2 April 2015 Rationale for Enhanced Response Framework Issues Despite efforts community engagement remains challenging in some areas Multiple partners with different strengths could coordinate ID: 798611
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Slide1
Kambia DistrictSurveillance and Response Framework
2 April 2015
Slide2Rationale for Enhanced Response Framework
Issues
Despite efforts, community engagement remains challenging in some areas
Multiple partners with different strengths could
coordinate betterFragmentation of approaches Selection of areas is not adequately based on consistent criteriaReactive approach
Opportunities
Harness energy from HE’s visit and focus on need for improved community engagement
Harness resources being offered by partners/other districts
Bring all partners together in well-coordinated approach under DERC operational structure and target areas and activities more appropriately
Incorporate cross-border work
Slide3Key Performance Indicators
OBJECTIVES
INDICATORS
Last 21 days*
Trend
Compared
GOAL
Get
to zero in Kambia
District
Primary Objective
Improve
the efficiency and effectiveness of the district surveillance and response system
100% of confirmed EVD cases
coming
from a contact list
66%
All suspect cases transferred to appropriate health facility within 24 hours of an alert being raised
100%
Outcome
1
Strengthen
alert system
to better
detect suspected EVD cases
(
live and dead)
Number of live alerts
104
Proportion of
death alerts
55%
Outcome 2
Strengthen reactive and proactive capacity of the surveillance system
100% of credible alerts are investigated within 24 hours
94%
100% of confirmed
EVD
cases come from a contact list
66%
Outcome 3
Strengthened community engagement in response activities
Time between symptom onset and alert report is less than 48 hours
49%
Median:
3
days
All positive swabs come from known contact lists
20.0
%
100% lab results are
tested and
returned to
patient/family members <24h from publication
99%
Slide4What does it look like?
An over-arching framework enhancing surveillance and response mechanisms
Requires that we work through the following steps
Slide5Indicators and Approaches
Issue
Appropriate Approaches
HotspotE.g.Active Case Search, Community meetings
Positive Swab
E.g.
d
irect
household engagement
New case not on a contact list
E.g. Active
Case Search in surrounding area, house to house
mobilisation
Death in a quarantine home
E.g. Direct
household Engagement
Cross-border transmission
E.g.
Active
Surveillance, radio messaging
Under reporting of deaths
E.g. Radio,
IEC
material dissemination, political engagement
,
community meetings,
house
to house
Unsafe
burial
E.g.
DERC
/ DO meeting with Paramount Chief and/or other key leaders, community visit from DO and Paramount Chief
Community
resistance/mistrust and denial
E.g. Community
visit from DO and Paramount Chief, Community meetings with key stakeholders and appropriate target groups (e.g. women,
soways
, youth),
EVD
Survivors, engagement with religious leaders and traditional
healers
Remote/hard-to-reach areas
E.g. House
to House mobilisation, community meetings with key
stakeholder,s
radio,
s
upport
to chiefdom and village taskforces
Areas not reached by social mobilisation activities
E.g. House
to House mobilisation, Support to chiefdom and village level taskforces, Radio interviews with key spokespersons
Slide6Target Areas
ISSUES
CHIEFDOM
VILLAGE
Hotspot
Magbema
Malal
Gbingleh
-Dixon
Lokoya
Positive swab
Magbema
Malal
Gbingleh
-Dixon
Konta
Dubalai
,
Lokoya
, Fouta,
Rogberay
,
Yeam-Labey
Samu
Soriya
Border issues
Samu
Soriya
,
Kanbagham
Gbingleh
-Dixon
Magbengbeh
,
Yeam-Labey
villages
around Pamelap
Community resistance
Mambolo
Malambay
Masungbala
Wula
Lol
Samu
Mabonah
,
Kortimaw
Slide7Target Areas of Intervention
Hotspot
Positive Swab
New case not on a contact list
Death in a quarantine home
Cross Border transmission
Community resistance
Community denial
Under reporting of
deaths
Epi link to + case
Slide8Issue
: Hotspot
Indicators:
Ongoing transmission. Out of nine
confirmed cases in week 11, eight came from a single household under quarantine in Malal
Response
:
D
edicated surveillance/
socmob
team assigned for daily visits
,
detailed
c
ase investigation,
contact tracing,
PC engagement.
Issue: Under reporting and community mistrust
Indicator: Positive swab/death in quarantine home
Response: DO and DC meeting with PC to define action plan. PC making frequent visits to
HH
and community.
SocMob
Pillar Lead engaging community directly
Weekly Response Plane.g. Malal
Issue
: Community Resistance to response efforts
Indicators: HH refusal to cooperate with surveillance team or to transfer suspect case to Holding Centre. Response: Dedicated team surveillance and PSS to make daily visits to the household. All suspects now removed.