the ISWG team in the State. Key submissions by the

HSWG was the constraints with referral services, funds for scaling up HTR mobile teams, funds

for NNGOs and the support for the cholera response from the NHF. The results of the recent

IRNA triggered by the farmers’ herders clash came very clear from all the sectors to the head of

OCHA. This has compounded the humanitarian crisis in the State. The ISWG requested that a

case be made for the State for more assistance.

Updates on the Humanitarian hub in Gulak Madagali LGA

With the approval of the technical working group at Borno level for the construction of the

humanitarian hub in Gulak, Madagali LGA, a team of experts came to the State and had an

interaction with stakeholders along the Mubi axis. Subsequently they proceeded to Gulak, where

they carried out detail assessment of the site which had existing structures. It was projected that

once construction commences, the work will last for less than 3 months. The final stage for the

approval lies with the SMT. The DHC who is a member of the SMT is expected in the State in the

coming months where he is expected to pay on the spot visit to the proposed site for the hub.

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 July, 2018.

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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

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

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

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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, Goggoji Initiative, Zireenza Support Initiatives,

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

ADRA, MSF-Spain

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-

SUBNATIONAL COORDINATOR)

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