Part 1. Data analysis

Task 1. Flag all the suspicious values. (Outliers, repetitions, etc.) (spend max 15 minutes)

District 1,3,4,10,14,15 are the suspicious districts in term of over reported data
District 2 & 5 are poor in terms of coverage
District 4 has reported 9008 beneficiary vaccination in May month which seems very unrealistic
District 1 – September data, District 3 – April May & November data looks suspicious

Task 2. Review the national and subnational coverage for MR1. Your data manager produces the following tables. What can you conclude from the administrative data?

Alu, Grnadtown & Remo has achieved more than 100% which requires attention
The National Average is consistent around 90% which is more realistic

Task 3. Review coverage evaluation survey data. You remember that in 2013, there was a coverage evaluation survey. You pull up the data for that. Does this change your view about coverage at national level? For any of the regions?

CES coverage of Easten, Grandtan, National and Average of reported coverage of MR 1 from 2013 to 2017 is relatively close to each other
Alu, Grnadtown & Remo has huge difference in between CES & reported coverage which require attention
The national coverage is relatively same in CES & reported coverage

Task 4. Review the chart with the age distribution of measles cases. Does that tell you anything additional about coverage?

37% population in age distribution of measles cases is in under 5.

Part 2. Brief the Minister

Task 5. Brief the Minister (spend max 1/2 hour on this section). Summarize the situation in three bullet points.

The national coverage is within 89 to 95 for last 7 years but the subnational regions especially Alu, Gandtown and Remo reportedly overachieved in coverage. District 4 data in May month can be quoted as an example of overachieved data.
In last 7 years 3285 cases were deducted in 2012, 462 cases in 2011 and 625 cases have been deducted in 2018. Under 5 population accounts for 37% in confirmed measles cases.
CES data of national average is matching with the national reported average but some provinces Alu, Gandtown and Remo looks shirker

Task 6. Brief the Minister. Propose three actions to respond to the outbreak.

Special Immunization Activity in prioritized regions especially Alu, Grandtown and Remo.
Special emphasis on under 5 immunization as they are contributing 37% in the measles cases
2nd dose of measles may also be introduced in the UIP program followed with MR/Measles campaign

Task 7. Formulate recommendations. List your top 3-5 recommendations specific to data strengthening you would prioritize as the EPI and surveillance teams in Vacciland

MoHFW should strengthen Supportive Supervision mechanism in the country
Data quality audit and review should be planned frequently
Strengthening of review meetings at all levels