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Kombra Network members and Community Health Officer, Sulima Chiefdom, counselling households in Yendeya Community, Falaba District 

With one child dead already we need to support the Health facility staff reach every household and community member as quickly as possible. Every child is our child and we are committed to his/her wellbeing” Peter S. Marah Chairman, Kombra Network Executive Mongo, Falaba District.

According to the Ministry of Health & Sanitation (MOHS), Falaba district had recorded 25 clinically confirmed cases of measles by 18 June, 2018 of which 1 child aged 1 year had died at Yendeya Community in the District from the disease. The cases are reported to be occurring among under 5 and never-vaccinated children who reside in remote communities close to the Sierra Leone Guinea border. They are believed to be linked to the on-going measles outbreak in Guinea as there is a lot of daily traffic between communities on both sides of the border. 

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Children confirmed with measles cases

Based on the Demographic Health Survey statistics, Percentage of children age 12-23 months who received specific vaccines at any time before the survey in Koinadugu District (out of which Falaba has been demarcated), has a routine immunization coverage level of 76.1. 

The table below shows the status of routine Immunization across the country  from Jan-Dec 2017.

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 Several socio-cultural factors are said to combine with logistical challenges in limiting access of children and families to basic services like immunization. 

“We are doing everything in our power to bring this outbreak under control, with teams already on the ground leading the response,” said Dr. Brima Kargbo, Chief Medical Officer at the Ministry of Health and Sanitation. “Given the location of the affected communities, we are working with our counterparts in Guinea to ensure continued collaboration on measles vaccination efforts, community engagement and surveillance.”

During a press conference held in Freetown, the Expanded Immunization Programme Manager Dr. Dennis Marke said for this new outbreak, 187,777 children are to be vaccinated and they need 260,444 doses of the vaccine which cost USD 72,944.32. “We need to put together 406 teams of three personnel. This means we have to employ 1,218 workers and an additional 135 supervisors. To send these teams in the field to do the immunization, we will have to spend Le 356,371,000. That is why we are calling on partners to support the Ministry” Dr. Marke disclosed.  

It was this understanding of the situation of children and women in this district that motivated key stakeholders of traditional and religious leaders, market women, traditional healers to decide to combine their collective expertise and reach to counsel families and communities on appropriate child care including use of basic services like immunization. With the establishment of the Kombra Network in the district, network members have been actively engaged in defaulter tracing and in counselling families to have their children fully immunized as well as promoting the practice of proper hygiene behaviours. 

Kombra Networks, already oriented and equipped with basic facts for life messages, are already active in all 16 districts of the country and are supporting disease surveillance, as well as basic health and nutrition education at the district, chiefdom and community levels. It is reported that the Kono KN are being credited for alerting their local health facility to cases of measles as early as May, 2018.“Dis too mus die pan wi pikin en belleh ooman dem toooo mus. Ee get for stop, so we di Kombr Network memba dem don tinap for ep government dis sai” Edna Khefalah Kombra Network Chairperson Koinadugu District. 

The Kombra Networks are linked to the community engagement component of the Saving Lives project that has been implemented by FOCUS 1000. The Saving Lives Project is supported by DFID, through UNFPA as part of the CHANGES Consortium.  Through this project, Focus 1000 has also supported government to establish a comprehensive database with details of all PHUs in the country and to develop an app that synchronizes with the national health information database (DHIS2) structure.