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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
J07CA11 DIPHTHERIA, TETANUS,PERTUSSIS, HEPATITIS B AND HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE B Diphteria Toxoid1 - ?25Lf (?30IU)/0.5ml, Tetanus toxoid1 - ?2.5Lf (?40IU)/0.5ml, Bordetella pertussis (Whole cell) - ?16OU (?4.0IU)/0.5ml, HBs Antigen (r DNA)1 - ?10mcg/0.5ml, H. Influenza type b, purified capsular polysaccharide2 - 10mcg/0.5ml, 1 adsorbed on aluminium phosphate, Al+++ - ?1.25mg , 2 conjugated to tetanos toxoid carrier protein - Injectable suspension 1,515,854 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,367,774 L.L
R03AL04 ULTIBRO BREEZHALER B Indacaterol - 110mcg, Glycopyronium - 50mcg Capsule, inhalation 4,031,528 L.L
R03AL06 SPIOLTO RESPIMAT B Olodaterol HCl - 2.5mcg/puff, Tiotropium bromide monohydrate - 2.5mcg/puff Inhalation solution 5,087,788 L.L
R03AL11 BREZTRI AEROSPHERE B Formoterol fumarate dihydrate - 5mcg, Glycopyrronium Bromide - 7.2mcg, Budesonide - 160mcg Inhalation suspension 6,705,774 L.L
G04BE30 LIF-DOL B Yohimbin HCl - 3.3mg, Thiamine - 5.5mg, Cyanocobalamine - 0.015mg, Ferrous fumarate - 50mg, Sildenafil citrate - 10mg Tablet, coated 231,653 L.L
C03EA01 MODURETIC B Hydrochlorothiazide - 50mg, Amiloride HCl - 5mg Tablet 767,985 L.L
G04BX ROWATINEX B Olive oil - 33mg, Cineol - 3mg, Fenchone - 4mg, Anethol - 4mg, Borneol - 10mg, Camphene - 15mg, ?-Pinene - 6.2mg, ?-Pinene - 24.8mg Capsule 255,330 L.L
B05CX01 DEXTROSE INJECTION 5% G Dextrose, H2O - 5g/100ml Injectable solution 212,797 L.L
D10AD51 ERYLIK G Tretinoin - 0.025%, Erythromycin - 4% Gel 378,964 L.L
D10AD51 RETINOMYCIN G Tretinoin - 0.025%, Erythromycin - 4% Gel 662,962 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.025%, Clindamycin (phosphate) - 1% Gel 801,186 L.L
C05A ANTROLIN B Nifedipine - 0.3%, Lidocaine - 1.5% Cream 1,333,092 L.L
D10AD51 MEDCLINIDERM-T G Tretinoin - 0.025%, Clindamycin (phosphate) - 1% Gel 801,186 L.L
C05AA01 SEDIPROCT G Hydrocortisone - 500mg, Cinchocaine HCl - 500mg Cream 290,270 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.05%, Clindamycin (phosphate) - 1% Gel 890,776 L.L
G04BX14 PRIXETIN 60 G Dapoxetine (hydrochloride) - 60mg Tablet, film coated 1,479,123 L.L
C05AA01 SEDIPROCT G Hydrocortisone - 5mg, Cinchocaine HCl - 5mg, Framycetin sulfate - 10mg, Esculoside - 10mg Suppository 237,860 L.L
D10AD51 MEDCLINIDERM-T G Tretinoin - 0.05%, Clindamycin (phosphate) - 1% Gel 890,776 L.L
C05AA01 SINAHEAL-H G Hydrocortisone acetate - 5mg, Lidocaine - 60mg, Zinc oxide - 400mg, Aluminium Subacetate - 50mg Suppository 501,253 L.L
D10AD53 EPIDUO B Adapalene - 0.1%, Benzoyl peroxide - 2.5% Gel 2,088,331 L.L
C05AA01 SINAHEAL-H G Hydrocortisone acetate - 0.275g/100g, Lidocaine - 5g/100g, Zinc oxide - 18g/100g, Aluminium Subacetate - 3.5g/100g Ointment 330,585 L.L
D10AD53 EPIDUO FORTE B Adapalene - 0.3%, Benzoyl peroxide - 2.5% Gel 2,201,214 L.L
B02BD06 HAEMATE P BioHuman Von Willebrand Factor - 600IU, Blood Coagulation Factor VIII - 250IU Injectable lyophilised powder for solution+diluent 14,117,737 L.L
A11A BEBE-VIT G Vitamin A - 1500IU/ml, Vitamin D3 - 400IU/ml, Vitamin E - 5mg/ml, Vitamin C - 40mg/ml, Vitamin B1 - 0.5mg/ml, Vitamin B2 - 0.6mg/ml, Vitamin B6 - 0.6mg/ml, Nicotinamide - 8mg/ml Drops 287,582 L.L
B02BD06 HAEMATE P BioHuman Von Willebrand Factor - 2400IU, Blood Coagulation Factor VIII - 1000IU Injectable lyophilised powder for solution+diluent 49,643,758 L.L
C05AX HEMOCARE G Bismuth subgallate - 100mg, Zinc oxide - 100mg, Lidocaine - 60mg Suppository 588,731 L.L
A11AA PHARMATON KIDDI B Vitamin E - 15mg/15ml, Phosphorous - 200mg/15ml, Calcium - 130mg/15ml, Vitamin D3 - 600IU/15ml, D Panthenol - 10mg/15ml, Nicotinamide - 20mg/15ml Syrup 417,935 L.L
B02BD06 HAEMATE P BioHuman Von Willebrand Factor - 1200IU, Blood Coagulation Factor VIII - 500IU Injectable lyophilised powder for solution+diluent 33,698,319 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine - 40mg, Tribenoside - 400mg Suppository 399,121 L.L
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