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  1. 1

    Travel to UNICEF / New York to participate in meeting on integrating vitamin A supplementation into immunization programs, January 12-13, 1998.

    Fields R; Sanghvi T

    Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998. [3], 6, [12] p. (Report; USAID Contract No. HRN-C-00-93-00031-00)

    This report pertains to a consultant meeting in New York City with UNICEF during January 12-13, 1998, to discuss the integration of vitamin A supplementation into immunization programs. One consultant stayed to talk about vitamin A/immunization training materials being developed by BASICS with World Health Organization (WHO) staff and staff from Helen Keller International. The UNICEF meeting included about 35 participants who were mostly WHO and UNICEF headquarters and field staff. There were WHO regional immunization advisers from the Eastern Mediterranean, Southeast Asia, and the Americas. Three staff from USAID and representatives from Canada attended. Several logistics issues arose. Vitamin A supplementation should be introduced at 4-6 months, but the closest immunization contact period is not until after 9 months or before 4 weeks. Second, there is no medical data to ensure that a massive dose of vitamin A would not interfere with DPT effects. It was agreed that the links are helpful but not limited to the Expanded Program of Immunization. The meeting produced a draft paper on background, summary findings, and conclusions and recommendations, which are included in the appendices. It is concluded that many countries already provide vitamin A during immunization contacts. One single recommended strategy does not meet diverse country settings. Additional fieldwork is needed before solidifying strategies. Training should not be delayed. A packaging alternative is to shift to a small squeeze bottle that can be calibrated by size and dose. The mid-level manager's module on vitamin A and EPI continues to be revised.
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  2. 2

    Participation at the Scientific Advisory Group of Experts (SAGE) meeting. WHO/HQ, June 9-11, 1998, Geneva, Switzerland.

    Steinglass R

    Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998. [50] p. (Report; USAID Contract No. HRN-C-00-93-00031-00)

    This report pertains to a meeting of the Scientific Advisory Group of Experts (SAGE) at the World Health Organization (WHO) in Geneva, Switzerland, during June 9-11, 1998. The meeting focused on technical issues relevant to the Global Program on Vaccines and the Children's Vaccine Initiative. The appendices include the annotated agenda, recommendations from the SAGE meeting, and a list of meeting participants and documents and documents relevant to the agenda. The recommendations which may be of interest to BASICS pertain to the following: impact of health reforms on national immunization days; integration of vitamin A into immunization programs; polio eradication, measles control, and control of neonatal tetanus; improving the quality of immunization data, injection safety, and vaccine procurement; financing for existing and new vaccines, and demand forecasting. The consultant distributed materials from the meeting to relevant BASICS staff and consultants. The agenda included presentations on: implementation of 1997 SAGE recommendations, future directions for the Expanded Program on Immunization (EPI), the quality of EPI data, critical issues for polio eradication by 2000, current WHO studies of quality control of oral polio vaccine, polio diagnosis/research needs, measles epidemiological modeling and optimal strategies, increased incidence of pertussis, use of typhoid vaccines, safety standards for mono-dose injection devices, a strategy for safe injections, adverse effects of immunization, a stronger role for WHO in vaccine procurement, forecasting demand for vaccine manufacturing, new vaccines, and public-private sector collaboration.
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  3. 3

    Participation in WHO EPI managers' meeting, Douala, Cameroon, October 1998.

    Nelson D; Othepa M

    Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998. [3], 6, [33] p. (Report; USAID Contract No. HRN-C-00-93-00031-00)

    This report pertains to a consultant visit to Douala, Cameroon, during October 1998, to fulfill World Health Organization objectives. The goals were to evaluate the implementation of recommendations made during a February conference in Chad, to examine the status of acute flaccid paralysis (AFP) surveillance in participating countries, to assess progress toward a vaccine independence initiative, and to set an agenda for 1999. The consultant participated in a workshop among representatives of Cameroon, Congo, Gabon, Equatorial Guinea, Central African Republic, Democratic Republic of Congo, and Chad. Representatives made presentations at the workshop on their current national situation on the state of preparedness for 1998 National Immunization Days (NIDs), implementation of the Chad conference recommendations on surveillance systems (SS), implementation of a sustainable integrated national SS, and reinforcement activities for routine immunization services. Plenary topics included certification criteria for eradication of polio, active surveillance of AFP, management tools for AFP surveillance, case investigation, sensitizing clinicians, reimbursing the cost of transporting samples, interagency collaboration, and vaccine independence. NIDs are planned for areas in the Congo where security risks are at the lowest, which would include coverage of about 54% of the country's population. Logistical evaluation needs to be performed before NIDs occur. A new budget needs to be drafted to meet the realities of the emerging situation. About 30 recommendations are listed for NIDs, routine EPI, and surveillance.
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  4. 4

    Participation in World Health Organization technical briefings, Geneva, Switzerland, October 13-24, 1997.

    Moore J; Boniface M; Nersesian P; Pacque M; Ross J; Alimbekova B; Shimp L

    Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997. [15] p. (Report; USAID Contract No. HRN-C-00-93-00031-00)

    This trip report pertains to a consultant visit to the World Health Organization's Technical Briefings on Child Health and Development and Immunization in Geneva, Switzerland, during October 13-24, 1997. Three BASICS technical officers, 2 operations officers, a regional child survival advisor, and a regional immunization coordinator attended the technical briefings. The aim was to allow BASICS staff to obtain an up-to-date overview of the 2 divisions' programs, approaches, and methods that are used in planning and management in developing countries. The briefings provided an opportunity for BASICS staff to meet WHO staff, discuss activities of mutual interest, and obtain technical materials. The workshop included lectures by WHO staff and some problem-solving exercises in small groups. Discussions occurred during presentations and in separate meetings. Other participants included members of government agencies, universities, multilateral organizations, and nongovernmental organizations worldwide. Appendices provide a full list of conference participants by name and organization or agency also provide the schedule of activities.
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  5. 5

    How to estimate incremental resource requirements and costs of alternative TT immunization strategies: a manual for health and program managers. Revised version.

    Brenzel L; Foulon G

    Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1989 Jun. [4], 22 p. (USAID Contract No. DPE-5927-C-00-5068-00)

    The REACH Project originally prepared this manual for health and program managers for WHO workshops in Africa on the control of neonatal tetanus. The manual provides rapid methods for determining incremental resource requirements and costs of tetanus toxoid (TT) immunization programs. Its design allows for flexibility. It categorizes costs into variable costs such as vaccines, syringes, and needles and fixed costs such as training, personnel, supervision, and transportation. The manual provides a worksheet for calculating the variable costs for programs which requires the managers to consider the target population (pregnant women or women of childbearing age) and coverage objective (TT2 or TT5). Further it presents a formula for determining costs of additional personnel (a variable cost): personnel costs=number of workers x proportion of time for TT vaccination for each worker x annual gross earnings of each workers. It also has guidelines for determining fixed costs such as cold chain equipment costs. Transportation costs consists mostly of fuel costs but also includes the costs of vehicles to move vaccines, supplies, and personnel. Training costs include production of training materials, travel, per diem, and proportion of annual salaries of trainers and trainees for training time. The manual also has worksheets for determining supervision and monitoring costs. Further it has a worksheet to calculate additional media costs for TT immunization including radio. TV, and posters. Once managers have determined the costs of various components of TT immunization programs, they can sum the costs up and determine the cost effectiveness of TT immunization strategies on another worksheet. The manual concludes with a formula to assist managers determine whether changing from 1 strategy to another would save them more money and be more cost effective.
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