NAME OF VISIT

RI SUPERVISORY TRIP REPORT

Name of supervisor: County: Date of Report; 30th June 2024

1. INTRODUCTION:
Mayom county lies in the North West of Unity State with the estimate population of 317,678 served by
one newly up gradated County Hospital (Mayom Hospital), two PHCCs, and 6 PHCUs distributed
according to Payam division in 10 administrative Payams except Wangbuor PHCU operating as Mobile
Clinic supported by Samaritans purse while the rest of the functional health facilities are supported by
UNICEF/World Bank through Cordaid as an IP. In the upcoming July World Bank project, Ruadh-Nyibol
PHCU has being left out from the support and funding. RI supportive supervision covered from 25 th -29th
June 2024 targeted all the functional health facilities in the county.

1. The purpose of his supervisory visit:

 Capacity building of RI vaccinators
 Make sure all RI monthly reports are send to CHD completely and timely.
 Proper management of fridges and vaccines storages
 Early request of vaccines, data tools and other accessories.
 Proper documentations of RI data
2. Key issues identified in the last visit:
 Stock out of BCG vaccines
 Low Stock of tally sheet in Ngop PHCU
 Low sock of Td vaccine in Riak PHCU only 10 doses left
 Data discrepancies in the majority of the visited HF
3. Formation of the supervisory team:
The team comprised of 5 personal namely below:
1) Stephen Nyieth Douth – Director Preventive services, SMOH Bentiu
2) William Dhoal Ruei – Director of Budgeting, planning, Monitoring and Evaluation, SMOH Bentiu
3) James Chuong Kai- CHD M&E –Mayom
4) Charles Nhial Gatdet –CHD EPI suervsior –Mayom
5) James Tong Dak, AFH RI officer –Bentiu

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 4. Places visited and persons met during supervision

S/N Name of the visited Health facility Contacted person

1 Mayom Hospital Bantor Duor Ruei
2 Mankien PHCC Gatluak Kuol
3 Pub PHCU Nyekueh Mawuon
4 Ngop PHCU Manyuan Yuot
5 Bieh PHCU James Gatluak Majok
6 Ruadh-Nyibol PHCU Mariem Mut
7 Kueryiek PHCU John Mawuk
8 Riah PHCU Wadar Kueth
9 Wangkey PHCU Stephen Nyang Thian

2. EXECUTIVE SUMMARY
Nine functional health facilities that are providing RI services visited during five days supportive
supervision in Mayom County and observed that the functional health facilities have improved on
planning activities with full implementation according to RI sessions plans.

But there is still some challenges in terms of waste disposal sites where only 67% of the functional
health has permanent incinerators , improper defaulter tracing claiming to be caused by delayed of the
social mobilizers incentives and data discrepancies in all health facilities according to the records shown
on RI registers and monthly reports booklets comparisons. On March 2024 RI supportive supervision,
the all summary of the health facilities performances was at 71% while only visited 7 health Facilities.
While the current performances is 88% in 9 visited health facilities. This show that the county has some
improvement.

3. FINDINGS/KEY ACTIVITIES ACCOMPLISHED

3. A Successes/Strengths:

 The current temperatures in the vaccine refrigerator in all the visited HFs are between +2 o C
to +8 o C
 All the vaccines in the stock are usable in all the visited HFs
 February session plans are existing and displayed in all the visited HFs
 Monitoring charts are correctly filed, plotted and displayed on the wall in all the visited HFs.
3. B Gaps/obstacles

 Data discrepancies between recording and reporting in 89% of the total functional health
facilities that are providing RI activities in the county.
 All the fridges Mayom Hospital are electrics fridges except one solar fridges which sometime
defaulted and the supplies of fuel from UNICEF has stop since late last year 2023.
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  Poor waste disposal mechanism in Pub, Kueryiek, Ruadh-Nyibol, Riah and Bieh PHCUs.
 Improper defaulter tracing mechanism caused by lack of commitment due to delay of
incentives of community social mobilizers assigned in each hf.
3. c. Action taken

 Vaccinators are advised to keep all their registers in the HF and to make sure data is consistent
both in the monthly report and the registers
 Help vaccinators on how to conduct and develop defaulter lists.
 Advices the vaccinators to keep safety boxes in safe place and send them to County HQs for
final disposal especially in this rainy seasons in location without incinerators.

4. Old and New Critical issues and problems remaining to be resolved.

 Poor waste disposal
 Data discrepancies
5. RECOMMENDATIONS
As per the above mentioned challenges, CHD and the IP needs to

1- Construct the incinerators in Kueryiek, Riak, Bieh, Ruadh-Nyibol and Pub PHCUs.
2- UNICEF provides of solar fridges to Mayom Hospital to curve the gaps in fuel supplies.
3- CHD EPI officer always to have quick action on vaccines supplies when request is sent
by HFs.
4- AFH technician to relocate the solar fridges to main building in Riah PHCU from the
nearly collapse building.
6. CONCLUSION:
As per the previous visited to Mayom County, HFs have improved in terms of performances while the
CHD office is decreasing in performances. Therefore, the CHD needs much improvement as technical
advised was given. So, the action taken from the previous visit are done except for data discrepancies.

But there is still some challenges in terms of waste disposal sites where only 67% of the functional
health has permanent incinerator while other remaining 33% requires construction of permanent
incinerators.

7. Annexes

Data falsification/verification

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 Months for which EPI Data is Verified May 2024
Name
of
Health
FacilityWangkei PHCC Mankien PHCC Kueryek PHCU Ngop PHCU Pub PHCU Mayom Hospital
Repor Repor Repor Repor Repor
Antigen Register t Register t Register t Register t Register t Register Report
BCG 78 114 231 157 89 65 56 60 42 51 128 118
Penta1 50 50 150 158 44 44 27 29 40 42 70 70
Td 67 65 153 174 95 85 14 28 17 14 0 190

Months for which EPI Data is Verified May 2024

Name
of
Health Ruadh-Nyibol
FacilityBieh PHCU PHCU Riak PHCU
Repor Repor Repor
Antigen Register t Register t Register t
BCG 231 229 165 165 66 66
Penta1 136 136 103 103 48 48
Td 224 224 137 151 75 75

Mayom County Health Facility Performance

June 2024
100% 95% 95% 92% 88% 88% 84% 88%
81% 76%
80% 72%
60% 50%
40%
20%
0%
CC l C y ce
PH CU CU ita CU CU CU HC HC
U ar
n PH PH sp PH PH PH
y P P m offi
o l k b um D
kie op eh H ah o ie ke Pu CH
an Ng Bi om Ri yib e ry a ng f ss
N
M ay h- Ku W al
H
M
uad ot
R T

Health Facilities

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 ANNEX 1

County RI Supervision Summary (Facility-by-Facility)

Mayom Mankien Pub PHCU Ngop Bieh PHCU Ruadh- Wangkey Kueryiek Riak
Hospital PHCC PHCU Nyibol PHCC PHCU PHCU
Health Facility Name
PHCU

Name of the supervisor James T James T James T James T James T James T James T James T James T
Date of Visit 25/6/024 25/6/024 26/6/024 26/6/024 27/6/2024 27/6/2024
28/8/2024 29/06/202 29/06/202 Total
4 4 ( County)
Yes/No/NA Yes/No/NA Yes/No/NA Yes/No/NA Yes/No/NA Yes/No/ Yes/No/ Yes/No/
S.N Activities Yes/No/NA # Yes % Yes
NA NA
1 Up to date estimate of target groups Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
2 Catchment area map with basic features displayed Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
3 RI session plan displayed Yes Yes Yes Yes Yes Yes No Yes Yes 8 89%
4 All planned sessions carried out last month Yes Yes Yes Yes Yes Yes No Yes Yes 8 89%
5 Complete/correct temperature monitoring chart Yes Yes Yes Yes Yes Yes No Yes Yes 8 89%
6 Current temperature between +2°C to +8°C Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
7 All vaccines and diluents in stock No Yes No Yes Yes Yes Yes Yes Yes 7 78%
8 All vaccines in stock usable Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
9 Vaccines arranged correctly Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
10 Date of opening written & no reconstituted vials Yes Yes No Yes Yes Yes No Yes Yes 7 78%
11 Up-to-date/correct stock control book Yes Yes Yes Yes No No Yes Yes Yes 7 78%
12 Vaccine/diluents brought to session correctly Yes Yes Yes Yes Yes Yes Yes Yes No 8 89%
13 All vaccines/ diluents available during the session No Yes No Yes Yes Yes Yes Yes Yes 7 78$%
14 Diluents for BCG and Measles are correct Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
15 Sufficient syringes /needles Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
16 Vaccinator verifies infants’ age and records Yes NA Yes NA Yes Yes NA NA Yes 5 100%
17 Vaccines administered correctly Yes NA Yes NA Yes Yes NA NA Yes 5 100%
18 Used needles/syringes placed in a safety box Yes NA Yes NA Yes Yes NA NA Yes 5 100%
19 Key messages provided to parents/caregivers Yes NA No NA Yes Yes NA NA Yes 4 80%
20 Five RI management data tools available and used Yes Yes Yes Yes Yes Yes Yes Yes No 8 89%
21 RI registers (child and Td) filled correctly Yes Yes Yes Yes Yes Yes Yes Yes Yes 9 100%
22 Data the same in the Registers and Monthly Report No No No No No No No No Yes 1 11%
for BCG, Penta1 and Td1.
23 RI monitoring chart displayed, correct, up-to-date Yes Yes No Yes Yes Yes Yes No Yes 7 78%
24 Drop out tracing mechanism in place Yes Yes No Yes Yes No Yes No Yes 6 67%
25 Appropriate waste disposal site Yes Yes No Yes Yes No Yes No No 5 55%
Total YES 22 20 18 20 23 21 16 17 22 179
Number of Applicable Questions 25 21 25 21 25 25 21 21 25 209
%YES 88% 95% 72% 95% 92% 84% 76% 81% 88% 86%

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 ANNEX 2

CHD Level Routine Immunization Supportive Supervision Summary (CHD summary)

County Name Mayom
Visitor’s Name(s) James Tong
Number of Payams 10
Number of Health Facilities Providing RI Services 9
Date of Visit 29/06/2024
S.N Activities Yes/No/NA
1 Payam-by-Payam situation analysis (P1) Yes
2 Up to date estimate of target groups Yes
3 Consolidated Health Facility and CHD session plan by strategy Yes
4 Quarterly Work plan No
5 Inventory of Cold chain equipment No
6 Complete/correct temperature monitoring chart No
7 Have Fridge Tag2 and corresponding figure of Temperature monitoring No
8 Up-to-date/correct stock control book No
9 Estimate of the vaccine and immunization supplies Yes
10 All vaccines in stock usable NA
11 Vaccines arranged correctly NA
12 Up-to-date data base (P3) training status of vaccinator No
13 Up-to-date RI report receipt monitoring chart No
14 Monthly RI report submission Yes
15 Five RI management data tools available Yes
16 County use DHIS2 for RI reporting Yes
17 Quarterly RI performance data and supervision summary No
18 RI monitoring chart displayed, correct, up-to-date No
19 Supportive supervision conducted by County EPI team Yes
20 Health facility RI Supervisory checklist, filled out Yes
Total YES 9

Number of Applicable Questions 18

%YES 50%

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