FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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FSDOH COVID-19 VACCINE ROLLOUT PLAN
Parliament Portfolio Committee on Health
Presented by : Dr David Motau, HOD Health Free State
03 March 2021
www.health.fs.gov.za
TABLE OF CONTENTS
• Introduction and Background
– Goals And Objectives
– FSDOH Provincial Vaccine Structure
– Roles And Responsibilities Of The Provincial COVID-19 Vaccine Coordinating Committee ( PCVCC)
– Free State Population Data
– Demographic Distribution
– Target Population
– Phase 1: Healthcare Workers
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TABLE OF CONTENTS (cont.)
• Provincial Work-streams
– Vaccine Distribution, Cold Chain, Logistics And Infrastructure
– Data Management, Information Systems And Monitoring And Evaluation
– Stakeholders
– Patient Safety and Surveillance
– Training
– Service Delivery
• Roll Out Plan
– Phase 1
– Phase 2
– Phase 3
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INTRODUCTION AND BACKGROUND
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GOALS & OBJECTIVES
• The overall goals are:
– To ensure the roll-out of a safe, effective, efficient and agile Provincial COVID19 Vaccination Programme that
plays a central role in halting the transmission of SARS COV-2 and bring an end to the pandemic.
– To build on the public health response to COVID-19 through the efficient provision of safe and effective vaccines
to the population of Free State and, thus, to reduce serious illness and death as a consequence of COVID-19.
• The objectives are to:
– Development and implementation of a provincial plan based on the national implementation plan.
– Identify target population, service points, availability of vaccinators, transport and supplies.
– Ensuring that HCWs register on the electronic system.
– Procurement of needles/syringes/waste disposal
– Liaise with national DOH regarding distribution of vaccines
– Monitoring of coverage
– Stakeholder liaison including liaison with the private sector
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FSDOH PROVINCIAL VACCINE COMMITTEE STRUCTURE
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ROLES AND RESPONSIBILITIES: PROVINCIAL COVID-19
VACCINNE COORDINATING COMMITTEE( PCVCC)
• Establish a Covid-19 Vaccine Task Team with similar functions as national team.
• The task team will be responsible for:
• Development and implementation of a provincial plan based on the national implementation plan.
• Identify target population, service points, availability of vaccinators, transport and supplies.
• Ensuring that beneficiary register (e.g. HCWs) on the electronic system.
• Procurement of vaccine related ancillaries (needles/syringes/waste disposal)
• Liaise with national DOH regarding distribution of vaccines
• Accurate information management and monitoring & evaluation
• Stakeholder liaison including liaison with the private sector
• Adequate communication and community engagement
www.health.fs.gov.za
GOVERNANCE AND COORDINATION STRUCTURE
Role Responsible person Responsibility
Surveillance Dr. Motloung & Ms Monyobo & Dr Mokoena Project coordinators
DHS Dr London Project Lead
CDC Dr Fanampe Operations Manager
Immunizations Ms Majenge EPI
CDC Coordinator Ms D. Baleni Coverage
EHP Mr J. Mokgatle Waste Management
Medical Depot Ms Book Cold chain & supplies
Logistics Mr Makhetha Transport
Logistics Ms Phitsane SCM & Logistics
Budget Mr Motsie Finance
Communications Mr Mvambi RCCE & Social Mobilisation
Data Management Dr Chikobvu & Mr Ntombela Information management & ICT support
Standard Compliance Ms Lucy Ramongalo Patient safety Incidents
HRM Ms Mahlangheni HR Support & OHS
Partners Departmental Partners DSD, DOE, DCS, SAMHS
Partners Partners WHO, NHLS, UFS, Right-to-care & private facilities
www.health.fs.gov.za
FSDOH PROVINCIAL VACCINE COMMITTEE STRUCTURE
• The province has decided on decentralized District-based approach with District Directors as project leads supported
by Primary health Care Mangers of each district and filtering down to local area managers using existing District-
bases COVID-19 response.
• The district governance & coordination structure will be aligned to that of the province.
• District EPI coordinators forms crucial of the district committees and will be assigned as the coordinators of the
vaccine implantation and will be reporting to the District Director.
• District and facility pharmacists will be responsible for the cold chain management.
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www.health.fs.gov.za
FREE STATE POPULATION DATA
Population To be Vaccinated
District
mid – 2020 (67%)
Fezile Dabi 510 124 341 783
Lejweleputswa 653 601 437 913
Mangaung 870 920 583 516
Thabo-Mofutsanyane 76 4815 512 427
Xhariep 129 443 86 727
Total 2 928 903 1 962 386
www.health.fs.gov.zaDEMOGRAPHIC DISTRIBUTION
Approximately 300 000 people in the FS are
above the age of 60
30-40% of the FS are rural and lack
appropriate access to routine healthcare
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www.health.fs.gov.zaTARGET POPULATION
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www.health.fs.gov.zaPHASE 1: HEALTHCARE WORKERS
PUBLIC POPULATION HCW DATA
Category 1 Those conducting aerosol-generating Those in contact with
DISTRICT TOTAL NUMBER
procedures i.e. intubation, patients
ventilation, taking Covid-19 CORPORATE OFFICE 2 801
specimens FEZILE DABI DISTRICT 2 143
LEJWELEPUTSWA DISTRICT 2 543
Category 2 Those in direct contact with known or MANGAUNG METRO 7 552
suspected Covid-19 patients THABO MOFUTSANYANA
DISTRICT 3 395
Category 3 Those in contact with patients (who XHARIEP DISTRICT 926
are not known or suspected to have COMMUNITY HEALTH CARE
2 328
Covid-19) WORKERS
OTHER GOVERNMENT
DEPARTMENTS 339
Category 4 Those with some (limited) in contact TOTAL 22 027
with patients
PRIVATE POPULATION HCW DATA
Category 5 Those not in contact with patients Those not in contact
with patients. TOTAL 14 966
TOTAL 36 993
www.health.fs.gov.zaHOW WILL HEALTH WORKERS ACCESS THE VACCINE?
Place of work Category Vaccinated at: Responsibility:
Health workers employed All health workers At their hospital Occupational health
in hospitals services
Hospital services
Health workers working in All health workers At workplace/Near Occupational health
smaller health facilities CHWs linked to health hospitals services
facilities District Health Services
Health workers not linked EMS staff At Vaccination Centre Co-ordinated by District
to a facility Independent practitioners Health Services
CHWs not linked to a May involve private and
facility public sector providers
Traditional healers
Administrative staff
www.health.fs.gov.zaSEQUENCING & PRIORITISING
• Sequencing:
– 1a: Hospitals including emergency workers
– 1b: Primary care settings
– 1c: Community
– 1d: Non-patient facing
• Prioritizing
– Level 1: Only patient-facing health workers will be eligible
– Level 2: Delivery will prioritize hospitals (larger then smaller) over PHC then community
– Level 3: Facilities to make rational decisions as to where to start
• Highest exposure within the facility
• Age and co-morbidities
www.health.fs.gov.zaPHASE 2: IDENTIFICATION AND PRIORITISATION OF TARGET POPULATION
Phase Priority Group Definition
Teachers, police officers, military, miners and workers
in the security, retail food, funeral, banking and
Essential workers
essential municipal and home affairs, border control
and port health services.
Persons in prison, detention centres, shelters and
Persons in congregate care homes. In addition, people working in the
settings hospitality and tourism industry, and educational
II institutions are also at risk.
Persons 60 years and
-
older
Persons living with HIV, tuberculosis, diabetics,
Persons older than 18
chronic lung disease, cardiovascular disease, renal
years with co-morbidities
disease, obesity, etc
www.health.fs.gov.zaPROVINCIAL WORKSTREAMS
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www.health.fs.gov.za1. VACCINE DISTRIBUTION, COLD CHAIN, LOGISTICS AND INFRASTRUCTURE
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www.health.fs.gov.zaCOLLECTION SITES IN FS
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www.health.fs.gov.zaVACCINE DISTRIBUTION, COLD CHAIN, LOGISTICS AND INFRASTRUCTURE
• For the start of phase 1 the J&J Covid 19 vaccine and consumables are supplied through a contract research
organisation who is also responsible for the storage between 2 to 8°C, accountability and adherence to the study
protocol.
• The Provincial central medical depot will distribute to the collection sites in phase 1 depending which vaccine is
supplied and if the minimum order quantity is too big for direct deliveries. In Phase 2 and 3 direct delivery from the
supplier to the collection site will also be used.
• The province has currently 31 collection sites with WHO prequalified fridges or walk-in fridges. Seventy five (75)
WHO pre-qualified vaccine fridges are needed for phase 2 and phase 3 of the Covid-19 vaccine roll out.
• Temperature is monitored with Fridge Tags®. The vaccines will be stored according the specifications of the
manufacturer as indicated in the package insert. The collection sites need to upgrade to continues temperature-
monitoring systems with sms alarms according to the South African Pharmacy Council Board Notice 50 of 2015.
• Each collection site has their own contingency plans in case of cold chain failure. These collection sites are based in
hospitals (30) and CHC (1) with permanent pharmacists.
• Rx solution is used as stock management system.
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www.health.fs.gov.za2. DATA MANAGEMENT, INFORMATION SYSTEMS AND MONITORING AND EVALUATION
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www.health.fs.gov.zaELECTRONIC VACCINE DISTRIBUTION SYSTEM(EVDS)
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www.health.fs.gov.za3. STAKEHOLDERS
ROLES & RESPONSIBILITIES
ACTIVITIES TARGET GROUPS
OUTCOMES
• Independent Private Practitioners;
Brief stakeholders including key provincial
• Private Nurses (Private Practice);
departments, private sectors and partners about • Weekly update on the roll-out implementation
• Traditional Health Practitioners;
COVID-19 vaccine introduction and their expected roles plan.
• Department of Education;
• Department of Social Development;
• Coordination of resource planning and
• Private Pharmacies;
forecasting demand with identified high impact
• Private Hospitals;
partners (Phase specific).
• Religious groups;
• Traditional Leaders;
Inform stakeholders regularly and disseminate national • Continuously identifying new high impact
• Department of Correctional Services;
guidance partners as the roll-out gain momentum.
• Mining Houses
• Large factories
• Tertiary Institutions
• Organized Labour
www.health.fs.gov.za4. PATIENT SAFETY SURVEILLANCE: SISONKE REPORTING SYSTEM
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www.health.fs.gov.za5. TRAINING
• Online training has started from 15-27 Jan 2021
• Training done through NDoH Knowledge hub
• Open to every HCW
• CPD accredited
• Pre-recorded video-sessions with study materials
• Interactive live Q & A sessions
• https://www.knowledgehub.org.za/lms/login/index.php
• Provincial Training to follow
www.health.fs.gov.za6. COMMMUNICATION
COVID-19Vaccine
(eagerness, trust and confidence)
1.Advocacy 2.Capacity Building 3.Media 4.Social Mobilisation 5. Adverse
& strengthening of Engagement & & Community Events
existing synergies Social Media Engagement Crisis
Communication
PLATFORMS
Individuals / Influencers Community Groups Media
CELEBRITY To be listed by SOCIAL MEDIA (Twitter, Facebook,
(entertainment industry, sport, provinces and districts WhatsApp, Youtube)
politics)
INFLUENCERS To be listed by COMMUNITY MEDIA
(Local Leaders, Faith Leaders, provinces and districts (Radio and TV)
Social-cultural Leaders, Traditional
Leaders, Teachers)
FRONTLINE WORKERS To be listed by Commercial MEDIA
(their supervisors and unions) provinces and districts
To be listed by OUTDOOR MEDIA (including wall
provinces and districts murals, Bus and taxi wraps, Digital
billboards, Poster, Banner)
GOVERNMENT EMPLOYEES 26
www.health.fs.gov.za7. Service delivery
• Identify target populations that will be prioritised for access to vaccines during Phase 2, estimate their numbers and
identify their geographic location.
• Identify potential COVID-19 vaccine delivery strategies and outreach strategies leveraging both existing vaccination
platforms and non-vaccination delivery approaches to best reach identified target groups.
• Identify vaccination sites and ensure that these sites register on the on-line portal.
• For delivery through private facilities, develop and approve Standard Operating Procedures, including service quality
and performance and reporting standards and mechanisms for complaints-handling, certification of facilities,
financing, performance monitoring and integrity checks.
• Update protocols for infection prevention and control measures including adequate personal protection equipment
(PPE) to minimize exposure risk during immunization sessions.
• Develop and review vaccination site accreditation and readiness assessment across all level in both private and
public
• Ensure that each vaccination site has sufficient vaccinators
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www.health.fs.gov.zaCOVID-19 VACCINE ROLLOUT:PHASE 1
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www.health.fs.gov.zaVACCINATION TEAM STRUCTURE
• Queue marshal(s)
• COVID-19 screening team
• Vaccinators
• Data capturer
• Observer(s) of vaccinated individuals
• Monitor/Supervisors
www.health.fs.gov.zaCHECKLIST
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www.health.fs.gov.zaSITES: BATCH 1
• Universitas Academic Hospital: 3800 doses
• Pelonomi Tertiary Hospital: 3080 doses
• Public vs private
– 2:1 ratio
• Total 6880 doses
28th February 2021
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www.health.fs.gov.zaSITES: BATCH 2
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www.health.fs.gov.zaVACCINE ALLOCATION & CATCHMENT SITES
Site Catchment Catchment
Vaccination Site Catchment Hospital No. of HCW Province District
Sector Sector Hospital Type
Lejweleputswa District
fs Bongani Hospital Public Mediclinic Welkom Private Hospital 954 Free State
Municipality
RH Matjhabeng Private Lejweleputswa District
fs Bongani Hospital Public Private Hospital 234 Free State
Hospital Municipality
Lejweleputswa District
fs Bongani Hospital Public St Helena Hospital Private Hospital 243 Free State
Municipality
District Lejweleputswa District
fs Bongani Hospital Public fs Katleho Hospital Public 161 Free State
Hospital Municipality
District Lejweleputswa District
fs Bongani Hospital Public fs Thusanong Hospital Public 200 Free State
Hospital Municipality
fs Fezi Ngumbentombi Fezile Dabi District
Public Netcare Vaalpark Hospital Private Hospital 238 Free State
Hospital Municipality
fs Fezi Ngumbentombi District Fezile Dabi District
Public fs Parys Hospital Public 149 Free State
Hospital Hospital Municipality
fs Universitas (C) fs Free State Psychiatric Specialised Mangaung Metropolitan
Public Public 991 Free State
Hospital Complex Hospital Hospital Municipality
fs Universitas (C) District Mangaung Metropolitan
Public fs National District Hospital Public 574 Free State
Hospital Hospital Municipality
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www.health.fs.gov.zaPREPARING SITES
• Bongani Regional Hospital and Fezi Ngumbentombi District Hospital was already prepared as one of the sites for
COVID-19 Vaccine Rollout
• Site visits were performed by Provincial Team
– Bongani Regional Hospital – Wednesday, 24th February 2021
– Life Rosepark Hospital – Thursday, 25th February 2021
– Fezi Ngumbentombi District Hospital – Friday, 26th February 2021
• Sites presented readiness plans on Thursday. 25th February 2021
• Friday – Meetings with Bongani Regional Hospital and Josha Research Team
• Sunday – Meetings with Fezi Ngumbentombi District Hospital and Chrismo Research Team
• Begin on 2nd March 2021
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www.health.fs.gov.zaCOVID-19 VACCINE ROLLOUT:PHASE 2
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www.health.fs.gov.zaPHASE 2
Essential workers Variety of platforms (through occupational health)
Some prioritization, but rather multipronged
Also based on capacity to deliver
Congregate settings Variety of platforms
Multipronged, capacity to delivery
Co-morbidities Access through chronic care facility including CCMDD
> 60 years Mass vaccinations centres in urban areas
? School infrastructure in rural areas
www.health.fs.gov.zaFree State - Public
This map outlines the
healthcare facilities in the Free
State Province for the public
healthcare hospital facilities.
In total, there are 32 public
hospitals in the Free State
www.health.fs.gov.zaFree State - Private
This map outlines the healthcare
facilities in the Free State Province
for the private healthcare care and
hospital facilities.
In total, there are 27 private
hospitals and centers in the Free
State
www.health.fs.gov.zaFree State - Schools
This map outlines the distribution of
schools as potential vaccination sites
The majority of the schools in the FS
are quintile 1 and 2, and are rural
Only quintile 3 and above can be
considered.
www.health.fs.gov.zaPROGRESS OF PHASE 2
• Stakeholder engagement has begun
• Provincial Joc Task team has been developed consisting of multiple stakeholders:
• Department of Social Development, Military
• Department of Police, Roads and Traffic
• COGTA
• Mining sector
• Community engagement
– Traditional leaders
– Religious leaders
– Business sectors
– Labor Movements
• Data is currently being collected for sequencing and prioritizing
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www.health.fs.gov.zaCAPACITY BUILDING
• Engagement with partners and other stakeholders for support and resources:
– GEMS (HR, logistics, equipment)
– University of the Free State (HR – 3rd and 4th year nursing students, final year medical students)
– Military (HR support, logistics, infrastructure)
– WHO
– Right to Care
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www.health.fs.gov.zaPHASE 2 AND 3: HIGH RISK PRIORITY GROUPS AND GENERAL
PUBLIC SERVICE DELIVERY PLATFORMS
PHASE 2a: Essential Workers
• Work-based Vaccination site:
Work areas where there’s occupational
health services,
• Facility based Vaccination site-
Work areas will be linked to the nearest
Health facility hospital/clinic (Private and public)
Vaccination Centres: • Mobile-Outreach based centers:
vaccination: Facility based or Designated district roving/mobile
Suitable in rural standalone vaccination vaccination team will visit each work
area/department
settings for community centres e.g. pharmacy • Private Vaccinators
access practices, GPs or NGOs This is another option to bolster capacity
where necessary, this will be contracted
to provide vaccinations per
schedule/appointment
PHASE 2b: Persons in congregate
settings
Outreach vaccination • Mass Vaccination Campaign:District based
programme: Service Work-based vaccination vaccination outreach teams will conduct mass
campaigns and visit these congregate areas to
provided by outreach programme: Suitable for vaccinate the residents
teams essential workers e.g.
mining sector, industry and • Mobile-Outreach based centers: Using mobile
Suitable for congregated bus/clinic, designated district roving/mobile
settings e.g. old age departments vaccination team will visit each congregate facility
homes especially small and remote facilities to vaccinate
per schedule/appointment
www.health.fs.gov.zaCONCLUSION
• Department has put systems in place to roll out the vaccine program as planned
• The successful implementation of this plan will depend on a number of factors which includes but not limited to:
availability of adequate vaccines to cover the population of the FS, aggressive demand creation efforts to counter
vaccine hesitancy, robust RCCE programs, stakeholder engagement and collaboration.
• The plan will be reviewed constantly to check if the we are still on track especially when dealing with Phase 2&3
respectively.
• Lessons learned from the Phase 1 rollout will assist in enrolling more facilities across the Province
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www.health.fs.gov.zaTHANK YOU!
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