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National Immunization Strategy 2017-2022


Foreword
 
There have been many transformations to the NIP inthe recent years. New vaccines wereadded to the vaccination schedule, the cohorts served by the public sector kepton expandingsince the onset of the Syrian crisis, measures to consolidatethe vaccine purchasing arrangements were adopted,and there wasa leveraging up ofthe vaccinovigilanceand its effective management.In 2016, the Ministryof health in Lebanon decided that it was the time to take stock, constructon the current NIP strengthsand achievements andidentify areas for further improvement. A strategy for the NIP for 2016-2020 wasenvisagedin agreementwith the development partners. A detailed situation analysis assessment was initiatedin October 2015 in two stages: at the initial stage, the country and health system contexts were analyzed, and immunization system performance was measured. In the second stage, a framework was developed in consultations with key stakeholders to define gaps in the evidence. Immunization coverage evaluation survey was conducted in 2016 and fed into filling the lacunas in information.

The present document expresses the country vision, goals and priorities of the national immunization program. It relies on a careful examination of the situation analysis, an assessment of the enablers and challenges facing the immunization services and defines the national immunization strategies addressing these contests. The strategies were formulated as informed choices across more than one solution deemed most feasible and efficient considering the country context.

The document is structured in three sections:

Section 1“Situational analysis” presents briefly the organization and operation of the national immunization program as well as the recent achievements and remaining challenges,

Section 2 “Conceptual framework” describes the future vision of the country in regards to vaccine preventable diseases, the long term goals to be achieved and the more specific results –immunization system objectives and targets for 2020,

Section 3 defines the Strategies to address the bottlenecks and achieve immunization system objectives by 2020. Most of strategies (so called “immunization system specific” ones) are presented by relevant health system blocks.The focus of the NIP Strategy, is to assistthe MOPH to meet international goals set by the World Health Organization (WHO) under the Global Immunization Vision and Strategy (GIVS). The Strategy articulates action areas to conserve the successful achievements of the last years, built on the current favoring momentum and propose solutions for the drawbacks

The Strategy comprises nineStrategic Priority Areas to complement and strengthen the NIP.

The matrix (Figure 2) in Annexesshows expected results of the immunization system development strategies by health system building blocks and links them to the root causes (weaknesses and treats) identified during the system analysis...
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ATC Name B/G Ingredients Dosage Form Price
R03AK13 BUTOSOL G Salbutamol (sulfate) - 100mcg/dose, Beclometasone dipropionate - 50mcg/dose Metered dose inhaler 548,288 L.L
D07CC02 GENTACORT-FC G Fluocinolone acetonide - 0.01%, Clotrimazole - 1%, Gentamicin (sulfate) - 0.1% Cream 302,365 L.L
J01CR05 TAZOBACT Piperacillin sodium - 4g, Tazobactam (sodium) - 500mg 783,460 L.L
J07BG01 RABIVAX-S (RABIES VACCINE INACTIVATED) BioTech Freeze dried inactivated purified rabies antigen (Pitman Moore PM3218 as virus strain) - Injectable freeze dried material 1,552,138 L.L
R03AL01 ATROVENT COMP. HFA B Fenoterol Hydrobromide - 20mcg/actuation, Ipratropium bromide - 50mcg/actuation Inhalation aerosol metered dose 544,256 L.L
A06AA01 HUILE DE PARAFFINE G Liquid paraffin - Liquid 207,336 L.L
A10BD20 EMPAZIMET G Metformin HCl - 1000mg, Empagliflozin - 12.5mg Tablet, film coated 1,840,168 L.L
D07XA01 DAKTACORT B Hydrocortisone - 10mg/g, Miconazole nitrate - 20mg/g Cream 208,296 L.L
J01CR50 FLUMOX G Flucloxacillin (monohydrate) - 250mg, Amoxicillin (trihydrate) - 250mg Capsule 348,055 L.L
J07BH01 ROTATEQ ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT B Rotavirus G1, live attenuated - ?2.2x106 IU, Rotavirus G2, live attenuated - ?2.8x106 IU, Rotavirus G3, live attenuated - ?2.2x106 IU, Rotavirus G4, live attenuated - ?2.0x106 IU, Rotavirus P1, live attenuated - ?2.3x106 IU Suspension 4,508,592 L.L
R03AL02 COMBIVENT B Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide - 500mcg/2.5ml Inhaltion solution with nebuliser 745,833 L.L
C02LA51 ADELPHAN ESIDREX B Reserpine - 0.1mg, Hydrochlorothiazide - 10mg, Dihydralazine - 10mg Tablet 371,157 L.L
D07XB05 ECOZONE G Dexamethazone sodium phosphate - 0.1%, Econazole nitrate - 1% Cream 364,757 L.L
J07BH01 ROTARIX ORAL B Rota virus human RIX4414, live attenuated - ?106 CCID50 Suspension 5,167,074 L.L
R03AL02 DUOLIN RESPULES G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 500mcg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
D07XC01 LOTRIDERM B Betamethasone (dipropionate) - 0.5mg/g, Clotrimazole - 10mg/g Cream 408,528 L.L
J07BH01 ROTASIIL, ROTAVIRUS VACCINE, LIVE ATTENUATED (ORAL FREEZE-DRIED) BioTech Rotavirus bovine-human , live attenuated - Suspension 2,822,069 L.L
R03AL02 IPRASAL VEM G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 0.5mg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
D07XC01 BETA-MICOTER G Betamethasone (dipropionate) - 0.5mg/g, Clotrimazole - 10mg/g Cream 415,951 L.L
J07BH01 ROTASIIL, ROTAVIRUS VACCINE, LIVE ATTENUATED (ORAL LIQUID) BioTech Rotavirus bovine-human , live attenuated - Liquid 2,822,069 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,181,575 L.L
A06AB05 HUILE DE RICIN G Castor oil - Liquid 163,821 L.L
A10BD20 EMPAZIMET G Metformin HCl - 1000mg, Empagliflozin - 5mg Tablet, film coated 1,840,168 L.L
D07XC01 DIPROSALIC B Salicylic acid - 30mg/g, Betamethasone (dipropionate) - 0.5mg/g Ointment 352,087 L.L
R03AL04 ULTIBRO BREEZHALER B Indacaterol - 110mcg, Glycopyronium - 50mcg Capsule, inhalation 4,031,528 L.L
A06AB07 COLON-X G Frangula Purshiana - 62.5mg, Plantago Afra - 100mg, Foeniculum Vulgare - 50mg, Zingiber Officinale - 50mg, Aniseed powder - 20mg, Glycyrrhiza Glabra - 12.5mg, Senna Alexandrina - 25mg Tablet, film coated 833,182 L.L
A10BD21 ENFORZA B Saxagliptin HCl - 5mg, Dapagliflozin - 10mg Tablet, film coated 6,072,824 L.L
D07XC03 ELICA M G Mometasone furoate - 0.1%, Miconazole nitrate - 2% Cream 459,594 L.L
J07BK01 VARIVAX B Varicella virus, live attenuated - 1350PFU Injectable powder for suspension+diluent 4,102,751 L.L
L04AA32 OTEZLA B Apremilast - 4x10mg- 4x20mg- 19x30mg Tablet, film coated 34,751,325 L.L
    ...
    178
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