Within Iraq’s emergency and humanitarian situation, the delivery of routine immunization (RI) services can be difficult. This situation becomes more challenging especially since a need has been identified for more effective supervision and planning of immunization activities, increased capacity for health workers for effective surveillance of Vaccine Preventable Diseases (VPDs), and improved social mobilization and communication activities. Meeting these needs will result in all populations having access to immunization services and reaching high immunization coverage in all communities across Iraq, especially the newly liberated and high risks provinces is achieved.

To assist the Iraq Ministry of Health (MoH) in meeting these needs, GHD| EMPHNET recently supported three activities geared towards strengthening the performance of routine immunization in the country.

The first of these activities was a workshop conducted to develop an improvement plan for RI supervision and monitoring. This workshop was conducted between January 14-15, 2018, in Baghdad. It was attended by managers of the Expanded Program on Immunization (EPI); central, provincial, and district EPI team members; and representatives from the World Health Organization (WHO) and UNICEF.

The workshop resulted in the development of an RI improvement plan for supervision and monitoring. This plan was developed after analyzing the status of supervision in Iraq and identifying gaps and challenges in EPI supervision at all levels. The analysis relied on information that had been previously collected by an assigned technical committee. This improvement plan is expected to institutionalize the best supervision and monitoring practices, tools, and mechanisms.

This activity was followed by a second workshop conducted January 16-18 in Baghdad. Its sessions focused on developing a communication strategy for EPI. Participants included MoH health communication officers, EPI officers, representatives of the WHO, UNICEF, and relevant ministries. They discussed the direction, tools, and methods needed to develop this strategy, especially within the context of the key challenges facing immunization in Iraq.

This workshop coincided with the Training of Trainers (TOT) Workshop for surveillance officers on Acute Flaccid Paralysis (AFP) and VPDs surveillance conducted between January 16-18 in Baghdad. Over twenty-five surveillance officers from the national and governmental levels participated in this training. One officer was participating from each province, and two officers were representing five selected high priority provinces; namely, Muthanna, Anbar, Salah Al-Din, Karballaand Ninewa.

The purpose of this ToT workshop was to build a roster of master trainers on AFP and VPDs surveillance to support surveillance officers at a subnational level. The three-day workshop focused on several topics including, strategies for polio eradication; AFP case definition and investigation; AFP surveillance indicators, data analysis and monitoring; measles surveillance, case definition and investigation; rubella) surveillance; measles elimination strategies and indicators. Other topics discussed during the workshop included stool and specimen collection and lab transportation; and the reporting and classification of vaccine-derived polioviruses.

At a later stage, participants in this workshop are expected to train provincial and district level surveillance staff and support hospital sensitization efforts.