Nigeria

Northeast Nigeria Response (Borno State): Health Sector Bulletin #5, 28 October 2016

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Situation Report
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28 October 2016

3.7 MILLION
IN NEED OF HEALTH ASSISTANCE 2016
1.89 MILLION
INTERNALLY DISPLACED PERSONS
2.6 MILLION
2016 TARGET BY HEALTH SECTOR
1,709,581
BORNO STATE POLIO VACCINATED CHILDREN

Highlights

  • Partners are scaling up their response to mitigate and control the risk of endemic malaria as more cases are emerging. In Epidemiological Week 42, there were 10,910 suspected malaria cases and seven deaths (CFR 0.1%) reported from the EWARS sites across 13 LGAs. 38% of all cases reported were children under 5 years.
  • Artemisinin-based Combination Therapy Combination therapy (considered best treatment option for malaria) will be used for one round of Mass Drug Administration (50% of total target population that is < 15 years old). Resources for the procurement of the drugs are being mobilised, while the initial 400,000 doses for immediate administration is currently being procured.
  • Following reports of measles cases in Muna garage IDP camp in Jere LGA, WHO and Partners supported Borno SMOH to conduct an intensified session of measles vaccination on 24 October 2016.
  • Available Routine Immunization vaccine stock was used. The exercise targeted infants and children aged 6 to 59 months of age. 705 out of an estimated 3,920 children under 5 years of age in Muna Garage camp were vaccinated during this session.

Situation Update:

In Borno State alone, 1,446,833 Internally Displaced Persons (IDPs) continue to live in over 100 formal and informal camps and remain extremely vulnerable and exposed to health risks. In addition, over 1.1 million children under the age of five, over 600,000 women of reproductive age (15-49 years), and over 140,000 elders over 60 years, are the most vulnerable population groups in the host communities. Epicentre and Médecins Sans Frontières (MSF) conducted a retrospective mortality and nutritional surveys (Mid Upper Arm Circumference) among displaced persons in Muna Garage Camp (19 August - 9 September 2016) and Custom House Camp (23-29 September) in Borno State. From the published report, in summary the cross-sectional survey show:

"The high mortality in the two camps confirms the deterioration of the health conditions of the population of Muna Garage and Custom House camps. The surveys performed in these two camps demonstrated very poor health indicators, in terms of retrospective mortality, nutrition and measles vaccination coverage, despite the accessibility of the camps. MSF mass intervention in terms of targeted food distribution, nutritional screening, and seasonal malaria chemoprophylaxis early September in the two camps have likely mitigated the situation. Interventions of other health and food actors in Maiduguri started to scale-up in September 2016. Nevertheless, situation in the two camps surveyed remains of high concerns."

The report further recommendations emphasize the need for an urgent scale-up, and include:
- Conducting general food distribution
- Extending criteria of admission to Ambulatory Feeding Treatment Centres (MAM and children under 10 years old)
- Conducting regular and systematic community based malnutrition screening and referral to nutritional program
- Performing measles vaccination catch-up campaigns
- Assessing and improving water and sanitation conditions in the camp, as well as access to health care and current nutritional program in the camps.

Reacting to the findings of the retrospective survey above, the Health Sector that has been scaling up operations since the end of September, convened a meeting to identify hot spots and adjust the response as per needs on ground to stop further deterioration of the health situation of the affected population. Reactive measles vaccination campaigns are underway in Muna-Garage camp.

Although tentative, the planned National Measles mass vaccination campaign was postpone to December. Thus considering the prevalence of SAM and repeated outbreaks of measles state wide, a measles catch-up vaccination campaign for most vulnerable populations (06 months – 15 years of age) with attention to IDP camps and around outbreak prone locations is currently in the works, with consultations going on at Federal level and micro-planning at Borno State level.