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

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

  1. 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. 2. Immunization Activity in AP <ul><li>Implementing department: Commissionerate of Family Welfare </li></ul><ul><li>Infrastructure: </li></ul><ul><ul><li>Rural – PHCs 1490, Sub-centres 12552 </li></ul></ul><ul><ul><li>Urban – PP units 82, area hospitals 56, Medical college hospitals 36, UHPs 60 </li></ul></ul>
  3. 3. Immunization Activity in AP contd.. <ul><li>Special features </li></ul><ul><ul><li>Hep-B vaccine introduced in RI since 2002. </li></ul></ul><ul><ul><li>AD syringes in use for all vaccination injections. </li></ul></ul><ul><ul><li>Safety boxes and needle cutters in use for safe disposal. </li></ul></ul><ul><li>Beneficiary groups </li></ul><ul><ul><li>OPV, DPT, BCG, Hep-B and Measles – 1.54 M. </li></ul></ul><ul><ul><li>DT – 1.74 M., TT pregnant women – 1.8 M. </li></ul></ul><ul><li>Extent and pattern </li></ul><ul><ul><li>Every month – at institutions/SCs – sessions – children. At villages (outreach sites) – sessions – children. At Headquarters – Wednesday – children & FW. At outreach – Saturday – children & FW. </li></ul></ul>
  4. 4. AEFI surveillance in AP <ul><li>Progress from 2002 to 2004: </li></ul><ul><ul><li>5 members trained at GTN, Colombo (2003) </li></ul></ul><ul><ul><li>Most of the DIOs are trained (the trained DIOs keep changing on transfers or on promotion) </li></ul></ul><ul><ul><li>SOPs, Forms and Guidelines developed and communicated </li></ul></ul><ul><ul><li>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). </li></ul></ul><ul><ul><li>Team/expert committee = 1 Epidemiologist + 1 Paediatrician + 1 Microbiologist from medical college. </li></ul></ul>
  5. 5. Constitution of state committee <ul><li>Constituted as per GO Ms 596 Dt.14-12-2004, the committee is as follows: </li></ul><ul><ul><li>Joint Director (MCH), O/o. CFW. </li></ul></ul><ul><ul><li>Professor & HOD, Niloufer Hospital. </li></ul></ul><ul><ul><li>Representative from State Drugs Control Administration </li></ul></ul><ul><ul><li>AEFI Coordinator appointed by WHO </li></ul></ul>
  6. 6. AEFI – selected conditions
  7. 7. Reporting channels HCW DIO/ DM&HO Hospital (Govt/Pvt) MO (PHCs) RIT SEPIO GOI
  8. 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. 9. AEFI Investigation <ul><li>Present Status: </li></ul><ul><li>Deaths and other events reported - Yearly figures indicated </li></ul><ul><li>All deaths/other events investigated </li></ul>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. 10. AEFI Investigation contd.. <ul><li>DIO to investigate </li></ul><ul><ul><li>TSS, BCG lymphadenitis, cluster of abscess, sepsis, hospitalizations </li></ul></ul><ul><li>RIT/expert committee to investigate </li></ul><ul><ul><li>Deaths, major AEFI causing public concern </li></ul></ul><ul><ul><li>For investigation of deaths – within 48 hours </li></ul></ul>
  11. 11. Laboratory investigation <ul><li>Present practices </li></ul><ul><ul><li>Lift the sample from the site </li></ul></ul><ul><ul><li>Send to CRI, Kasouli (the used vial along with 5 un-used vials of the same batch) </li></ul></ul><ul><li>Results received from CRI, Kasouli in 30 days </li></ul><ul><li>Referral labs </li></ul><ul><ul><li>CRI, Kasouli </li></ul></ul>
  12. 12. Review of AEFI <ul><li>Being done at State level and district level </li></ul><ul><li>SEPIO compiles the data and forwards to GOI by email </li></ul>
  13. 13. Arrangements already in place <ul><li>Investigation system established </li></ul><ul><ul><li>DIOs trained, RITs trained </li></ul></ul><ul><ul><li>HCWs, Pharmacists trained </li></ul></ul><ul><li>Forms and formats ready </li></ul><ul><li>SOPs ready </li></ul><ul><li>VLF captures AEFIs at PHC level </li></ul><ul><li>Supportive supervision educates the HCWs on AEFI </li></ul><ul><li>Supportive supervision captures AEFIs </li></ul>
  14. 14. Current barriers to reporting <ul><li>Not all HCWs are aware of What to report, Where to report </li></ul><ul><li>Fear of Punishment </li></ul><ul><li>Compensation issue -? </li></ul><ul><li>Efforts are still on way to educate every Health Worker to report a case of AEFI be it a minor or major event </li></ul>
  15. 21. Thank you

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