Yemen FETP

YEMEN FETP NEWSLETTER | Issue 2-2016

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Yemen FETP

Newsletter Issue #2 April – June 2016

Ministry of Public Health and Population Primary Health Sector General Directorate of Disease Control and Surveillance Yemen Field Epidemiology Training Program


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Read in this Issue  Welcome Speech by Y-FETP Director  Y-FETP Participated in the TEPHINET Program Directors Meeting - Madrid, Spain 27-29 June 2016  Y-FETP Third Cohort Residents Completed their First Assignment at 33 Central Ministry Programs  Y-FETP was Invited to GHSA Workshop on Regional Strategic Framework for Human Health Workforce Development on Epidemiology, Yogyakarta, Indonesia 9-10 May 2016  Y-FETP Facilitated the Training Workshops Towards Launching the Pilot Microcephaly Surveillance System  EMPHNET Offers Technical Support for Building In-country Capacity in Disease Detection, Outbreak Response, and Health Security Funded by Biosecurity Engagement Program  Y-FETP Conduct Four Dissemination Workshops to Share Findings from the Second Cohort Planned Studies  Y-FETP Participated in the National Strategy for Dengue Control Workshop, Sana'a, 2627 June, 2016  Y-FETP Graduates and Residents Conducted Eight Outbreaks Investigation  Y-FETP Launched the First Issue of its Quarterly Bilingual Arabic/ English Newsletter


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Welcome Speech Dr. Abdul Hakeem Al Kohlani Y-FETP director

While recognizing the challenges and difficulties we are facing, our accomplishments during the past three months reflect the commitment, dedication and diligence of our staff. The first issue of our Y-FETP Newsletter was greatly welcomed and this makes us all, at the program, very proud. Therefore, I would like to take this opportunity to thank all those who congratulate us, commented on our newsletter, and who visited our web sites at: (http://www.yfetp.com/). During this quarter, we concentrate on strengthening capacities in areas of surveillance, preparedness and response to disease outbreak and emergencies. Our residents and graduates conducted during this quarter eight outbreaks investigation that its helped rapid containments. Furthermore, the findings from these field investigations were shared with relevant stakeholders to take actions to prevent its further spread and recurrence. Furthermore, our program participated in the national strategy for dengue control workshop.

We continue working to strengthen our public health system through participating in launching a pilot surveillance system for microcephaly under the guidance of the National Zika Preparedness Committee and with support from the World Health Organization (WHO). Such pilot systems –after evaluation- could be the corner stone towards establishing a congenital birth defect surveillance in Yemen. Furthermore, our program conducted three dissemination workshops to share the findings from third cohort residents' planned studies with different stakeholders where steps forwards to strengthen the health system in view of these findings were taken. Our achievements continue to mount as we maintain focus on workforce development. Third cohort residents completed the first assignment for three months where they spend one to five-day short rotations at 33 central ministry programs. During these rotations they learned how to better support these programs. They also gained the experience of working through the health system. The Y-FETP also secured the EMPHNET technical support for conducting BEP planned trainings.

These trainings aim to develop incountry workforce capacity in disease detection, outbreak response, and health security. This will ensure the quality of these trainings through benefiting from the vast EMPHNET building capacity experience. Within our role as members of a program that relies heavily on exchange and learning from the experiences members of other programs, Y-FETP residents and graduates participated in the TEPHINET Program Directors’ Meeting which was held between June 27–29, 2016 in Madrid, Spain. We also participated in the GHSA Workforce Development Video Conference where update provided on progress and discussion on future activities was facilitated. Finally, we believe that the role that can be played by our newsletter and the website in such exchange and networking opportunities is invaluable. Till the next issue, we wish you a happy read! FOR Contact Information Dr. Abdul Hakeem Al Kohlani Y-FETP DIRECTOR [email protected]


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Y-FETP Participated in the TEPHINET Program Directors Meeting - Madrid, Spain 27-29 June 2016 As members of a program that relies heavily on the exchange of experiences from members of other programs, Y-FETP was proud to participate in the TEPHINET Program Directors’ Meeting that was held at The National School of Health in the Instituto de Salud Carlos, III, in Madrid, Spain between June 27-29.

two group-discussions. The first group discussion was on the impact of FETP on Ministries of Health priorities and on building public health capacity and plans for FETP growth and sustainability.

This participation shows the increasing interest Y-FETP has in strengthen its bonds with TEPHINET. In doing so, it hopes to ensure the sustainability and the high quality of the program’s effective response to the national, regional and global public health problems and threats. The meeting saw discussions on the priorities of the FETPs. It saw discussions that highlighted ways to improve quality and ensure sustainability of programs. Additionally, discussions were held on the role of FETP program in supporting public health strategies and mobilizing graduates and trainees during public health emergencies. The importance of accreditation as a quality improvement tool and the next steps to better track alumni were also topics highlighted during the meeting. The aim of tracking alumni is to involve them in supporting program activities and new projects. On another note, the FETP directors voted unanimously to appoint Carl Reddy as the new Chairperson of the TEPHINET Advisory Board during the meeting. Y-FETP participated effectively in this meeting through the presence of its Technical advisor who was the reporter on

The second group discussion was on the Eastern Mediterranean Region FETPs: its challenges, priorities and the support needed from global and regional networks. The meeting provided an excellent opportunity for Y-FETP to exchange experience with different programs and to discuss future collaboration with different networks and partners e.g. TEPHINET, EMPHINET, AFENET, MediPIET, CDC and Task Force for Global Health. Y-FETP also presented a poster that gave an overview about the YFETP, key accomplishment, main challenges and its planned activities for the coming year.


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Y-FETP Third Cohort Residents Completed their First Assignment at 33 Central Ministry Programs Y-FETP third cohort residents completed their first three- month assignment where they spend one to five-day short rotations at each of the 33 central level ministry programs. During these rotations, they learned about the programs’ activities and how to provide better support for them. They also gained the experience of working through the health system. In each program, the director/ mentor prepared a series of presentations and documents that cover: 1- Background on the health problems tackled by the program 2- History of the program and its development 3- Program organogram and its different section/ department both at central and governorate/ district level 4- Program activities and guidelines 5- Data collection, reporting systems and flow of data .

6- Any previous data analysis/studies/evaluations 7- Available raw data for further analysis 8- Programs priorities and needs regarding data analysis, studies, evaluations etc. 9- How Y-FETP residents could help the program

office. Presentations were made in front of other residents, graduates and concerned ministry staff. The program directors/mentors were also invited to these presentations to comment and share experience.

For each ministry program, study tours to its different sections were organized. These tours helped familiarize the residents with each program’s functions and activities.

An evaluation form was also distributed to the residents in order to learn from their experience and find ways to improve rotations in the future.

In order to gain the scientific writing skills needed to prepare and deliver presentations and write reports, each resident prepared a presentation and a short report about two to three programs visited. The program director/mentor as well as the YFETP technical staff revised these presentations/reports and advised the residents on how to improve. Residents then delivered these presentations during the Y-FETP biweekly meetings held at the Y-FETP

During the next quarter, the residents will start their second assignment where each resident will be placed at one of ten key central programs for six months. During this period, the resident will start to support these programs and preparing to successfully complete his/her first deliverable i.e. the surveillance data analysis.

At the end of these rotations, a written exam was conducted to assess the skills gained by residents.


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Y-FETP was invited to GHSA Workshop on Regional Strategic Framework for Human Health Workforce Development on Epidemiology, Yogyakarta, Indonesia 9-10 May 2016 The five-year target of the Global Health Security Agenda (GHSA) Workforce Development Action Package states that a workforce includes physicians, animal health specialists or veterinarians, biostatisticians, laboratory scientists, farming/livestock professionals, with an optimal target of one trained field epidemiologist (or equivalent) per population cluster of 200,000. This workforce should be able to systematically cooperate to meet relevant IHR and PVS core competencies. The National Strategic Plan is the key instrument that strategizes and prioritizes the important actions steering towards efficient management and implementation of the specified policies. It serves as another step towards the GHSA initiatives. To clarify these points further, a workshop titled “GHSA: Workshop on Regional Strategic Framework for Human Health Workforce Development on

Epidemiology” was conducted in Yogyakarta, Indonesia on 9-10 May 2016. The workshop was conducted under the support of the United States Agency for International Development (USAID) and Food and Agriculture Organization of the United Nations (FAO). It saw the generation of national workforce strategies developed while building on existing structures. Furthermore, the human health focal points for GHSA Workforce Development Action Package were identified in each member country. This was done to accelerate collaboration among the member countries towards GHSA goals. To strengthen regional networking, three countries from the EMRO region (Yemen, Jordan, Saudi Arabia) were invited to the conference to serve as contributing countries for the Workforce Development Action Package. Although the Y-FETP Technical Advisor travelled to

Malaysia to get the visa to Indonesia, the visa was not granted and therefore he could not attend the conference! Nevertheless, the Y-FETP Technical Advisor participated in the GHSA Workforce Development Video Conference. After the opening, updates on achievements made by the Thailand team were presented. Furthermore, GHSA Thailand/Regional Coordinating Office provided a summary of the Workshop on Regional Strategic Framework for Human Health Workforce Development on Epidemiology Advancing IHR/GHSA, May 9 and 10, 2016, Yogyakarta, Indonesia. During the conference, the future role that could be played by Y-FETP was discussed and agreed to continue.


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Y-FETP Facilitated Training Workshops Towards Launching the Pilot Microcephaly Surveillance System The global prevention and control strategy launched by WHO urged for providing up-to-date and accurate epidemiological information on the Zika virus disease, neurological syndromes and congenital malformations through strengthening surveillance and research activities. Although no Zika cases had been yet reported from the EMR or Yemen, WHO stressed that countries must use the dengue dynamics as a reference point. It also stressed that countries that experienced a dengue outbreak in previous years or were home to the mosquito Aedes could be at risk. Therefore, H.E Minister of Health issue a decree to establish the National Zika Preparedness Higher Committee (NZPHC) where the YFETP director nominated as General Secretary for this committee and the Y-FETP Technical Advisor was also a member. In order to be aligned with WHO, CDC and other international

organizations’ recommendations the Committee appointed the Y-FETP Technical Advisor to develop a proposal to establish a surveillance system for microcephaly. The proposal with the required training materials was developed and shared with the NZPHC. It was agreed that before launching a fullfledged surveillance system for microcephaly in all governorates, the system should be piloted at Al Sabein Child Maternity Hospital in Sana’a city (non-endemic area for dengue) and at Al Thwara General Hospital in the Hodeidah governorate (an endemic area for dengue) for three months. The results and lessons learned from this pilot will guide future reviewing/updating of the surveillance protocol and forms as well as the measurement techniques and reporting procedures. Three training workshops –funded by WHO- were conducted for all staff working at different shifts at delivery rooms and obstetric operation theaters at Al Sabein Child and

Maternity Hospital. The Y-FETP Director gave an introductory presentation about the Zika virus and the objectives and methodology of the pilot microcephaly surveillance system. Practical training on filling the surveillance forms and standard techniques for taking measurement were also performed under the supervision of the senior consultants in obstetric and neonatology. One Obstetrician and one Neonatologist from Al Thawra General Hospital in Al Hodeidah governorate that was known to be endemic governorate for dengue, also participated in the training in order to duplicate this training at their hospital. The pilot system is going to be evaluated after three months and scaled up as sentinel surveillance at all maternity hospitals in the country. Such pilot microcephaly surveillance system could be the starting point towards establishing a congenital birth defect surveillance in Yemen.

Center for Surveillance, Epidemiology, and Laboratory Services

Division of Public Health Information Dissemination


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EMPHNET Offers Technical Support for Building in-country Capacity in Disease Detection, Outbreak Response, and Health Security Funded by Biosecurity Engagement Program Due to joint efforts led by Dr Aisha Obad Jumaan, TEPHINET and YFETP, BEP funds were secured to support Disease Detection, Outbreak Response, and Health Security Efforts in Yemen. Four trainings will be conducted in Sana’a, Yemen during 2016-2017 to reach nearly 100 professionals. These trainings will cover a wide variety of biosecurity-related topics. They will also serve to support technical staff for the Y-FETP, residents, graduates, and mentors as well as relevant staff from the ministry and governorates health offices. These trainings are: 1. Health Security Training A six-day training module will cover both theoretical knowledge and practical skills, including basic epidemiology, public health response, infection control, isolation unit care, biosecurity and crisis management. This training will improve preparedness in hospitals and the MoPHP to effectively respond to public health emergencies in Yemen. 2. International Health Regulations (IHR) Introductory Training A five-day training will cover two modules. The first module will include an introduction to international relations and law, focusing on IHR in general and how it

applies to Yemen, human rights, legislation and international organizations. The second module will focus on surveillance and response systems, covering emergency management, health risk assessment and IHR core capacities. 3. Outbreak Investigation Field Training Two weeks of training, seeking to build theoretical and practical institutional capacity to rapidly and accurately identify and respond to disease outbreaks. Week one will focus on theory and include six modules: passive surveillance, outbreak determination, environmental assessment, epidemiologic investigation, laboratory guidance and concluding actions when investigating an outbreak. The second week will be spent implementing the first week’s topics in a field exercise where participants will demonstrate their investigative skills. This training will greatly increase Yemen’s ability to rapidly and accurately identify and respond to disease outbreaks using local resources.

4. Rapid Response Team Training A five-day training will cover the following topics: team composition, institutionalization and administration, outbreak investigation, laboratory confirmation, personal protective equipment and infection control, and risk communication. Upon completion of the course, participants will be able to create and function within effective RRTs, increasing Yemen’s capacity to quickly respond to disease outbreaks. To ensure the quality of these trainings, the Y-FETP program director met with EMPHNET Executive Director: Dr. Mohannad Al Nsour and Dr. Adel Belbaisi, Public Health Programs Director Assistant during the Seventh Yemen's Schistosomiasis Control Project technical meeting took place in Amman-Jordan between 28-30 April 2016, As part of EMPHNET’s commitment towards strengthening disease detection, outbreak response, and health security efforts in the region in general and specifically in Yemen, EMPHNET agreed to offer its technical expertizes to help in conducting these BEP planned trainings and to cover all their expenses.


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Y-FETP Conducts Four Dissemination Workshops to Share Findings from the Second Cohort Planned Studies As part of the commitment of Y-FETP towards strengthening health system through evidence based data, the program conducted three dissemination workshops. These workshops were held to share findings from the planned studies conducted by the second Y-FETP cohort and to agree on how to implement recommendations that came up from these studies. These workshops covered the following planned studies: 1- Pattern of road traffic injuries in Sanaa city, Yemen, 2015 by Dr. Eshrak Alfalahi 2- Risk factors for breast cancer in Hadramout Al Wadi, Yemen, 2011-2015 by Dr. Ghazi Bashamakha 3- Risk factors of end-stage renal failure among hemodialysis patients at

Algomhory Hospitals, Saadah governorate, 2015 by Dr. Mohamed Dehnan

and discussed recommendations could implemented.

how be

The workshops were attended by the relevant stakeholders from inside and outside the Ministry of Health as well as the decision makers at the central and governorate level. YFETP staff residents and graduates together with the field teams/data collectors and the surveyed facilities’ directors also participated.

They also exchanged experiences and ideas regarding the priority areas for interventions and future research that Y-FETP residents and graduates could conduct in the future to highlight the health system challenges and help better understanding of the health problems in Yemen.

Each resident presented background, objectives, methodology and findings of his planned study as well as the recommended actions to be taken. These workshops provided excellent opportunities to discuss and enrich the findings. Workshop participants identified the gaps and challenges that were highlighted by the studies

From another angle, Y-FETP renewed its commitment to continue working with all MoPHP programs and directorates in order to address the health system challenges and participate in finding solutions through supporting evidence based and better informed decision making process.


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Y-FETP Participated in the National Strategy for Dengue Control Workshop, Sana'a, 26-27 June, 2016 In a view of a large increase in the number of suspected cases of dengue fever in Yemen, the Ministry of Public Health and Population and the World Health Organization organized a workshop to agree on the National Strategy for Dengue Control. The YFETP director and graduates participated in this workshop. During this workshop, the national strategy for 5 years to expand the scope of preparedness and response for the prevention of dengue fever, developed by 35 experts from the World Health Organization and national programs in the Ministry of Public Health and Population and other government sectors, including the ministries of information and education were adopted. This plan was based on the following key elements: 1- Strengthening integrated diseases surveillance system 2- Expansion of Electronic Disease Early Warning System (eDEWS) 3- Support entomological surveillance in high-risk areas 4- Implementation of additional campaigns to control vectors by insecticide spray

5- Provide the most affected governorates with necessary human resources 6- Training of physicians on the clinical management of dengue fever 7- Increase of community health awareness During the workshop the deputy minister Dr. Dr. Abdul Salam Madani and the DG of Disease Control and Surveillance, director of Y-FETP Dr. Abdul Hakeem Al Kohlani stressed the importance of the workshop to introduce the National Strategy for Dengue control and increase awareness regarding vector borne diseases and their mode of transmission as well as the case management and control. They pointed the need to increases the community awareness regarding these vector borne diseases as corner stone for prevention and control especially for dengue fever. "Adopting a national strategy for dengue control is crucial to the country's efforts to containing the spread of dengue and mobilizing more resources to combat vectorborne diseases," said Dr Ahmed Shadoul, WHO Representative, Yemen. "This year, the response to

the outbreak has been fraught with challenges as a result of increased insecurity and a near-collapse of the health system. In addition, recent heavy rainfall, disruption of water supplies and scarce of safe drinkingwater have contributed to the spread of mosquitos in the affected areas, resulting in an upsurge in dengue cases," Dr Shadoul added. Dr. Ahmed Abdul Rahman, the WHO Emergency Coordinator underlined the importance of this workshop in building consensus among the partners in various sectors and coordinate with each other to meet the health challenges, including dengue fever. He explained that the workshop outputs will help to leverage the donors' support, especially in light of the spread of this dangerous disease in Yemen and to contain and prevent any further outbreaks in the future. He stressed that the WHO will continue its support to Yemen, especially the Ministry of Health in order to combat dengue fever and prevent its spread.


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Y-FETP Graduates and Residents Conducted Eight Outbreaks Investigation Being conscious of the hardship that prevails in Yemen and that constrain the delivery and functions of the health systems, Y-FETP achievements continue to mount as we retain focus on strengthening surveillance, preparedness and response to disease outbreak and emergencies.

During these field investigations, our residents and graduates took the primary actions that helped rapid containments. Furthermore, the findings from these field investigations were shared with relevant stakeholders to take actions to prevent further spread and recurrence.

During this quarter, Y-FETP graduates and residents conducted eight outbreaks investigation: five dengue outbreaks at Hajah, Hodeidah, Shabwa, Sayoun, and Marib; two scabies outbreaks at Sadah and Amran; and one Tinea Capitis outbreak at Amran.

The table in the next page gives more details about these outbreaks investigations. The full reports of these investigations could be downloaded from our website under sub- window " Outbreaks investigation" .


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Second Quarter outbreaks Investigation (April-June 2016) Outbreak

1.Dengue fever

Governorate

Team

Date

Suspected cases

Samples collected

+ve Samples

Lab Test

Hajjah

Dr.Yasen A.Al Wareth

19 April

118

23

16

Eliza-IgM

27 Apil

224

8 May

6036

Dr. Mohamed Alemad

(48%)

Availability of the report on Website



Dr. Ahmed Alsahethi 2.Scabies

Sadah

Dr. Mohamed Alemad Dr. Nabil Al Abhar



Dr. Mohamed Dhanan 3.Dengue fever

Hodeidah

Dr.Hamod Al Shameri

13

6

Dr. Qais Jassar

(46%)

Dengue rapid test

Dr.Mohamed Al Fakeh Dr. Ibrahim Makbool 4.Scabies

Amran

Dr. Mohamed Alemad Dr. Nabil Al Abhar

18 May

333

May

1020

May

61



Dr. Yaser Al Gomai Abdul Halek Haash 5.Dengue fever

Shabwa

Dr Awad Basleh Dr.Ghazi Bashamakha Khaled Al Barek Saleh Al Atal

6.Dengue fever

Sayoun

Dr. Ghazi Bashamakha Dr. Samer Ba Jober

38

18

Eliza-IgM

(49%)

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Ahmed Boker Saied Sadan Abdulah Al Hadri 7. Tenia

Amran

Dr. Nabil Al Abhar Dr. Mohamed Kasem

1st June

148

15 June

323

15

7

Culture

(47%)



Dr. Yaser Al Gomai Dr.Mohamed Almoker 8.Dengue fever

Marib

Dr. Ahmed Alsahethi Saleh Al Baheshi

24

14 (58%)

Eliza-IgM


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Y-FETP Launched the First Issue of its Quarterly Bilingual Arabic/ English Newsletter As a growing and new program that relies heavily on knowledge and experience exchange, Y-FETP look forward to investing more efforts in building new relations and cooperation with different FETP programs and public health specialists in general. We also look forward to sharing our successes with our partner programs as well as with our advocates and supporters. Therefore, Y-FETP launched during this quarter the first issue of the quarterly bilingual Arabic/English Y-FETP Newsletter. We hope that this newsletter will present a forum for the Epidemiology and Public Health community in Yemen and the region to keep them updated about the recent activities of the Y-FETP in the field of epidemiology and public health e.g. outbreaks, research, trainings etc. The newsletter will strengthen communication with other FETP programs in the region as well as in different regions

and will foster experience/ideas exchange that will benefit FETPs as well as other public health programs and improve the performance. Through this newsletter, both Y-FETP residents and graduates will follow their program’s activities and could become more attached to it. They will also find new opportunities to develop their careers and participate in the upcoming trainings and conferences at local, regional, and global levels.

The Y-FETP newsletter will be posted quarterly at the website: (http://www.yfetp.com) We greatly acknowledged technical support from the ICT section at EMPHNET. FOR MORE INFORMATION For more information about the program, please visit YFETP website:

www.yfetp.com