Health Sector Bulletin - HumanitarianResponse · Malaria: In Epi week 31, 6,565 cases of confirmed malaria were reported through EWARS. Of the reported cases, 375 were from General

HEALTH SECTOR

Health Sector Bulletin

Northeast Nigeria

Humanitarian Response

COVID-19 response

July 2020

4.4 Million PEOPLE TARGETED BY

THE HEALTH SECTOR

>2.0 Million*** PEOPLE REACHED IN

2020

1.9 Million* IDPs IN THE THREE

STATES

45 HEALTH SECTOR PARTNERS

(HRP & NON HRP)

HEALTH FACILITIES IN BAY STATES**

1529 (58.1%) FULLY FUNCTIONING

268 (10.2%) NON-FUNCTIONING

300 (11.4%) PARTIALLY FUNCTIONING

326 (12.4%) FULLY DAMAGED

4.9 Million CONSULTATIONS****

1,490 REFERRALS

72,566 CONSULTATIONS THROUGH HARD

TO REACH TEAMS

CUMULATIVE CONSULTATIONS

EARLY WARNING & ALERT RESPONSE

275 EWARS SENTINEL SITES

201 REPORTING SENTINEL SITE

1,477 TOTAL ALERTS RAISED*****

*Total number of IDPs in Adamawa, Borno and Yobe States by IOM DTM XXX

**MoH/Health Sector BAY State HeRAMS September/October 2019/2020

***Number of health interventions provided by reporting partners as of June 2020.

**** Cumulative number of medical consultations from Hard-To-Reach Teams.

***** The number of alerts from Week 1 – 26, 2020

SECTOR FUNDING, HRP 2020

6.2% FUNDED GAP: 80.9M USD

5.6 Million PEOPLE IN NEED OF

HEALTHCARE

• COVID-19 cases are steadily increasing in the three states. In Borno, currently, 12 out of 27 LGAs are affected and >80% of reported cases are among travellers tested at POE locations. Challenges remain around stigma and discrimination among people discharged from quarantine and treatment centres; this results that the majority of confirmed cases (73%) are opting for self-isolation. Partners are working to scale up the COVID-19 surveillance and contact tracing efforts to enable rapid detection, isolation, testing, and management of cases.

• As of 30th July 2020, 88% of 844 confirmed cases in BAY states have been discharged since the beginning of the COVID-19 response. With 40 new cases, Adamawa state maintains a weekly lead in COVID-19 burden among the BAY states; Yola North and South LGAs account for 75% of all cases in the state. Yobe state launched a heroes campaign to celebrate survivors of COVID-19 who were declared as “heroes and heroines”

• As the schools’ plan to resume, SMoH, WHO and other partners are putting measures in place to ensure compliance with the guidelines for the safe reopening of schools in the state through timely IPC measures.

• Malaria SMC Cycle-1 implementation in Borno State Started on 11th July 2020. The campaign was based on three strategies i.e. House to House (H2H), Reach every settlement (RES) and engagement of community informants from inaccessible areas. 25 accessible LGAs were planned for the implementation, with (CIIAs) in these LGAs are fully accessible, partially accessible and inaccessible areas. As such, the fully accessible areas were reached by H2H teams, partially accessible areas were reached using the RES teams, while inaccessible areas were reached through CIIAs. This was to ensure that all eligible children within the 25 LGAs were protected from malaria.

• Since the beginning of the COVID-19 pandemic, attacks on health care have received increasing attention. As health care providers worldwide search for effective solutions to protect health care during the COVID-19 pandemic, it is important to keep in mind that incidents of attacks should not be viewed as isolated events, but as one piece of a larger puzzle. One of the health facility in Chabal Limanti in Magumeri LGA recently renovated by WHO was vandalized by BHT, while drugs and equipment were carried away.

•

Highlights

Health Sector Bulletin | July 2020

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Situation Updates

Seasonal Malaria Chemoprevention Week

SMC Cycle 1 implementation in Borno State Started on 11th July 2020. Three (3) strategies were used in Cycle 1 due

to complex operating environment: House-to-house (H2H); Reaching every settlement (RES); and Community

informants from inaccessible areas (CIIAs).

25 accessible LGAs were planned for the implementation, within these LGAs are fully accessible, partially accessible

and inaccessible areas. As such, the fully accessible areas were reached by H2H teams, partially accessible areas were

reached using the RES teams, while inaccessible areas were reached through CIIAs. This was to ensure that all eligible

children within the 25 LGAs were protected from malaria.

Several levels of monitoring and supervision took place during implementation and daily review meetings at all levels

held throughout the period of activity.

GIS Tracking was deployed to support the Cycle 1 Campaign of the SMC 2020 Round. GPS Tracking devices were for

teams implementing: H2H strategy in accessible settlements across 23 LGAs, RES strategy in partially accessible

settlements across 13 LGAs, and CIIA support in inaccessible settlements across 9 LGAs. Settlement visitation status

were analyzed and reported daily for H2H strategy, while visitation status for RES and CIIA activities were analyzed

post campaign and settlement coverage (visited and not visited) were reported on a daily basis during LGA and state

evening review meetings.

Implementation of July 2020 (1st

Cycle)

Borno State Map showing implementing LGAs

H2H only RES only Not Accessible RES

& H2H CIIAs

Map showing locations supervised by various agencies across Borno State.


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Early Warning Alert and Response System (EWARS)

Number of reporting sites in week 31: A total of 196

out of 276 reporting sites (including 32 IDP camps)

submitted their weekly reports. The timeliness and

completeness of reporting this week were 66% and

67% respectively (target 80%).

Total number of consultations in week 31: Total

consultations were 34,750 marking a 3% decrease in

comparison to the previous week (n=35,914).

Leading cause of morbidity and mortality in week 31:

Malaria (suspected n= 9,314; confirmed n= 6,565) was

the leading cause of morbidity reported through

EWARS accounting for 42% of the reported cases,

apart from deaths due to other causes (4), Severe

Acute Malnutrition (2) was the leading cause of

mortality reported through EWARS accounting for

28% of the reported deaths.

Number of alerts in week 31: Seventeen (17)

indicator-based alerts were generated with 100% of

them verified.

Morbidity Patterns

Malaria: In Epi week 31, 6,565 cases of confirmed

malaria were reported through EWARS. Of the

reported cases, 375 were from General Hospital Biu,

273 were from PUI Waterboard Extension IDP Camp

Clinic in Monguno, 211 Algon Clinic in Monguno, 204

were from Uba General Hospital in Askira-Uba, 200

were from ICRC FSP Clinic in Monguno, 187 were from

Peta Model Health Centre in Kwaya Kusar, 151 cases

each from AAH Waterboard Extension IDP Camp Clinic

in Monguno and MCH Clinic Konduga and 146 were

from AAH Veterinary IDP Camp Clinic in Monguno. No

associated death was reported.

Figure 2: Trend of malaria cases by week, Borno State, week 34 2016 – 31 2020

Acute watery diarrhea: In Epi week 31, 499 cases of

acute watery diarrhea were reported through EWARS.

Of the reported cases, 102 were from Ngaranam PHC

in MMC, 48 were from PUI Gana Ali IDP Camp Clinic in

Monguno, 32 were from Gwoza Wakane IDP Clinic in

Gwoza, 31 were from Gamadadi PHC in Bayo, 30 were

from PUI Waterboard IDP Camp Clinic in Monguno

and 20 were from Gamboru PHC in MMC. No


Figure 3: Trend of acute watery diarrhea cases by

week, Borno State, week 34 2016- 31 2020

Acute respiratory infection: In Epi week 31, 6,317

cases of acute respiratory infection were reported

through EWARS. Of the reported cases, 322 were from

Algon Clinic in Monguno, 294 were from PUI

Waterboard Extension IDP Camp Clinic in Monguno,

251 were from AAH GGSS IDP Camp Clinic in

Monguno, 238 were from AAH Fulatari IDP Camp

Clinic in Monguno, 222 were from Waterboard

UNICEF IDP Camp Clinic in Monguno and 216 were

from AAH Veterinary IDP Camp Clinic in Monguno. No



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Figure 3: Trend of acute respiratory infection cases by

week, Borno State, week 34 2016- 31 2020

Suspected Measles: One (1) suspected measles case

was reported through EWARS from Dalaram PHC in

Jere. Seven (7) additional cases were reported

through IDSR* from MMC (5) and Monguno (2) LGAs

making a total of 8 suspected measles cases. No


Figure 4: Trend of suspected measles cases by week,

Borno State, week 34 2016- 31 2020

Suspected Yellow Fever: Three (3) suspected yellow

fever cases were reported through EWARS from

Chibok General Hospital (1) and Njimtilo Health Clinic

(2) in Konduga. Four (4) additional suspected cases of

Yellow Fever were reported through IDSR from Hawul

(2), Jere (1) and Monguno (1) LGAs making a total of 7

suspected yellow fever cases. No associated death

was reported.

Suspected Meningitis: No suspected meningitis case

was reported in week 31.

Suspected VHF: No suspected VHF case was reported

in week 31.

Suspected COVID-19: Two (2) confirmed COVID-19

cases were reported through EWARS from University

of Maiduguri Teaching Hospital in Jere. No associated

death was reported.

Suspected cholera: No suspected cholera case was

reported in week 31.

Malnutrition: 1,454 cases of severe acute

malnutrition were reported through EWARS in week

31. Of the reported cases, 124 were from Kurbagayi

MCH in Kwaya Kusar, 103 were from AAH Waterboard

IDP Camp Clinic in Monguno, 50 cases each from

Damboa MCH and Fori PHC in Jere, 44 were from

Muna Garage Camp Clinic B in Jere and General

Hospital Ngala (FHI360). Two (2) associated deaths

were reported from Chibok General Hospital

Neonatal death: One (1) neonatal death was reported

through EWARS from University of Maiduguri

Teaching Hospital in Jere.

Maternal death: No maternal death was reported

through EWARS in week 31.

*IDSR- Integrated Disease Surveillance and Respons

Health Sector Actions

AAH continue to enhance Sexual and Reproductive Health in humanitarian response in Borno and Yobe State through dissemination of appropriate maternal counselling, and providing access to quality basic health care services that

support women have a fit pregnancy, deliver safely and have a healthy baby. Thus, 8,469 women (ANC-6,912 and PNC-1,557) received Sexual Reproductive Health Services and 359 live births were attended by skilled health personnel. 75,302 (Male – 32,144 Female – 43,158) received health care services at our health facilities. Among those 27,808 are under 5 children and 47,494 are 5 years old and above. The major consultations were malaria (17,662) being the major cause of consultation, followed by AWD (10,086), RTI (8,768), and other medical conditions (38,786). A total of 21,107 (Male – 2,547 Female – 18,560) were reached with six key hygiene messages through mother-to-mother support groups and Community Health Mobilizers. The key messages disseminated include childhood illness danger signs and early referral to health facilities, MIYCN including balance diet with the use of locally available nutritious foods. In addition, importance of ANC cervices,

Sensitization on COVID-19 at Daddawel PHC


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institutional delivery, immunization, malaria prevention through environmental sanitation and appropriate use of insecticide treated mosquito nets, cholera preventive and control measures, availability of STIs care at health clinics and COVID-19 preventive measures. Support to routine immunization continued with the provision of immunization services to 13,925 (Male – 6,482, Female-7,443). Children and pregnant women were vaccinated against vaccine preventable diseases by providing BCG, OPV, PENTA, PCV, IPV as well as TT vaccines. Capacity enhancement sessions were also conducted for health professional and community workers of different cadres where 136 (39 males, 97 females) Community Health Mobilizers received refresher training on Infant and Young Child Feeding in Emergency (IYCF-E) while 30 (12 males, 18 females), compromising of 1 Medical Doctor, 8 Nurses/Midwives, 4 Pharmacy Technicians and 17 Community Health Extension Workers (CHEWs)/Health Educators had a refresher training on Emergency Preparedness and Response. Other 30 Health workers (1 male, 29 females), comprising of 1 Medical Doctor, 29 Nurses/Midwives had a refresher training on Basic Emergency Obstetric and Newborn Care (BEmONC). Two (2) sessions of continuous Medical Education (CME) on-the-job training on Paediatrics Medical Emergency training was conducted for 22 (12 males, 10 females) stabilization centre staff, comprising of 2 Medical Doctors, 8 Nurses, 8 Nurses’ aides, 1 Laboratory Technician, 1 Pharmacy Technician, 1 Psychosocial, and 1 Community Health Extension Worker, and in Yobe State, 25 Health workers (17 males, 8 females), comprising of 1 Medical doctors, 3 nurse/midwives, 1 pharmacy technicians, 20 community health extension workers, have received BEmONC refresher training. In addition, ACF project staff and government staff provided supportive supervision and mentoring at 7 health facilities to improve the quality of Health Care Services. In the case of COVID-19 response, 47,213 (male – 19,398, female – 27,815) clients were sensitized on COVID -19 Infection Prevention and Control measures across facility sites.

AHI conducted training and orientation for 10 National Union of Road Transport Workers (NURTW) drivers with their stakeholders and 4 Health Care providers in Dikwa on

referral/transport scheme in Dikwa to bridge the gap of referral in the LGA. 13 Health facilities were supported with Reproductive Health drugs and consumables. The facilities are: General Hospital Dikwa, MCH Dikwa, 1000 IDP clinic Dikwa, Rabiri clinic Dikwa, Shehu Masta clinic, PHC Dikwa, MCH Monguno, UNICEF clinic Waterboard Monguno, PUI Clinic ALGON Monguno, PUI Clinic Waterboard Monguno, FP Kuya Monguno and ICRC clinic GGSS Monguno. Sexual and Reproductive Health sessions with adolescent girls, young women and medical house to house outreaches is still ongoing. Sensitization of Adolescent girls on health messages, general hygiene and sexual violence was conducted. Pregnant women were enlightened on the need of Anti-natal care, post-natal care and were referred to clinics which we support with delivery kits and relief materials. 24 dignity kits were given to returnees from Baga in Monguno LGA and 10 dignity kits to returnees from Gomboru.

ALIMA provided a total of 2,555 outpatient consultations for children under 5 in Muna Clinic with 15 referrals and 3,024 consultations for all ages in TVC Clinic with 102 referrals. 743 OPD consultations for all ages were provided at Waterboard Reception Clinic in Monguno LGA of Borno State. In Hawul and Askira in Southern Borno, 4,158 OPD consultations were conducted for children under 5. Six (6) measles cases were treated at ALIMA’s health facilities in Monguno LGA of Borno State. Most

of the cases were from Fulatari and GGSS IDP camps. 1 case of gunshots wounds was received at ALIMA facility and 1 case of deep laceration cut was referred to Maiduguri in collaboration with ICRC. For Sexual and Reproductive activities, 1,277 were provided with ANC and 180 PNC consultations in MMC and Jere, out of which 551 ANC are first visits and 180 PNC within 72 hours of delivery at Muna Clinic with no referrals. At the Teachers’ Village Clinic, 1,098 pregnant women in total came for ANC while the total PNC consultations were around 159 (123 PNC within 72 hours). BEmOC activities were conducted at CBDA clinic where 129 deliveries were recorded, which is higher compared to previous month delivery. A total of 1 referral was made to secondary/tertiary care and 134 deliveries were conducted at TVC Clinic, the total number of deliveries is higher compared to preceding month deliveries. Traditional Birth Attendants (10) in Muna and TVC (8) were engaged to refer patients from the community for delivery at CBDA and TVC Clinic. 203 deliveries were recorded and 1,119 ANC consultations were conducted in Askira and Hawul LGAs in southern Borno. MHPSS activities were conducted which include 10 trauma psychotherapeutic sessions with 53 participants in total, 9 Individual therapeutic consultations and Community awareness for 8 group sessions. These were all conducted in Monguno LGA.


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TOPIC OBJECTIVES OF TRAINING PARTICIPANTS LOCATION

MHPSS Overview • Discuss MHPSS in emergency context.

• Establish referral paths and services.

Community Health workers (27)

Monguno

PFA Place of PFA in Humanitarian response. How, when and Where and principles for using PFA. Communication skills in PFA

Community Health workers and Nurses. (31)

Monguno

SGBV Establish a common understanding of SGBV, Awareness, medical and psychological management. Identify contributing/risk factors, scope and consequences and appropriate referral path for SV.

Midwives, Nurses, and CHW’s (62)

Monguno.

eHealth Africa is currently partnering and providing technical support to the Borno State

government and WHO in tracking the settlement coverage of Community Drug Distributors

(CDDs) for the 2020 SMC Round as they carry out drug distribution and administration to children aged between 3

to 59 months in households across settlements in the state. The 2020 SMC round is targeting about 2 million children

in Borno state. eHealth Africa also piloted the GIS tracking support and provided support for data-driven decision

making for microplanning, provision of GPS enabled devices for tracking CDDs, intra-campaign tracking of

settlements coverage, tracking and resolution of missed settlements during the campaign.

FHI 360 provided 13,951 outpatient curative consultations in her clinic facilities in Dikwa, Banki,

Ngala and Damasak. Acute Respiratory Infection (ARI) was the leading cause of communicable

disease morbidity with 3,710 cases. It accounts for the highest morbidities in four (4) sites (Dikwa,

Ngala, and Banki). Also, malaria (2,106 cumulative cases) was the second major cause of morbidity across the four

(4) sites. Peptic Ulcer disease remains the leading single etiology of non-communicable disease (NCD) morbidity, and

a total of 819 persons with peptic ulcer were treated across all FHI 360’s clinics. Cases of hypertension was also seen

in significant numbers, at 466 cases. A total of 535 children were vaccinated against various vaccine-preventable

diseases in Banki and Damasak. Also, 842 women of reproductive age received tetanus toxoid vaccination in Banki

and Damasak as well. One (1) case of sexual violence was managed at the health facility accordingly while maintaining

confidentiality. The patient was referred appropriately to Protection for Psychosocial support.

FSACI with support from the Civil Society on Malaria Control, Immunization and Nutrition (ACOMIN)

carried out discussions and enlightenment in Sabon Gari Community and Primary Health Care Centre

at Dwam Ward of Demsa LGA of Adamawa State. The purpose was to involve community members

on Risk Communication and Community Engagement on Malaria and COVID-19. Clients Exit

Interviews, Key informant interviews at the PHC and Focus Group Discussion with Community leaders and members

were also conducted to evaluate the accessibility of health facility and services to pregnant women and children from

0-5 years. Health education and Community Mobilization on COVID-19 was conducted. Posters on hand washing

techniques were distributed and the community members were advised to seek medical care early and maintain

social distancing.

INTERSOS carried out a total of 29,253 outpatient consultations (male – 13,700 and female –

15,553) of which under 5 was 11,467(39%). The total number of consultations for the reporting

month recorded an increase compared to the previous month of June. Under 5 consultations were the predominant

age range for consultations; an increase compared to the previous month. A total number of 5,943 of Acute

Respiratory Infection was reported and it continues to be the highest cause of morbidity, closely followed by Malaria

with a total of 3,318 cases. INTERSOS health facilities registered a slight increase in the cases of Acute Watery

Diarrhea, and Blood Diarrhea across all sites, compared to the previous month, with 24 cases for Acute Watery

Diarrhea, and 230 for Bloody diarrhea respectively. Sexual and Reproductive Health Services were provided to a total

of 2,611 women who attended ANC services at our health facilities, and out of which 1,198 were first time attendees

and 1,413 were follow-up attendees. Ngala Clinic recorded the highest number of ANC attendees with a total of 885

attendees. A total of 304 PNC attendance was recorded and 79 new deliveries across 5 health facilities. Magumeri

Hospital recorded the highest number of PNC attendance and new deliveries with a total of 143 attendees and 42

new deliveries respectively.


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146 hospitalizations were recorded, out of which 58 cases were SAM cases with complications, 39 were Non SAM

cases under 5 years, with life threatening conditions, 27 non SAM above 5 years, with life threatening conditions, 15

Gynecology/Obstetric cases (complicated cases admitted for more than 24hrs) and 7 patients were hospitalized for

other reasons. A total of 19 referrals were made. 13 were discharged, 1 is still on admission and 5 deaths were

registered.

PUI in collaboration with Ministry of Health and NCDC was able to provide training to all staff

on Infection Prevention and Control. This is to enable staff to effectively promote and prevent

themselves of infection especially COVID-19. A total number of 15,095 OPD consultations was

recorded, more than the previous month which was 12,141. For Sexual and Reproductive Health Services, 3,643

women were provided with SRH services. 280 post-natal hygiene kits were distributed to mothers who gave birth in

our facilities. Malaria cases confirmed by RDT indicates that the disease is on the increase as 905 cases were

recorded, which much higher compared to the preceding month where 711 cases were recorded. 2,497 cases of

Acute Watery Diarrhea were recorded while 2756 ARI cases were recorded.

Immunization services were also provided to beneficiaries, and a total of 1,435 doses of different vaccines were

provided to women and children at Herwa Peace PHC, 1,237 doses at Ngarannam PHC and 1,729 doses of different

vaccines were provided to pregnant women and children by Mobile Health Teams at Bayan Texaco, Jajeri Kantudu

and Bulabulin Alhajiri. MHPSS were provided to 37 beneficiaries at Herwa Peace PHC, 15 at Ngarannam PHC as well

as 17 beneficiaries by Mobile Health Teams at Bayan Texaco, Jajeri Kantudu and Bulabulin Alhajiri.

RHHF supported by UNFPA is implementing the integrated one stop approaches to GBV prevention,

mitigation and responses project in Adamawa, Borno and Yobe States through the establishment and

management of One Stop Centers (OSCs). The project also strengthens the provision of Sexual and

Reproductive Health (SRH) information and services at the supported health facilities across the

intervention sites. These are parts of effort to ensure continuous access and utilization of comprehensive SRH and

GBV (health care, GBV Case management, access to police and legal support, shelter, as well as culturally and age

appropriate counseling and psychosocial support) services by women and girls experiencing GBV or at risk of GBV

across the intervention sites at this critical time. A 3-day virtual training on GBV case Management was conducted

for twenty (20) community primary health caregivers and social workers from Borno, Yobe and Adamawa States in

partnership with UNFPA. The training contents were adapted from the Inter Agency Standing Committee (IASC)

guidelines on GBV Case Management) guidelines. The training aimed to strengthened the capacity of GBV service

providers across the intervention states in the provision of quality services to GBV survivors, respond to disclosure

and facilitating referral of GBV survivors to higher level of care when the need arises.

Also, a 3-day virtual training on Mental Health and Psychosocial support (MHPSS) was conducted for thirty- five (35)

service providers from the OSCs and the SRH service delivery points of the supported health facilities in Borno,

Adamawa and Yobe (BAY) states as well from the States Ministry of Women Affairs, Justice, Health and the Nigeria

Police Force. The training was conducted using Adult Learning Methodology and adheres to key principles of the

Inter-Agency Standing Committee (IASC) guidelines on MHPSS

training in Emergency; which are building local capacities,

supporting self-help and strengthening the resources already

present in affected communities.

RHHF/UNFPA donated COVID-19 PPE and commodities to the

OSC and SRH units of General Hospital Potiskum and General

Hospital Mubi, in Yobe and Adamawa States respectively. The

items donated include mechanized hand washing spots,

Hazmat suits, N95 face masks, sterile gloves, sterile face

masks, re-washable face masks, alcohol-based hand sanitizers,

family planning commodities, RH Kits and malaria test kits.

Local production of COVID-19 Personal Protective materials and reusable sanitary pads as well as assembling of

Dignity Kits is ongoing at the Dignity Kit production Centre in Maiduguri. This is being supported by UNFPA.

Production of reusable sanitary pads in Maiduguri


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TdH continue to provide humanitarian assistance in Mafa Central LGA by organizing Health

Mobile Hub in GGSS IDP Camp, Mafa Rural LGA with support to Zanari PHC Clinic and Health

post in Host Community and IDPs population and in Rann, Kala Balge LGA, with specialized

MNCH and CU5 Health Mobile Hub. A total of 3,169 medical consultations (women and children) were provided in

the 3 locations. 3,834 PLW received Reproductive health services (ANC, delivery and PNC). TdH continue to create

awareness on COVID-19 to all beneficiaries accessing the TdH supported health facilities. IPC measures are in place

for the prevention of COVID-19 transmission at the point of service delivery. A total of 44,788 persons were sensitized

on COVID-19 within TdH areas of intervention.

UNFPA in collaboration with Borno State Ministry of Health and Primary Health Care Development

Agency has sustained continued access to Sexual Reproductive Health Services through

coordination and provision of lifesaving commodities and COVID-19 Infection prevention control

measures. It has procured and prepositioned infections prevention and control materials in 16 integrated facilities

in addition to the earlier COVID-19 prevention ongoing compliance mechanism. 16 motorized hand washing aqua

kits were placed in integrated facilities including Fistula Centre of Excellence. 90 alcohol-based sanitizers and liquid

hand washing soap were distributed, 3 infrared thermometers for taking beneficiaries temperature at integrated

facilities, 500 disposable pieces of facemask were distributed to beneficiaries and 15 Hazmat suit, hand gloves and

other protective disposable wears were provided to services providers across integrated facilities.

UNFPA also supported the One Stop Centre for GBV & SRH at General Hospital Potiskum with Toll Free Help Lines to

facilitate Health Response to GBV, and provided care to 14 individuals, and also 76 cartons of Emergency

Reproductive Health Kits expected to cater for up 150, 000 people in need.

UNFPA continue to support provision of Sexual and Reproductive Health (SRH) Services, emergency obstetric care

including family planning. The service provision sites include integrated facilities and mobile medical outreaches to

most affected communities within 3 supported LGAs, including strengthening referral mechanism for SRH Services

and survivors of GBV.

S/N INDICATOR TOTAL

1 # of affected population reached with all type Family Planning services 91

2 # of people diagnosed and treated for an STI/HIV (new) 119

3 # of pregnant women who attended Ante-Natal Care 1st visit 419

4 # of deliveries attended by a skilled health personnel (not traditional attendant) 30

5 # of Women that attend at least one Post Natal Clinic Visit 34

6 # of adolescents and young persons reached with SRH services including Family Planning and HIV education

840

7 Nutrition counselling (IYCF) 51

8 # number VVF survivors mobilized screened in Fistula unit 56

9 Fistula repaired 36

10 # individuals reached key lifesaving SRH information 2,571 1,676

11 Other services 9

Total 4,256

A mini Obstetric Fistula Campaign to reduce burden of Fistula cases in Borno was conducted. Community mobilization

and engagement of stakeholders including traditional and religious leaders across IDP camps and host communities

focusing on prevention of child/force marriage, improve attendance to antenatal care, delivery at health facilities

and uptake of family as part of VVF prevention measures was carried out. 2,571 individuals were reached during

community sensitization, 56 fistula survivors – women and girls were mobilized and screened at State Specialist

Fistula unit. 36 fistula survivors were repaired, treated and recuperated at the Fistula Centre of Excellence. 100

survivors were followed up, counselled and ready to be enrolled in comprehensive skills acquisition and

reintegration, rehabilitation packages.

UNICEF reached a total of 168,030 children, women and men with integrated PHC in all the UNICEF

supported health facilities in the IDP camps and host communities in Adamawa, Borno and Yobe

States, out of which 88,968 (53.04%) were children below five years. 72,131 Out-Patient Department

(OPD) consultations were recorded with Malaria – 20,585 being the major cause of consultation, followed by ARI –


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11,760; AWD – 8,517 measles – 182, and other medical conditions – 31,087. A total of 88,751 prevention services

were recorded including 4,710 children vaccinated against measles through RI services; 40,541 children and pregnant

women reached with various other antigens; Vitamin A capsules – 14,132, Albendazole tablets for deworming –

8,779, and ANC visits – 17,795, and 2,794 LLINs distributed through RI and ANC clinics in Adamawa, Borno and Yobe

States. A total of 2,567 deliveries (skilled delivery – 2,304, unskilled – 263) and 4,581 postnatal/home visits were

recorded.

WHO continue to provide support to States Ministries of Health in Borno, Adamawa and Yobe in the

fight against COVID-19 pandemic. There is a total of 844 cases (Borno- 613 %, Adamawa 164, Yobe-67

confirmed cases) including 53 deaths (case fatality ratio 6.3%). Overall, Eight-three (83) health workers

are among the confirmed cases since the start of the outbreak in the BAY states, making up 9.8% of all

cases. To date, 37 (60%) out of 65 local government areas (LGAs) have reported at least one confirmed case of COVID-

19. There are 231 active contacts across the BAY states, of which an average of 156 (68%) are seen in the past 24

hours. Active case search is ongoing, and alerts are being report both at health facility and at the community level of

which > 95% of COVID-19 related alerts are verified/investigated within 48hours of reporting.

Up until week 30, there has being decrease in the number of confirmed cases of COVID-19 and deaths reported in

Borno and Yobe state, whereas Adamawa have seen a recent surge in COVID-19 cases compared with the 2 other

states. Though the positivity rate is relatively low, the level of established community transmission is of concern.

Apparent failure to follow public health guidelines by the population, inadequate contact tracing (about 68% of

contacts are seen daily) and occasional stock out of reagents (leading to delayed test results) remains a challenge in

the response. Public health actions still ongoing include regular coordination meetings in the BAY states, screening

of travelers at point of entry locations, which has seen over 35,340 travelers screened, Health Facility and Community

surveillance in the 3 states except inaccessible LGAs, risk communication activities including motorized campaign at

IDP camps, entry point locations in Jere, Konduga and MMC LGAs. Messages are focused on community voluntary

testing, de-stigmatization, timely reporting of cases, high-risk age group, use of facemask, handwashing and social

distancing. Training and deployment of additional contact tracers to strengthen contact tracing efforts is also ongoing

in the 3 states. WHO implemented the 1st cycle of SMC in Borno State beginning from the 11th July 2020. Three (3)

strategies were used in Cycle 1 due to complex operating environment: House-to-house (H2H); Reaching every

settlement (RES); and Community informants from inaccessible areas (CIIAs). 25 accessible LGAs were planned for

the implementation, within these LGAs are fully accessible, partially accessible and inaccessible areas. As such, the

fully accessible areas were reached by H2H teams, partially accessible areas were reached using the RES teams, while

inaccessible areas were reached through CIIAs. This was to ensure that all eligible children within the 25 LGAs were

protected from malaria. Several levels of monitoring and supervision took place during implementation and daily

review meetings at all levels held throughout the period of activity.

CAPACITY BUILDING ON COVID-19 110 Government frontline healthcare worsskers from Girei and Ganye LGAs were trained by WHO on COVID-19 IPC, case reporting and risk communication. IEC materials were provided to these cohort of trainees to enhance risk communication to clients and patients in the health facilities and to the support outreach services in the communities. They are also expected to cascade to other staff in their facilities. 124 team members of HTR Mobile teams across the 21 LGAs of the State were also trained. These HTR Mobile teams are supported by UNICEF (60), SOML (30) and WHO (36). They were trained on COVID-19 IPC, case reporting and risk communication. Trained personnel will enhance activities of PoE and strengthened compliance and reporting of cases.

101% 102% 99% 102% 105% 107%99%

113%

84%92% 99% 104% 103% 98% 100%

146%

100% 100% 100% 99%

126%

100%92%

Ask

ira/

Ub

a

Bam

a

Bay

o

Biu

Ch

ibo

k

Dam

bo

a

Dik

wa

Gu

bio

Gu

zam

ala

Gw

oza

Haw

ul

Jere

Kag

a

Kal

a/B

alge

Ko

nd

uga

Ku

kaw

a

Kw

aya

Ku

sar

Maf

a

Mag

um

eri

Mai

du

guri

Mo

bb

ar

Mo

ngu

no

Nga

laPERCENTAGE COVERAGE BY LGAS


10

ICCM 1,367 children were treated for malaria, diarrhea and Pneumonia by 48/63 CoRPs in 8 LGAs of the state. 1080 of the children were screened for malnutrition using MUAC. 53 (5%) of the children screened had MAM and were counseled on proper nutrition, while 0 (0%) of them had SAM demonstrated by Red on MUAC and were referred to CMAM sites for proper management. HTR 15,640 clients were seen by WHO supported 8 H2R teams providing services in 8 LGAs of Adamawa state. The teams treated 14,341 persons with minor ailments and dewormed a total of 2,003 children during the month. Pregnant women were provided FANC services with 806 of them receiving Iron folate to boost their hemoglobin concentration while 615 received Sulphadoxine Pyrimethamine (SP) as IPTp for prevention of malaria in Pregnancy.

WHO – Mental Health outreach sessions have continued, and 94 MH sessions were conducted in 11 LGAs (Bama,

Damboa, Dikwa, Gubio, Jere, Kaga, Kalabalge, Konduga, Mafa, MMC, and Nganzai) across 37 health facilities. A total

of 2,583 patients were treated, with 16 referrals to Federal Neuro Psychiatric Hospital (FNPH) Maiduguri for further

management. 3 patients were provided with transport to FNPH, and 14 admitted for inpatient treatment.

WHO supported State Ministries of Health in Borno, Adamawa and Yobe to train 44, 50, and 50 social workers

respectively in the month of July 2020, on COVID-19 Psycho Social Support (PSS) response in order to meet the unmet

gap of COVID-19 PSS counselling. These trained social workers will scale up COVID-19 PSS counselling at the

community levels, HFs, and provide synergy with other pillars providing COVID-19 response.

238 MH patients with their care givers were supported with COVID-19 PSS counselling during routing MH outreaches

in Jere, Mafa, MMC and Gwoza LGA on basic information on COVID-19, and standard precautionary measures.

JHF continue to support to the affected population in Adamawa state by verbally screened a total of 12,410

persons, 1,044 presumptive TB cases were detected out of which 827 had their sputum samples

transported. 534 samples were analysed using GeneXpert equipment while 270 were analysed by AFB

microscopy. A total of 73 All Forms of TB cases were detected and enrolled on TB treatment. Of the 1044 presumptive

TB cases detected, 782 had HCT out of which 7 were found to be HIV+ and were linked to ART sites for Treatment,

care and support.

Nutrition Updates ALIMA continue to provide lifesaving Nutrition services across all implementing sites. A total of 259 new

SAM cases were admitted at Muna Clinic and 378 cases were discharged from the program. 36 SAM cases

with complications were transferred out to ALIMA ITFC at UMTH. In total, 172 new SAM cases with

complications were admitted at ALIMA ITFC at UMTH and 168 were discharged. 46 new SAM cases were admitted

in the ATFC at Waterboard Reception Clinic in Monguno LGA. 15 were discharged from the programme. In Askira and

Hawul LGAs, 189 children suffering from SAM were admitted in ATFC and 12 complicated SAM cases at the ITFC in

Askira General Hospital. 10,438 caretakers completed ALIMA facilitated MUAC-Mother training sessions; and 89%

have shown mastery in the use of the MUAC tapes during the training post-test evaluations. The number has

drastically reduced because of the reduction of participants in order to maintain social distance during the training

session.

262, 10%230, 9%

974, 38%

1117, 43%

Proportion of MH Pts. treated

BOYS

GIRLS

MEN

WOMEN

90227

7157

131626

12696

188925

46

0 200 400 600 800 1000

Bama

Dikwa

Gwoza

Kaga

Mafa

Nganzai

MH Pts treated by LGA


11

PUI provided Nutrition services at Herwa Peace PHC where 59 new admissions for SAM cases in OTP

were recorded, 173 new admissions in Ngarannam PHC for SAM cases in OTP and 223 new admissions

for SAM cases in OTP by Mobile Health Teams at Bayan Texaco, Jajeri Kantudu and Bulabulin Alhajiri.

WHO screened 8,742 children were screened for Malnutrition using MUAC by WHO supported 8 H2R teams. Of this number, 67 (0.77%) children had MAM and their caregivers were counseled on proper nutrition, while 25 (0.3%) of them had SAM as demonstrated by Red on MUAC. The SAM cases were

referred to the Outpatient Therapeutic Program (OTP) centers, while the SAM cases with medical complications were referred to the stabilization centers across the state for proper management.

Public Health Risks and Gaps • High risk of COVID-19 spread due to various factors including population living in congested IDP camps, weak

surveillance due to insecurity issues, porous international borders, poor compliance in the use of facemask, social distancing, and good hygiene practices by the general public.

• High risk of epidemic outbreaks especially cholera, meningitis, measles, yellow fever. The northeast region is highly endemic for malaria and cholera.

• Unpredictable security situation hampers movements of health workers, drugs and other medical supplies.

• Although health situation is improving under the NE Nigeria Health Sector 2019 Strategy, the health service delivery continues to be hampered by the breakdown of health facilities infrastructure.

• There is a serious shortage of skilled health care workers, particularly doctors, nurses and midwives, with many remaining reluctant to work inaccessible areas because of ongoing armed conflict.

• Continuous population displacements and influx of returnees and/or refugees disrupt and further challenges the health programs implementation.

• Access to secondary health care and referral services in remote areas is significantly limited.

• Unavailability of network coverage in the newly liberated areas negatively affects timely submission of health data for prompt decision-making.

ssssHealth Sector Partners and Presence Federal Ministry of Health and Adamawa, Borno and Yobe State Ministries of Health, UN Agencies: IOM, OCHA,

UNFPA, UNICEF, UNDP, WHO, National and International NGOs: ALIMA, Action Against Hunger, Action Health

Incorporated, AGUL, CARE International, COOPI, GOAL PRIME, Janna Foundation, MSF (France, Belgium, Spain and

Switzerland), ICRC, INTERSOS, Malteser International, Medicines du Monde, Premiere Urgence Internationale,

International Rescue Committee, eHealth Africa, FHI-360, International Medical Corps, Catholic Caritas Foundation

of Nigeria, Nigerian Red Cross Society, Victims of Violence, Terre des hommes, SIPD, Swift Relief Foundation, Nigeria

Centre for Disease Control, RUWASA, BOSEPA, PCNI, BOSACAM; other sectors (WASH, Nutrition, Protection, CCCM,

Food Security, Shelter and RRM), Nigerian Armed Forces and Nigerian Air Force.

-Health sector bulletins, updates and reports are now available at http://health-sector.org

For more information, please contact:

Dr. Salisu Aliyu Kwaya-bura

Commissionner for Borno State Ministry of Health

Email: [email protected]

Mobile: (+234)08035774564

Dr. Kida Ibrahim

Incident Manager PHEOC


Mobile : (+234)08035570030

Mr. Muhammad Shafiq

Health Sector Coordinator-NE Nigeria


Mobile: (+234)07031781777

Mr. Oluwafemi Ooju

Health Sector IMO-NE Nigeria


Mobile: (+234)08034412280

Mr. Safianu Ado Ibrahim

Health Sector IMO-NE Nigeria


Mobile: (+234)07039236199

http://health-sector.org/

mailto:[email protected]





Documents

Health Sector Bulletin - HumanitarianResponse · Malaria: In Epi week 31, 6,565 cases of confirmed malaria were reported through EWARS. Of the reported cases, 375 were from General