08 ap model- aefi - 08-11-05 - chandigarh

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  • 1. Sri C.B.S. Venkata Ramana, IAS Commissioner of Family Welfare & Ex-officio Secretary Dr. R. Gopal Krishna Rao Joint Director (CHI) A.E.F.I. Surveillance in Andhra Pradesh
  • 2. Immunization Activity in AP
    • Implementing department: Commissionerate of Family Welfare
    • Infrastructure:
      • Rural – PHCs 1490, Sub-centres 12552
      • Urban – PP units 82, area hospitals 56, Medical college hospitals 36, UHPs 60
  • 3. Immunization Activity in AP contd..
    • Special features
      • Hep-B vaccine introduced in RI since 2002.
      • AD syringes in use for all vaccination injections.
      • Safety boxes and needle cutters in use for safe disposal.
    • Beneficiary groups
      • OPV, DPT, BCG, Hep-B and Measles – 1.54 M.
      • DT – 1.74 M., TT pregnant women – 1.8 M.
    • Extent and pattern
      • Every month – at institutions/SCs – sessions – children. At villages (outreach sites) – sessions – children. At Headquarters – Wednesday – children & FW. At outreach – Saturday – children & FW.
  • 4. AEFI surveillance in AP
    • Progress from 2002 to 2004:
      • 5 members trained at GTN, Colombo (2003)
      • Most of the DIOs are trained (the trained DIOs keep changing on transfers or on promotion)
      • SOPs, Forms and Guidelines developed and communicated
      • Revised G.O. issued forming AEFI team (expert committee) in 10 medical colleges vide G.O.Ms.No.596 Dt.14-12-2004 (1 team for 2-3 districts).
      • Team/expert committee = 1 Epidemiologist + 1 Paediatrician + 1 Microbiologist from medical college.
  • 5. Constitution of state committee
    • Constituted as per GO Ms 596 Dt.14-12-2004, the committee is as follows:
      • Joint Director (MCH), O/o. CFW.
      • Professor & HOD, Niloufer Hospital.
      • Representative from State Drugs Control Administration
      • AEFI Coordinator appointed by WHO
  • 6. AEFI – selected conditions
  • 7. Reporting channels HCW DIO/ DM&HO Hospital (Govt/Pvt) MO (PHCs) RIT SEPIO GOI
  • 8. Community Level District Level ANM & MPHA M.O. PHC Physician RRT + DIO DIO/ DM&HO Hospital & private clinics AEFI Committee SEPIO Commissioner FW AEFI investigation team State Level Proposed AEFI reporting system AEFI Clinico-Epid. Data-(AEFI Format) Investigation Communication Strategy Investigation Final report Central level Severe AEFI/Death Y N AEFI Severe & death case Coordinate timely investigation Final report Causality assessment Compile reports Implement corrective measures if any Y N Further data Collect Prelim. Data & Report
  • 9. AEFI Investigation
    • Present Status:
    • Deaths and other events reported - Yearly figures indicated
    • All deaths/other events investigated
    2002 2003 2004 Other events Deaths 11 11 11 2005 Deaths Deaths Deaths - 5 11 1 Investigated by RIT 6 8 13 1 Total Investigated 6 8 13 2 Deaths reported Year wise
  • 10. AEFI Investigation contd..
    • DIO to investigate
      • TSS, BCG lymphadenitis, cluster of abscess, sepsis, hospitalizations
    • RIT/expert committee to investigate
      • Deaths, major AEFI causing public concern
      • For investigation of deaths – within 48 hours
  • 11. Laboratory investigation
    • Present practices
      • Lift the sample from the site
      • Send to CRI, Kasouli (the used vial along with 5 un-used vials of the same batch)
    • Results received from CRI, Kasouli in 30 days
    • Referral labs
      • CRI, Kasouli
  • 12. Review of AEFI
    • Being done at State level and district level
    • SEPIO compiles the data and forwards to GOI by email
  • 13. Arrangements already in place
    • Investigation system established
      • DIOs trained, RITs trained
      • HCWs, Pharmacists trained
    • Forms and formats ready
    • SOPs ready
    • VLF captures AEFIs at PHC level
    • Supportive supervision educates the HCWs on AEFI
    • Supportive supervision captures AEFIs
  • 14. Current barriers to reporting
    • Not all HCWs are aware of What to report, Where to report
    • Fear of Punishment
    • Compensation issue -?
    • Efforts are still on way to educate every Health Worker to report a case of AEFI be it a minor or major event
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  • 21. Thank you