Chapter 6- HepB-BD- Service Delivery Strategies.pptx

HC

1. HepB - BD vaccine Introduction 4-Sep- 25 1

2. Chapter 6: Service Delivery 4-Sep- 25 2

3. Outline 4-Sep- 25 3 Strategies for HepB- BD vaccination for health facility births Strategies for HepB- BD vaccination for outside health facility births Strategies to increase Health facility births Opportunities for improving HepB- BD service uptake Service integration

4. Learning objectives At the end of the chapter, participants will be able to: Describe key strategies for administering HepB- BD in health facilities Describe key strategies for administering HepB- BD for outside of health facility births Understand the opportunities for improving HepBD BD service uptake 4-Sep- 25 4

5. Background 4-Sep- 25 5 Births take place in two main settings; in health facilities or out of health facility Different strategies will be needed for reaching newborns in each of these settings EPI and MNCH programmes has to work together to make sure that HepB- BD administration is coordinated with current newborn care practices This shouldn’t interfere with essential life- saving interventions

6. Strategies for health facility births HepB BD vaccination (1/3) 4-Sep- 25 6 Essential new- born care national guideline has been revised to include the administration of HepB vaccine within 24 hours of delivery in health facilities Pregnant women visiting health facilities for ANC and those who are in the community will be educated on the importance of HepB- BD vaccine All public s private HFs having WHO- pre- qualified- refrigerators and providing delivery and immunization services has to provide HepB BD vaccine

7. Strategies for health facility births HepB BD vaccination (2/3) 4-Sep- 25 7 All private health facilities providing delivery service but not immunization should refer the newborn to the nearest HF for timely HepB- BD vaccination In order to increase the coverage of HepB- BD vaccine in big cities, it is also important to establish or strengthen referral mechanisms to the nearby public facilities or establish a temporary fixed post at the high- yield private facilities The vaccination can be administered in the EPI, delivery/PNC rooms, or other units if they are suitable for vaccination. It is more advisable to provide the service in the EPI room for proper documentation, continuity of care, and vaccine handling.

8. Strategies for health facility births HepB BD vaccination (3/3) 4-Sep- 25 8 The vaccine should be administered by a health care worker who has completed the IIP training. In the absence of IIP- trained health worker for various reasons, a health worker properly trained during the HepB- BD introduction training or through on- the- job training could provide the service. It will also be provided at the health post level (community referral to the HPs). A house- to- house vaccination will not be implemented. It is important to ensure vaccine safety and always keep the vaccine following the standard in the refrigerator or a vaccine carrier within the temperature range of 2 ° C to 8 ° C.

9. Strategies for outside health facility births HepB BD vaccination (1/2) 4-Sep- 25 9 The newborn delivered at home should be brought to the nearby health facilities to be vaccinate within 24 hours If bringing the newborn within 24 hours of birth to HF not possible, the neonate has to be vaccinated within 14 days of birth Utilizing the existing community structure to improve linkage and referral system for home- delivered mothers for both early postnatal care and HepB BD immunization.

10. Strategies for outside health facility births HepB BD vaccination (2/2) 4-Sep- 25 10 Educate community structures including women development group Health Extension Workers, Village Health Leaders including, men community members, etc Link the newborn to the HFs as early as within 24 hours of birth or for early postnatal care and HepB BD vaccination Integrate HepB BD vaccination into early postnatal care through HEWs

11. Strategies to increase Health facility births 4-Sep- 25 11 HWs will need to record the mobile phone numbers of the mother/family member/neighbors who help to track pregnancy Mothers’ tracked through CHIS/eCHIS) should be linked to the nearby HF for the timely administration of Hep B BD vaccine Midwives/HCWs/HEWs will conduct pregnant women conferences to improve facility delivery Pregnant women who couldn’t access ambulance services easily and those who are from hard-to- reach areas will be counseled to use maternity waiting homes before 2 weeks of the expected date of delivery

12. Opportunities for improving HepB BD service uptake 4-Sep- 25 12 Availability of 24 hr. care and stay guideline (Obstetric management protocol) for delivered mothers The existing Triple Elimination (HIV, Syphilis and Hepatitis) of mother to child transmission strategy (2021- 2025) Existing community structures such as WDGs, VHLs, community volunteers for advocacy, linkage and referral system strengthening The existing surveillance system for adverse immunization outcome and digitization (e- CHIS) The strategy of referring an out of health facility delivery women within 24 hrs to the nearby health facility The existence of private health facilities providing immunization services The increase in health facility deliveries

13. Service integration 4-Sep- 25 13 HepB BD vaccine administration will be integrated into MNCH and National Essential New- born care The HWs who are responsible for the child’s birth are also responsible for ensuring the child receives HepB BD vaccine The administration of HepB- BD immunizations necessitates a collaborative effort between the immunization unit and the maternity and postnatal unit, task sharing is very critical There is a need for strong collaboration and coordination among the health programs for smooth rollout of Hep BD vaccine. The revised IMNCI guideline has included HepB- BD to be given along with OPV0 s BCG to all newborns after delivery and before discharge as an early essential new- born care package.

14. Summary 4-Sep- 25 14 All public s private HFs having WHO- pre- qualified- refrigerators and providing delivery and immunization serviceshas to provide HepB BD vaccine HepB BD must be integrated in the essential newborn care protocol The newborn delivered at home should be brought to the nearby health facilities to be vaccinate within 24 hours Hep B BD vaccine can be administered up to 14 days if the child didn’t receive the vaccine with in 24 hours of birth There is a need for strong collaboration and coordination among the health programs for smooth rollout of Hep BD vaccine.

15. Thank You! 4-Sep- 25 15