1. MINISTRY OF COMMUNITY DEVELOPMENT MOTHER AND CHILD HEALTH MRS. ELIKA KAMIJI CHIEF EPI OFFICER IMPLEMENTATION OF GAPPD: ZAMBIAN EXPERIENCE Global Immunization Meeting: PIA Sitges, 23-25 June 2015

2. LAYOUT Background GAPPD – The Zambian Case Mazabuka GAPPD Pre and Post GAPPD Launch activities Challenges Next steps

3. BACKGROUND-COUNTRY PROFILE Population:14,222,307 2.8% Population Annual Growth Rate Under 1 year population is 653,131 (4.6%) Under 5 years population is 2,844,461 (20%) Under 15 years population is 6,471,150 (45.5%) Geography: has 10 provinces & 81+ districts

4. GAPPD - THE ZAMBIAN CASE Zambia participated in the African Regional Workshop on coordinated approaches to Pneumonia and Diarrhoea Prevention and Control in Nairobi, Kenya, January 2011. Identified as a priority country to introduce GAPPD. Provided technical support to develop an integrated framework for implementing GAPPD in the context of Zambia’s Roadmap for A Promise Renewed (APR).

5. MAZABUKA GAPPD Mazabuka district in Southern Province was selected as the first district for implementation of GAPPD in partnership with stakeholders. Some of the criteria for selection of the district included- low levels of coverage of high impact child health interventions, high commitment from district health management, close proximity to Lusaka facilitating documentation, follow up and monitoring Inclusion of activities that address GAPPD initiative in the annual action plan.

6. MAZABUKA GAPPD CONT’D Field visit to Mazabuka district in 2013 undertaken by a team from Ministry, WHO (HQ and Country Office) led to the development of a Mazabuka GAPPD action plan which was incorporated into the district annual action plan. Minister of MCDMCH launched GAPPD in Zambia on the 14 th of October 2014. Minister made an early call on relevant government Ministries, civil society, NGOs to expand GAPPD to all districts in the shortest time possible.

7. MAZABUKA GAPPD CONT’D The priority activities identified were: - baseline KAP survey; training of health providers in IMCI and (iCCM) supervision; training of CHWs in iCCM; Integrated Disease Surveillance and response (IDSR) training in programme management including focus on protection, prevention and treatment of pneumonia and diarrhoea. PATH expressed interest to consider including Mazabuka in the Better Immunisation Data programme to improve quality and local utilisation of data. The protocols and tools for baseline household and facility survey are still being awaited from HQ The survey to follow soon after ethical clearance

8. PRE- AND POST LAUNCH ACTIVITIES CONT’D Launch of the introduction of Rota vaccine in the context of GAPPD was conducted in Mazabuka in 2013 Mazabuka Community Medical Office, with support from WHO, conducted the Integrated Disease Surveillance and Response (IDSR) training in October, 2014 34 staff from district office and Health Centers trained in data collection skills, analysis and interpretation and also in efficiently and effectively reporting on notifiable diseases By end of 2014, the district had achieved 73% reporting by rural and urban health centres for conditions such as non-bloody diarrhea, dysentery, pneumonia and confirmed malaria, (Target at least 80% reporting by health facilities).

9. PRE- AND POST LAUNCH ACTIVITIES CONT’D 25 health care providers were trained in IMCI in Mazabuka district, October 2014. Last IMCI training was in 2002 The training of 30 CHWs from 17 Rural Health Centre catchments in iCCM took place in Mazabuka District from December 2014 with the support of WHO. During the same period, PATH supported the district in training iCCM supervisors. There were 20 participants from 18 Rural Health Centres & the district office.

10. PRE- AND POST LAUNCH ACTIVITIES CONT’D Advocacy for GAPPD concept as part of technical guidelines for 2015 district plans Advocacy to already existing programmes/projects to include GAPPD (EU funded MDGi programme; Health for the Poorest People; Canada H4+; PATH; Programme for Awareness and Elimination of Diarrhoea-PAED) Advocacy to upcoming programmes/projects (RMNCH & Nutrition project funded by World Bank; RMNCH Trust Fund GAPPD is an agenda item in the IMCI technical working group

11. CHALLENGES WITH IMPLEMENTING GAPPD IN MAZABUKA The district is set to scale up GAPPD. However the development of the survey tools for baseline survey has been delayed. Coordination of the different stakeholders from the various sectors and institutions.

13. HEALTHY CHILD BROCHURE

14. KEY MESSAGES GAPPD has became a catalyst to bring together key stakeholders to plan together and agree on roles and responsibilities The Mazabuka GAPPD Action Plan facilitated alignment of activities and pooling resources from different stakeholders Multi-sectoral coordination is very critical for a successful implementation especially at district level.

15. NEXT STEPS Planning for Mazabuka health facility and household baseline survey Strengthen the application of GAPPD in the National Technical updates and District planning guidelines Continued advocacy to all stakeholders for GAPPD Strengthening documentation of implementation and progress of GAPPD. Need to strategize and mobilize resources to support its rollout. Can link GAPPD with the global financing mechanisms like GAVI, RMNCH Trust Fund, GFF etc.

16. ACKNOWLEDGEMENTS Government of Zambia Line Ministries World Health Organization UNICEF PATH SAVE THE CHILDREN CIDRZ European Union

17. THANK YOU