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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
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,343,843 L.L
H02AB04 SOLU MEDROL Act-O-Vial B Methylprednisolone sodium succinate - 40mg 40mg Injectable powder for solution+diluent 318,491 L.L
J01DD08 SUPRAX B Cefixime (trihydrate) - 200mg 200mg Capsule 1,067,011 L.L
L04AD02 PROGRAF 0.5 MG B Tacrolimus - 0.5mg 0.5mg Capsule 13,942,481 L.L
A10BA02 GLUCOPHAGE XR B Metformin HCl - 500mg 500mg Tablet, prolonged release 484,421 L.L
B05BA10 PERIOLIMEL N4E B Olive oil + Soja oil - 45.00g, Alanine - 5.50g, Arginine - 3.72g, Aspartic Acid - 1.10g, Glutamic Acid - 1.90g, Glycine - 2.63g, Histidine - 2.26g, Isoleucine - 1.90g, Leucine - 2.63g, Lysine - 2.99g, Methionine - 1.90g, Phenylalanine - 2.63g, Proline - 2.26g, Serine - 1.50g, Threonine - 1.90g, Tryptophan - 0.64g, Tyrosine - 0.10g, Valine - 2.43g, Sodium acetate, 3H2O - 1.73g, Sodium glycerophosphate, H2O - 2.87g, Potassium chloride - 1.79g, Magnesium chloride, 6H2O - 0.67g, Calcium chloride 2H2O - 0.44g, Glucose monohydrate - 123.75g Injectable emulsion 5,288,020 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 12.5mg Tablet, film coated 1,846,440 L.L
D01AE15 LAMISIL B Terbinafine HCl - 10mg/g 1% Cream 616,824 L.L
L01BC07 VIDAZA B Azacitidine - 100mg 100mg Injectable lyophilised powder 15,158,791 L.L
M03BC51 NORGESIC B Paracetamol - 450mg, Orphenadrine (citrate) - 35mg Tablet 412,560 L.L
N06DA03 EXELON TRANSDERMAL PATCH 10 B Rivastigmine - 9.5mg/24h 9.5mg/24h Patch 2,457,888 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 25mg Tablet, film coated 1,846,440 L.L
G02AD02 PROPESS B Dinoprostone - 10mg 10mg Vaginal delivery system 5,838,996 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 3mg 3mg Capsule, prolonged release 68,645,618 L.L
N06DA03 EXELON TRANSDERMAL PATCH 5 B Rivastigmine - 4.6mg/24h 4.6mg/24h Patch 2,457,888 L.L
B01AA07 SINTROM B Acenocoumarol - 4mg 4mg Tablet 490,183 L.L
C07BB03 TENORETIC B Chlortalidone - 25mg, Atenolol - 100mg Tablet, film coated 291,614 L.L
C09DB01 EXFORGE B Amlodipine - 5mg, Valsartan - 160mg Tablet, film coated 1,333,092 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 1mg 1mg Capsule, prolonged release 25,729,044 L.L
N02BE51 HUMEXLIB PARACETAMOL CHLORPHENAMINE B Paracetamol - 500mg, Chlorphenamine maleate - 4mg Capsule 598,010 L.L
N06DA03 EXELON TRANSDERMAL PATCH 15 B Rivastigmine - 13.3mg/24h 13.3mg/24h Patch 7,582,922 L.L
R03DC03 SINGULAIR PEDIATRIC B Montelukast (sodium) - 4mg 4mg Tablet, chewable 1,217,521 L.L
S01EE01 XALATAN B Latanoprost - 50mcg/ml 50mcg/ml Drops solution 704,173 L.L
J01DD08 SUPRAX B Cefixime (trihydrate) - 400mg 400mg Capsule 2,053,391 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 5mg 5mg Capsule, prolonged release 85,485,667 L.L
N02BE51 PANADOL COLD AND FLU B Paracetamol - 500mg, Pseudoephedrine HCl - 30mg, Chlorpheniramine maleate - 2mg Tablet 278,175 L.L
C07BB07 CONCOR PLUS B Bisoprolol fumarate - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 888,105 L.L
J01DD08 SUPRAX B Cefixime (trihydrate) - 400mg 400mg Capsule 2,053,391 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 0.5mg 0.5mg Capsule, prolonged release 13,297,758 L.L
M03BX DORIXINA RELAX B Lysine clonixinate - 125mg, Cyclobenzaprine HCl - 5mg Tablet, film coated 581,884 L.L
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