The Moroccan Ministry of Health (MoH) is collaborating with GHD/EMPHNET to enhance the surveillance of Acute Flaccid Paralysis (AFP) and other Vaccine Preventable Diseases throughout the country.

Within this collaboration, the MoH held a national and subnational review meeting to discuss the performance of AFP surveillance. Taking place in Rabat between July 4 and 5, 2018, the meeting saw participants from over 40 AFP/VPD surveillance officers from central, regional, and provincial levels.

The meeting’s sessions were facilitated by a team from MoH and GHD/EMPHNET. The participants reviewed the progress made in the past year towards improved AFP and VPDs surveillance at regional and provincial levels, especially within the context of regional plans. More Specifically, they discussed issues pertaining to the flow of data from the health facilities to district, provincial, and central levels; and gaps witnessed at the sub-national level.

Discussions revealed that the high and rapid turnover of trained staff, particularly in remote areas was an issue that needed to be addressed. It was concluded that addressing such issues should be done in a more systematic approach incorporating continuous training, mentoring and replacement plans. From another angle, the participation of the EPI manager in the meeting was an opportunity for better coordination between the EPI and Surveillance Units. Furthermore, the development of regional action plans for improving AFP surveillance is also expected to provide a solid platform for continuous improvement and systematic monitoring of progress.

All in all, the meeting presented a great opportunity for an in-depth analysis to be conducted on performance at regional and provincial levels.

GHD/EMPHNET and the Morocco MoH are also collaborating to digitalize the national notification system of AFP cases in the country. This new system will replace the current, manual one, and provide timely alerts regarding AFP cases reported in both private and public hospitals in the country. Furthermore, the digitalized system will generate reports compatible with World Health Organization (WHO) reporting system and enhance effective monitoring.

Between July 5 and 6, 2018, a delegation from GHD/EMPHNET visited the MoH to discuss the activities to be implemented prior to the official launch of the system. Both parties discussed enhancements and customizations that need to be made to the system.

Furthermore, the GHD/EMPHNET team gave a presentation introducing the Web-based AFP Notification System, as well as an orientation session on the system. These sessions targeted administrators and other team members within the MoH set to use the system.

Upon the completion and the launching of the digitalized system, further improvements are expected to be seen in the standardization of the notification and investigation of AFP cases as well as enhancing the monitoring system.

In Rabat, a refresher training was also conducted for national and governorate level master trainers between July 9 to July 10, 2018. Over 40 AFP/VPD surveillance focal points from major educational hospitals as well as from the regional and provincial levels participated in the training.

Participants sat through sessions relevant to AFP surveillance: case definition; differential diagnosis and investigation; active surveillance and zero reporting; surveillance indicators, as well as data analysis and monitoring. Other sessions focused on the reporting and classification of vaccine-derived polioviruses (VDPVs); strategies for polio eradication; and stool collection procedures and transportation.

The Master trainers from a previous TOT  workshop took part in facilitating the sessions.

This series of events concluded with the overall observation that the performance of AFP surveillance in Morocco showed significant improvement. There was also a high level of commitment seen at central, regional, and provincial levels within the MoH.