Enhancing COVID 19 vaccination coverage in Sierra Leone

Abstract   The project aim to support Sierra Leone in enhancing vaccination coverage. BACKGROUND In November 2021, the vaccination coverage rate was 7% for one dose and 4% for two. According with EPI program, the main problem was not the lack of vaccines (already provided by different donors) but the need of support (training, motivation, allowances) to health personnel. Lombardy project involved 31 local vaccination teams performing a refresh training, followed, by micro-planning meetings. SIGNIFICANCE The Covid epidemiology in SL is not well known, but the possible new waves makes this intervention a high public health priority. USEFULNESS. The model is based on training, motivation, follow up and a very simple monetary allowance system based on performance. An online daily report available on smartphone was provided to follow up performances and manage allowances system. PROBLEM The objective was a donation of vaccines, but after a short assessment the issue changed to the need of supporting the local health staff. The goal shifted to train, give incentives for health workers, support to micro-planification and also to work on timely reporting to follow up the project results. QUESTIONS ANSWERED. Can support to microplanning be effective in enhancing vaccination numbers? Can monetary incentives to personnel based on performances enhance vaccination numbers? Can a setting approach (school, workplaces,..) enhance vaccinations numbers? RESULTS the numbers of vaccination Increased from an average of 5 per team by day in early December (after the refresh training) up to an average of 15 by day after the support to micro-planning, the monetary progressive incentives based on performance and the introduction of settings approach. Up to 85.000 doses was performed in 4 months. Key messages • Planning, performance based payement and training can enhance vaccination coverage. • African countries can performe good vaccination programs if supported in organization and non only in vaccine donation.


Background:
Health education for promoting healthy lifestyle from early ages is considered to be important. However, this issue has not been thoroughly examined in Georgia. The research, undertaken on adolescents, aimed to analyse adolescents' lifestyle, awareness and attitudes towards healthy lifestyle.

Methods:
The study applied a mixed methods design and included both, qualitative and quantitative research methods. 145 students aged 17 to 23 years participated in the research. In order to evaluate the adolescent's perceptions and attitudes, qualitative individual interviews with university students were conducted. For the quantitative method, a self-administered questionnaire assessing the level of adolescents' awareness and attitudes towards healthy lifestyle was developed.

Results:
This section presents preliminary findings of the study. We found that more than 67% of adolescents were aware on the importance of healthy lifestyle. However, most of the participants did not transfer their knowledge into practice. The participants found it challenging to maintain healthy eating habits due to increased costs of healthy, organic food. The study also confirmed the need for integrated work of public, governmental, and non-governmental organizations to initiate and implement health promotion programs for children and adolescents.

Conclusions:
Overall, the study found that even though adolescents are aware about the importance of the healthy lifestyle, it is challenging for them to maintain it. In order to change adolescents' attitudes towards unhealthy behaviour, it is necessary to carry out targeted interventions.

Key messages:
Health education is a necessary component for healthy lifestyle. Healthy lifestyle requires careful study of the issue and making evidence-based conclusions.
The project aim to support Sierra Leone in enhancing vaccination coverage. BACKGROUND In November 2021, the vaccination coverage rate was 7% for one dose and 4% for two. According with EPI program, the main problem was not the lack of vaccines (already provided by different donors) but the need of support (training, motivation, allowances) to health personnel. Lombardy project involved 31 local vaccination teams performing a refresh training, followed, by microplanning meetings. SIGNIFICANCE The Covid epidemiology in SL is not well known, but the possible new waves makes this intervention a high public health priority. USEFULNESS. The model is based on training, motivation, follow up and a very simple monetary allowance system based on performance. An online daily report available on smartphone was provided to follow up performances and manage allowances system. PROBLEM The objective was a donation of vaccines, but after a short assessment the issue changed to the need of supporting the local health staff. The goal shifted to train, give incentives for health workers, support to micro-planification and also to work on timely reporting to follow up the project results. QUESTIONS ANSWERED. Can support to microplanning be effective in enhancing vaccination numbers? Can monetary incentives to personnel based on performances enhance vaccination numbers? Can a setting approach (school, workplaces,..) enhance vaccinations numbers? RESULTS the numbers of vaccination Increased from an average of 5 per team by day in early December (after the refresh training) up to an average of 15 by day after the support to micro-planning, the monetary progressive incentives based on performance and the introduction of settings approach. Up to 85.000 doses was performed in 4 months.

Key messages:
Planning, performance based payement and training can enhance vaccination coverage. African countries can performe good vaccination programs if supported in organization and non only in vaccine donation.

Background:
Considering the current pandemic situation, the growing problem of antibiotic resistance and the increase in healthcare costs, attention to daily disinfection is becoming increasingly important. This study aimed to evaluate the bactericidal efficacy of a modern and stylish UV-C device designed for the home environment.

Methods:
The experimental study was conducted between July-August 2020 on four bacterial strains: Staphylococcus aureus, Salmonella typhymurium, Klebsiella pneumoniae and Escherichia coli. The UV-C device consist of a protective dome with a reflective coating, a UV-C lamp (placed in the device base) and three reflective holders. Different positions and exposure times were tested using two different carriers holder for the bacterial inoculum (plastic and stainless steel) to estimate the germicidal efficency related to UV-C lamp exposure, with direct and reflected (from the dome coating) light.

Results:
The experiment showed that the higher bacterial inactivation effect (3.5 to 7 log10) was achieved for all four strains at 3 minutes, but even at 1 minute, there is a marked reduction in the bacterial load with the only exception of Klebsiella pneumoniae. After 45 and 30 seconds, steel carriers contaminated by Escherichia coli and Staphylococcus aureus on the opposite side of the UV-C source showed significant reductions in the range between 99 and 99,9%.

Conclusions:
The device has proven to be effective for the disinfection of various everyday objects placed into the lamp and introduces beauty to the household environment.
Key messages: In this study, UV-C device proved to be a valuable tool for disinfecting household items and enhancing safety for everyday health.
UV-C device proved to be a valuable tool for disinfecting household items and enhancing safety for everyday health.

Background:
Severe aortic stenosis prevalence has been growing worldwide and constitutes a public health challenge. The gold-standard treatment is Surgical Aortic Valve Replacement (SAVR) however Transcatheter Aortic Valve Implantation (TAVI) has been increasing, especially in high-risk surgical patients. This study aims identifying the factors associated to the implementation of TAVI to minimize possible disparities in access to health services.

Methods:
This study used data on inpatient discharges from the Portuguese NHS, from 2015 to 2017. SAVR and TAVI, were classified according to the International Classification of Diseases (ICD). Chi-square test and independent T-tests with 1% significance level in the SPSS Õ were performed to identify the factors associated with both interventions.

Conclusions:
TAVI was performed in more severe patients and there was an increase in TAVI over the years, which is consistent with the growing use of the technology among other patients, e.g., the high-risk surgical patients. We also found a geographic pattern in the use of SAVR and TAVI. This might reveal the existence of geographic disparities regarding availability and access to health services. Key messages: In Portugal, there is an increase in the performance of TAVI, with geographical concentration that reflects on access. TAVI is more often performed in more severe patients as an alternative to SAVR with similar discharge outcomes.