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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
C09AA05 NORMOPRIL G Ramipril - 10mg 10mg Tablet 599,354 L.L
C10AA05 APO-ATORVASTATIN G Atorvastatin (calcium) - 10mg 10mg Tablet 889,624 L.L
D06BB53 ACTI-VIR H G Aciclovir - 5%, Hydrocortisone acetate - 1% Cream 833,182 L.L
J01CA04 AMOXICILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 6,199,145 L.L
J01FA09 CLAMYCIN G Clarithromycin - 250mg 250mg Tablet, film coated 641,205 L.L
J05AG01 NEPINE G Nevirapine - 200mg 200mg Tablet 5,921,678 L.L
L01DB07 MITOXANTRON EBEWE G Mitoxantrone - 20mg/10ml 20mg/10ml Injectable concentrated solution 11,064,120 L.L
M01AB01 INDOMEL G Indometacin - 100mg 100mg Suppository 222,694 L.L
M05BA08 DROMEZON G Zoledronic acid - 4mg/5ml 4mg/5ml Injectable concentrate for solution 4,577,128 L.L
N05AX12 JOSWE ARIPAL 5 G Aripiprazole - 5mg 5mg Tablet 1,389,533 L.L
A06AB05 HUILE DE RICIN G Castor oil - Liquid 163,821 L.L
A10BD19 EMPAGLINE G Empagliflozin - 25mg, Linagliptin - 5mg Tablet, film coated 2,237,050 L.L
B01AF01 RIBAVAN G Rivaroxaban - 15mg 15mg Tablet, film coated 1,343,843 L.L
B05BC01 MANNITOL G Mannitol - 10g/100ml 10g/100ml Injectable solution 494,147 L.L
C09AA05 RAMIPRIL-REMEDICA G Ramipril - 10mg 10mg Tablet 896,343 L.L
C10AA05 ASCOVA G Atorvastatin (calcium) - 10mg 10mg Tablet, scored 1,126,268 L.L
J01CA04 AMOXICILLINE ARROW LAB G Amoxicillin (trihydrate) - 500mg 500mg Capsule 564,414 L.L
J01FA09 CLAREM 250 G Clarithromycin - 250mg 250mg Tablet, film coated 467,657 L.L
J05AG03 STOVIRENZ G Efavirenz - 600mg 600mg Tablet, film coated 6,857,456 L.L
L01XX05 CUREAML G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 1,228,272 L.L
M01AB05 TRATUL G Diclofenac Deanol - 90mg 90mg Injectable solution 490,503 L.L
M05BA08 ZOLEDRA G Zoledronic acid - 4mg 4mg Injectable powder for solution 6,368,470 L.L
N05AX12 PIRIFY G Aripiprazole - 5mg 5mg Tablet 614,328 L.L
S03AA07 API-CIPROCIN G Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops 530,818 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
B01AF01 RIXALTA 15 G Rivaroxaban - 15mg 15mg Tablet, film coated 1,164,664 L.L
B05BC01 MANNITOL 10% USP INJECTION G Mannitol - 10% 10% Injectable solution 430,943 L.L
C09AA05 TRILTEC G Ramipril - 10mg 10mg Capsule 575,933 L.L
C10AA05 ATOR MEDIS G Atorvastatin - 10mg 10mg Tablet, film coated 305,052 L.L
D06BX01 CUTIDERMINE G Metronidazole - 1% 1% Gel 593,850 L.L
    ...
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