PART 1

* The heading of the table should indicate the year (2018) and not last year.

* District 1 has  repeated data in the months of November and December.

* District 14 has repeated data in March, April, October and November.

* District 6 has all even values which suggests that the data might have been rounded up.

* District 4 has very high data for May which suggest data entry error

* District 2 and 5 have reported low coverage.

*District 1,3,4,10,11,14, and 15 have reported very high coverages as against the target population.

*District 13 is the only district that didnt have a repeated data for February and March but had very low data for November.

PART 2

In 2017, a huge number of children missed vaccination, approximately 34,354. This might have been the reason for the outbreak.

At the sub national level, there were 2 low coverages in Westan and Nemo. Grandtown has high coverage possibly as a result of urbanization; more people moving into the capital.

PART 3

After reviewing the Coverage Evaluation Survey data  and the administrative data, there is no significant difference at the national level.

However, at the subnational level, 80% of unvaccinated or unknown vaccination cases with more than half within the capital Grandtown. The large and growing number of poor and underserved people suggests that they might not be aware that immunization is free in Vacciland and hence do not take up immunization.

Also, sporadic stock outs in select areas might result in missed opportunities.

PART 4

The chart with the age distribution of measles cases clearly shows that 37% of the affected children are under 5 years. A large proportion of the population affected fall out of the current immunization cohort (under 5).

PART 5

* There are challenges in data collection in some district areas especially Grandtown.

* Vacciland immunization strategy and plan targets the absence of endemic measles transmission for children greater than or equal to 12 months.

* Current outbreak of measles is the highest since the last 6 years.

PART 6

* Conduct Supplementary Immunization Activities for children under 5 years.

* Create Awareness campaigns and community engagement about the benefits of immunization.

* Strengthen immunization system through proper micro planning

PART 7

* Conduct supportive supervision and training among lower level staff on data entry into registers.

* Conduct quaterly Program Appraisal for Performance Management and Action (PAPA)

*Conduct Coverage Evaluation Survey (CES)

*The use of electronic registers to reduce data errors.