Diarrheal disease is among the five leading causes of morbidity and mortality among under-five children in Malawi. In the multiple indicator survey conducted in 2006, nearly a quarter (23.3%) of under-five children reported having a diarrhea episode in the previous two weeks. Rotavirus infection contributes significantly to diarrheal diseases among children under the age of five years. To reduce this burden, Malawi launched rotavirus vaccine on October 29, 2012. While the launch happens in a day, numerous plans are prepared, many decisions are made, and a number of steps are taken along the way to arrive at this celebratory day. Preparations for the introduction of rotavirus vaccine were started over two years ago by first expanding the cold storage space at all levels. To increase cold storage capacity, additional walk-in cold rooms were procured and installed with the support of UNICEF, and refrigerators were procured through WHO and UNICEF support and distributed to districts and health facilities. The GAVI New Vaccines Introduction grant was used to fund most of the preparatory activities. In early 2012, the Government of Malawi and other immunization partners - - mainly CHAI, MCHIP, UNICEF and WHO - - have revitalized the national task force (NTF) to coordinate and prepare a detailed plan of action for the introduction of rotavirus vaccine. The content of the plan of action included adapting the rotavirus introduction field guide to be used as training and reference materials at all levels; conducting advocacy, communication, and social mobilization activities; revising the management tools; conducting supportive supervision visits to monitor the introduction of pneumococcal vaccine (PCV) which was launched in November 2011; and assessing readiness for the introduction of rotavirus vaccine. Furthermore, Malawi conducted the PCV post-introduction evaluation (PIE) and Data Quality Self-Assessment (DQS) during this time in order to apply the lessons learned in the PCV introduction to the introduction of rotavirus vaccine. Additionally, cascaded trainings were conducted at national, zonal, and district levels. These trainings involved all managers and service providers, including all health surveillance assistants who conduct most of the vaccinations at the peripheral level. Social mobilization activities were conducted using all media outlets. The rotavirus vaccine was distributed to all zones before launching. Most importantly, Malawi conducted all of the preparatory activities on time and the launch was conducted as planned. Maternal and Child Health Integrated Program (MCHIP), USAID’s flagship maternal and child health program, provides technical and financial support to the Government of Malawi in these preparatory activities. Certainly, the launching is one of the milestones in the introduction process, but as we move forward, there is a need to strengthen the technical capacity for full integration of the rotavirus vaccine into the routine immunization program by conducting supportive supervision visits and facilitating basic Expanded Program on Immunization (EPI) trainings. In addition, Malawi rotavirus introduction applies the age restriction for vaccination (1st dose before 15 weeks of age and last dose before 32 weeks of age). Such age restrictions require strong communication for timely vaccination. Therefore, all partners need to support the communication activities at all levels in order to follow this successful launch with a successful integration into Malawi’s routine immunization system. ____________ I have attached what we at MCHIP call a scale-up map for new vaccine introduction. It focuses on the many steps required to apply and prepare for the smooth introduction of a new vaccine. At MCHIP, we found it necessary to create this graphic to remind senior staff that the launch itself, which generates so much attention and excitement, is but one step in a long process. ~Robert Steinglass, MCHIP ___________ MCHIP is the USAID Bureau for Global Health’s flagship maternal, neonatal and child health (MNCH) program, which focuses on reducing maternal, neonatal and child mortality through a package of MNCH interventions. The immunization component focuses on providing countries with technical support to strengthen routine immunization and introduce new vaccines. For more information, please visit http://www.mchip.net or email email@example.com with questions. MCHIP-New-Vaccine-Introducation-Scale-Up-Map.ppt
TechNet-21 - Forum
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