Introduction In Zimbabwe, there is a gap between sexual violence (SV) survivors' health care needs versus the existing facilities. Harare city started Sexual Gender Based Violence (SGBV) project in 2011, with the aim to reduce SV morbidity.Only 592 (42%) of 1425 SV survivors reported for medical services within 72 hours in 2015. HIV post-exposure prophylaxis (PEP) is effective within 72hours of post exposure. We evaluated the program performance in Harare city. Methods We conducted a process-outcome evaluation using a logic model. We purposively recruited all eight SGBV sites and key informants. We randomly selected 27nurses into the study. Interviewer-administered questionnaires and checklists were used to collect data. To generate frequencies, means and proportions we used Epi info 7. Results The program adequately received inputs except for counselling rooms (1/8). About 4285 survivors were recorded from 2013-2016. Of these, 97% were counselled, 93% received HIV test, 41% reported to the clinic within 72hrs of post-rape, and 12% received PEP. About 16% of the total survivors were followed up. The programme failed to meet its targets on decentralised sites (8/10), awareness campaigns(16/32) and sensitisation activities(16/32). About 500(12.5%) IEC materials were distributed. All 96-targeted supervisory visits were achieved. Two ofeight district supervisors were trained. Majority of health workers (25/35) citedlack of awareness as major reasons for underperformance. Conclusion Availability of resources did not translate to program performance. Most survivors were not reporting to the clinic timeously due to the low level of awareness of the programme to the community, hence were not protected from getting HIV through PEP. The programme was not well disseminated, as most supervisors were not trained. Following this evaluation, we distributed150 IEC materials to each of the eight facilities. A follow-up study on outcomes of clients referred for services and training of district officers were recommended.

No abstract

Introduction Following a declaration by the World Health Organization that Liberia had successfully interrupted Ebola virus transmission on May 9th, 2015; the country entered a period of enhanced surveillance. The number of cases had significantly reduced prior to the declaration, leading to closure of eight out of eleven Ebola testing laboratories. Enhanced surveillance led to an abrupt increase in demand for laboratory services. We report interventions, achievements, lessons learned and recommendations drawn from enhancing laboratory capacity. Methods Using archived data, we reported before and after interventions that aimed at increasing laboratory capacity. Laboratory capacity was defined by number of laboratories with Ebola Virus Disease (EVD) testing capacity, number of competent staff, number of specimens tested, specimen backlog, daily and surge testing capacity, and turnaround time. Using Stata 14 (Stata Corporation, College Station, TX, USA), medians and trends were reported for all continuous variables. Results Between May and December 2015, interventions including recruitment and training of eight staff, establishment of one EVD laboratory facility, implementation of ten Ebola GeneXpert diagnostic platforms, and establishment of working shifts yielded an 8-fold increase in number of specimens tested, a reduction in specimens backlog to zero, and restoration of turn-around time to 24 hours. This enabled a more efficient surveillance system that facilitated timely detection and containment of two EVD clusters observed thereafter. Conclusion Effective enhancement of laboratory services during high demand periods requires a combination of context-specific interventions. Building and ensuring sustainability of local capacity is an integral part of effective surveillance and disease outbreak response efforts.

Introduction An adverse event following immunisation is any untoward medical occurrence which follows vaccination. Frequency of adverse events ranges from 13% to 34% and they should be reported regardless of severity. From the beginning of 2016 to mid-2017, Guruve district in Zimbabwe did not report any AEFIs. This suggests the surveillance system may be failing to detect adverse events. We therefore evaluated the AEFI surveillance system in Guruve district. Methods We conducted a surveillance system evaluation using the updated Centers for Disease Control guidelines for evaluating public health surveillance systems. We interviewed health workers and caregivers of babies under 2 years in Guruve district. We also reviewed all records on AEFI surveillance for the period of January 2016 to November 2017. Results We recruited 31 health workers and 33 caregivers into the study. Between January 2016 and mid-2017, 39% of the caregivers had children who had suffered AEFIs and 45% of the health workers had encountered AEFIs but none had been notified. The main reasons for failure to report AEFIs included health workers' fear of personal consequences and caregivers thinking that an adverse event was not serious enough to report. Knowledge of the surveillance system was good amongst the majority of health workers. All the resources needed by the surveillance system were available. Conclusion We concluded that health workers in Guruve district were afraid to report adverse events following immunization and caregivers were reluctant to report mild adverse events hence the surveillance system was performing poorly and was not useful. However, the stability of the system and the good knowledge gives a good foundation for improving the surveillance system.

Introduction Road traffic accidents are leading cause of injuries and deaths globally. Low income economies are the most affected. Most causes of RTA are predictable and preventable. This study describes trends and causes of road traffic accidents in Anambra State, South Eastern Nigeria. Methods We conducted a retrospective study of road traffic accidents from 2010 to 2014. Data were obtained from the Federal Road Safety Commission, Anambra State Command. Information extracted included sex, age, cause of accidents, number of people and type of vehicles involved. Cases were recorded as fatal if any victim died, serious if any victim was hospitalized for more than 24 hours and minor if any victim was hospitalized for less than 24 hours. Causes of accidents were classified into human, mechanical, and climatic factors. Univariate analysis to generate frequencies and proportions was conducted using Microsoft Office Excel 2007. Results A total of 1,141 road traffic accidents consisting 271 fatalities, 652 serious and 218 minor cases were recorded in Anambra State from 2010-2014. Seven thousand, four hundred and forty-four persons involving 1,816 vehicles were involved in RTA that resulted in 448 deaths and 2,785 injuries. More deaths 348 (77%) and injuries 2009 (72%) occurred more in males than females. Major causes of road traffic accidents were loss of vehicle control 256 (17%) and speed violation 207 (14%). There was an increased number of persons involved in RTA in 2014 (1,842) compared with 2010 (299). In all, 3,233 casualties (deaths and injuries) and crashes (fatal, serious and minor) were recorded out of which 900 (27.8%) casualties and 294 (9.1%) crashes occurred in 2013. Conclusion Leading causes of road traffic accidents are human factors; speed violation, loss of vehicle control and dangerous driving which are sadly preventable. Sensitization and enforcement of safe road principles among commercial vehicles and car drivers will help curb this menace. Government at all levels should implement strong policies aimed at reducing the speed of vehicles on roads.