Challenges at the End of 2019
- 75% of health facilities lack vaccine fridges to store vaccines
- Low TB case detection
- Late reporting of weekly IDSR by some facilities
- High RTS,S drop out rate
- Low RTS,S coverage
- Negative drop-out rates
Ekumfi District Health Directorate
2020 END OF YEAR PERFORMANCE REVIEW
Presented By Disease Control Unit
Presentation Outline
- Challenges in 2019
- Objectives/Priorities for 2020
- Planned and Implemented Activities
- EPI Coverages
- COVID-19 Updates
- 2021 Objectives
- Way Forward
- Acknowledgement
Priority for 2020
- To achieve 97% EPI coverage for all antigens and 100% for BCG
- To detect at least 60 cases of TB by the end of the year
- To achieve 95% TB treatment success rate
- To detect at least two suspected cases of all priorities diseases by the end of 2020
- To provide timely feedback on weekly IDSR
- To conduct data quality audit to ensure data consistency
Planned & Implemented Activities
- Daily TB screening at OPD, RCH, ANC at the various facilities and ART centres
- Conducted Integrated monitoring and support visits to all facilities
- Trained health workers and CBS volunteers on Covid-19 activities and recommended protocols
- Transported samples of suspected cases of priority diseases including covid-19 to appropriate laboratory
Implemented Activities...
- Conducted periodic records review in consulting room for case search in the district
- Conducted on the job training in all the health facility on EPI antigens and data capturing
- Carried out mass immunization activities (IPV campaign, mOPV, and yellow fever (MPVC)
- Conducted training on NTDs DHIMS 2 new data collection forms
Implemented Activities...
- Conducted CDD(community volunteers) training morbidity management and disability prevention of NTDs
- Installations of vaccine refrigerators in 9 health facilities
- Carried out mass immunization activities (IPV campaign, mOPV, and yellow fever (MPVC)
- Provided weekly and monthly feedbacks on IDSR and EPI coverage respectively
EPI Metrics for Essueyhia
EPI Trend for Narkwa
EPI Performance for Otuam
Table Showing EPI Coverage for Ekumfi District
| Antigens | 2018 (%) | 2019 (%) | 2020 (%) |
|---|---|---|---|
| BCG | 1989 (81.7) | 2290 (92.8) | 2605 (103.8) |
| OPV1 | 2155 (88.5) | 2401 (97.3) | 2377 (94.7) |
| OPV3 | 2153 (88.5) | 2393 (97.0) | 2410 (96.0) |
| ROTA2 | 2167 (89.0) | 2369 (96.0) | 2521 (100.4) |
| PENTA3 | 2122 (87.2) | 2382 (96.5) | 2695 (107.4) |
| MR2 | 2023 (83.1) | 22316 (93.8) | 2405 (95.8) |
| YF | 1958 (80.4) | 2314 (93.8) | 2457 (97.9) |
| MENA | 1980 (81.3) | 2028 (82.2) | 1983 (79.0) |
| TT2+ | 2056 (84.5) | 2547 (103.2) | 2278 (90.8) |
EPI Metrics for Ekumfi District
Dropout Rate in Antigens
2020 RTSS Coverage By Sub-Districts
| Sub-Districts | RTSS1 (%) | RTSS2 (%) | RTSS3 (%) |
|---|---|---|---|
| Essuehyia | 953 (85) | 1012 (91) | 985 (88.4) |
| Narkwa | 871 (107) | 755 (92.7) | 723 (88.8) |
| Otuam | 495 (85) | 523 (89) | 494 (87) |
Priority Diseases Notified From 2018-2020
| Priority Diseases | 2018 | 2019 | 2020 |
|---|---|---|---|
| AFP | 2 | 3 | 3 |
| Measles | 4 | 6 | 5 (+1) |
| Yellow Fever | 4 | 2 | 5 |
| Buruli Ulcer | 9 | 4 (+1) | 5 |
| Cholera | 0 | 0 | 0 |
| COVID-19 | 0 | 0 | 249 (+7) |
TB Cohort Analysis: 2017-2020
| Year | Cases Notified | Smear Positive | Smear Negative | Cured | Completed | Loss | Died | Success Rate |
|---|---|---|---|---|---|---|---|---|
| 2017 | 21 | 19 | 2 | 14 | 2 | 2 | 1 | 76.0% |
| 2018 | 18 | 13 | 5 | 10 | 7 | 1 | 0 | 94.0% |
| 2019 | 17 | 11 | 6 | 8 | 7 | 1 | 1 | 88.0% |
| 2020 | 15 | 9 | 6 | 0 | 0 | 0 | 0 | 0.0% |
TB Notification Rate
TB Co-infection
TB Treatment Outcomes
| Year | Cured (%) | Completed (%) | Died (%) | Default (%) | Failure (%) | Transfer (%) |
|---|---|---|---|---|---|---|
| 2017 | 67.0 | 9.5 | 4.0 | 9.5 | 0.0 | 0.0 |
| 2018 | 56.0 | 39.0 | 0.0 | 5.0 | 0.0 | 0.0 |
| 2020 | 47.0 | 41.0 | 5.0 | 5.0 | 0.0 | 0.0 |
Current Update on COVID-19
| Indicator | 2020 |
|---|---|
| Total suspected cases | 247 |
| Samples takeb & sent to lab | 247 |
| Positive cases in communitites | 5 |
| Positive cases among students | 1 |
| Positive cases among health workers | 1 |
| Total tested positive cases | 7 |
| Total tested negative cases | 240 |
| Total pending results | 0 |
COVID-19 Activities
Challenges in 2020
- No sputum smear test centre in the district leading to low TB case detection
- Inadequate vaccine fridges in some facilities
- low TB case detection rate
- High RTS,S drop-out rate
- Low RTS,S coverage
Objectives for 2021
- Collect and transport sputum samples from suspected TB cases to nearby laboratories through Ghana post
- Intensify TB screening at the various facilities
- Use of immunization reminder system and defaulter tracing register to track defaulters
- To continue regular monitoring and supervision on EPI activities
- To conduct two mop-ups before the end 2020
- To continue weekly and monthly feedback to facilities
Way Forward
- Collect and transport sputum samples to nearby laboratory
- Lobby with RHD to acquire Gene expert machine and enhance TB case detection
- Strengthen TB screening at the various facilities
- Data Audit to reduce negative drop-outs
- To strengthen collaboration with Community based volunteers to search for suspected TB cases
- Conduct mop-up on RTSs before the end 2021
- Conduct TB screening at selected communities in the district.
Acknowledgement
- Our sincerely gratitude goes to the Regional Director of Health Service and her team, District Health Director and the entire health staffs of Ekumfi District.
- Also to the Ekumfi District Assembly, Ekumfi traditional council Operation Eyesight universal, Plan International Ghana, GNPC, for donation of PPEs