Angola

Monthly Update

December 2011- January 2012

• No WPV cases have been reported since the last case in July 2011 in the Northern part of the country, making it a total of five WPV cases for the whole of 2011.
• The Angolan Government has contributed 5 million dollars towards polio eradication activities for 2012-2013. Preparations are under way to introduce environmental surveillance (testing sewage or other environmental samples for the presence of poliovirus.) 
• 120 new volunteers were trained and 25 current volunteers received refresher training totaling 2,404 trained volunteers out of the 2,670 volunteers to be trained. Eighty interviewers were also trained to conduct a baseline survey in the CGPP expansion areas. (Quarter 1 of 2012.)
• CGPP Angola also took part in the evaluation meeting of Epidemiological Surveillance and Vaccinations (December 13-16, 2011.) Quality monitoring of the Sub NIDS in six provinces was also coordinated by the CGPP Secretariat in the first quarter of 2012.

September-November 2011

• Angola has made strong progress, with the lowest incidence of poliovirus among all the priority countries. In 2011, only five cases have been reported so far, compared to 30 for the same period last year. Cases were clustered in Kuando Kubango, but traced back to transmission in Luanda province. No new WPV cases have been reported since the last case (onset of paralysis) in July 2011 in Uige (Northern part of the Country.)
• Sub-National Immunization Days (SNIDs) were conducted from Nov. 25-27.  Over three million children were vaccinated and the round covered the majority of the northern and southwestern parts of the country
• CGPP Angola Highlights: Low-literacy counseling cards with key messages on polio, disease surveillance, and immunization were developed and distributed to community volunteers for use during household and group education sessions.  The most recent round of quarterly supervision meeting between PVO supervisors and community volunteers has focused primarily on the effective use of these counseling cards.  Additionally, weather-related incentives such as rain boots and hats were purchased and distributed to the CGPP community volunteers to increase their motivation and efficiency.
• CGPP piloted a new approach to track routine immunization appointments, using chit or numbered squares, to track mothers after they leave the health post. Preliminary results were very promising and were used to identify key characteristics of under-immunized urban populations, fostering innovation for new approaches (intensifying social mobilization and the strategic placement of immunization booths in market areas) to increase routine immunization levels in FY 11.

August 2011

• There has not been a new case reported since March 27, 2011 in the southeastern part of the country.
• Positive developments from Angola include refresher training on AFP for health workers in the high risk municipalities after a rapid surveillance assessment was conducted in four municipalities as of mid-July in Luanda. A seven-month emergency plan for Luanda province has been mapped out.
• CGPP Secretariat, in conjunction with WHO, conducted a training for all provincial coordinators and provincial EPI managers country-wide in campaign quality monitoring. Also, a contingent of partner polio staff as well as secretariat staff participated in the National Meeting of evaluation of routine vaccination and epidemiological surveillance.
• The secretariat worked with a graphic artist to complete a series of counselling cards and a program brochure to support the activities of social mobilization in health talk meetings with leaders and healers. The counselling cards will be printed and distributed to the project focal points over September and October and the information bulletin next month. The program brochure awaits finalization.
• Using project-wide training materials, partners conducted a refresher and induction training for 1,570 former volunteers and 520 new volunteers, respectively.

July 2011

• The total number of cases for 2011 remains four. The most recent case (WPV1) had onset of paralysis on 27 March in Kuando Kubango, in the country's south-east. No new cases were reported in July, but three new hot cases in Uige, a border district. Due to consistently sub-optimal surveillance performance, especially in Luanda and Benguela (urban areas), Africare’s Luanda team conducted intensive case search in the registers of major Luanda hospitals, identifying additional cases for investigation. The joint PVO partner/MOH/WHO case search at a facility was a new element in the urban environment and was well received.
• At the Annual Planning Meeting, an e-STOP team member from UNICEF, Brazil, led all the partner CGPP staff in a TOT-style participatory micro planning exercise intended to be replicated by the CGPP in their districts.
• CRS shared initial feedback on its piloting of a new system to help track referrals made by volunteers to the health post for routine immunizations.  Volunteers and health post staff report satisfaction with the system and preliminary data suggest more mothers are returning to the health post.

May/June 2011

• The total number of cases in Angola this year remains four as compared to 12 at the same time last year. Surveillance data continues to reveal gaps at the sub-provincial level, however, especially in the urban areas.
• The CGPP-Angola continued to focus on monitoring campaign quality and supporting, as well as progressing with conducting additional local level advocacy meetings to more thoroughly mobilize leaders and district (municipio) and sub-district (communa) levels.
• Campaign quality monitoring results from the May NID (National Immunization Day) in the CGPP project areas reveal only modest improvement with only two provinces reporting greater than 10% of children missed. The fact that the two provinces reporting at least 10% of children missed are the two urban centers reveals that improvement of campaign quality in urban areas is of the highest priority.

January- April 2011

• Angola reported no new wild poliovirus cases in January.  The total for 2010 also held steady at 32 cases for the year.

• Angola did not hold supplemental polio campaigns in January. Several rounds of campaigns are currently scheduled to occur in coming months.

• Secretariat staff worked with partners, Africare and Catholic Relief Services, as they began establishing new coverage areas in border regions of Cunene, Namibe, and Lunda Norte provinces.  This Gates-funded project expansion promises to be particularly important in Lunda Norte province, the location of a large outbreak in 2010 which spread to areas of the Democratic Republic of Congo.  Here, the project will be working through the local Catholic Church (with CRS as lead PVO) to reach areas virtually unreached by development efforts.
• Angola has reported two cases of wild poliovirus this year. Confirmation that these two cases are genetically linked to the virus circulating last year means that Angola has not met the Global Polio Eradication Initiative milestone of ending all re-established transmission by the end of 2010.
• Angola held Supplementary Immunization Activities (SIAs) during each month, including, in late April, a National Immunization Day, which was synchronized with similar campaigns in neighboring DR Congo and the Republic of Congo.  Angola exported the virus to these two countries last year.
• An informal delegation of international partners observing the April NID in Angola included the CGPP’s Sr. Technical Advisor, its technical officers from both USAID and the Gates Foundation and the US Ambassador to Angola and selected members of his staff, as well as representation from UNICEF and WHO headquarters.  The observers documented gaps in campaign quality including poor vaccinator selection and supervision, inadequate sub-district adherence to microplanning.

September 2010

• Angola reported four new wild poliovirus cases in September, bringing the total for 2010 to 24 cases.  All four cases occurred within the Luanda-Benguela corridor, the historically high-risk area along Angola's west coast. Improvements to the quality of polio campaigns are essential to halting Angola's expanding polio outbreak.  While Angola had a break in polio campaigns in September, the CGPP continued to collaborate with national and provincial stakeholders to plan quality rounds in October and coming months.  In addition to participation in routine planning meetings at the national and provincial levels, Secretariat staff collaborated with the Ministry of Health and UNICEF to identify gaps and weaknesses in social mobilization efforts during the August national polio campaign.  

• Secretariat staff worked with provincial health leaders in Luanda to develop a standard guide and tools to train campaign coordinators on community mapping; vaccinator recruitment, training, and supervision; and the logistics of vaccine distribution and cold chain management.  Building the capacity of coordinators and vaccinators is a key strategy for quality improvement in Angola.