FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021

 
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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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                                                                                             www.health.fs.gov.za
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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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                                                                            www.health.fs.gov.za
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
INTRODUCTION AND BACKGROUND

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                              www.health.fs.gov.za
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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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                                                                                                               www.health.fs.gov.za
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
FSDOH PROVINCIAL VACCINE COMMITTEE STRUCTURE

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                                               www.health.fs.gov.za
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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 COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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
FSDOH COVID-19 VACCINE ROLLOUT PLAN - Parliament Portfolio Committee on Health Presented by : Dr David Motau, HOD Health Free State 03 March 2021
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.za
DEMOGRAPHIC 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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TARGET POPULATION

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PHASE 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.za
HOW 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.za
SEQUENCING & 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.za
PHASE 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.za
PROVINCIAL WORKSTREAMS

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1. VACCINE DISTRIBUTION, COLD CHAIN, LOGISTICS AND INFRASTRUCTURE

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COLLECTION SITES IN FS

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VACCINE 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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2. DATA MANAGEMENT, INFORMATION SYSTEMS AND MONITORING AND EVALUATION

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ELECTRONIC VACCINE DISTRIBUTION SYSTEM(EVDS)

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3. 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

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4. PATIENT SAFETY SURVEILLANCE: SISONKE REPORTING SYSTEM

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5. 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.za
6. 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
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7. 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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COVID-19 VACCINE ROLLOUT:PHASE 1

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VACCINATION TEAM STRUCTURE

•   Queue marshal(s)

•   COVID-19 screening team

•   Vaccinators

•   Data capturer

•   Observer(s) of vaccinated individuals

•   Monitor/Supervisors

                                               www.health.fs.gov.za
CHECKLIST

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SITES: 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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SITES: BATCH 2

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VACCINE 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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PREPARING 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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COVID-19 VACCINE ROLLOUT:PHASE 2

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PHASE 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.za
Free 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.za
Free 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.za
Free 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.za
PROGRESS 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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CAPACITY 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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PHASE 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.za
CONCLUSION

•   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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THANK YOU!

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