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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
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 129,934 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE C G Potassium chloride - 2.611g/l, Magnesium chloride, 6H2O - 5.33g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 190.505g/l, Sodium chloride - 204.54g/l Injectable solution L.L
C09DB02 SEVIKAR B Olmesartan medoxomil - 40mg, Amlodipine - 10mg Tablet, film coated 1,245,742 L.L
D02AX GLYCERINE G Glycerol - Liquid 163,821 L.L
R03AL06 SPIOLTO RESPIMAT B Olodaterol HCl - 2.5mcg/puff, Tiotropium bromide monohydrate - 2.5mcg/puff Inhalation solution 5,087,788 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE D G Potassium chloride - 5.215g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 166.7g/l, Sodium chloride - 214.76g/l Injectable solution L.L
C09DB02 VOCADO B Olmesartan medoxomil - 40mg, Amlodipine besylate - 10mg Tablet, film coated 1,186,613 L.L
D03AX BEPANTHEN PLUS B Chlorhexidine HCl - 5mg/g, Dexpanthenol - 50mg/g Cream 319,835 L.L
M01BX DORIXINA B1B6B12 B Lysine clonixinate - 125mg, Vitamin B1 - 50mg, Vitamin B6 - 30mg, Vitamin B12 - 50mcg Tablet, film coated 804,962 L.L
R03AL11 BREZTRI AEROSPHERE B Formoterol fumarate dihydrate - 5mcg, Glycopyrronium Bromide - 7.2mcg, Budesonide - 160mcg Inhalation suspension 6,705,774 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 224,565 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE E G Potassium chloride - 2.611g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 7.00g/l, Sodium acetate, 3H2O - 190.505g/l, Sodium chloride - 205.49g/l Injectable solution L.L
C09DB04 TWYNSTA B Telmisartan - 80mg, Amlodipine - 10mg Tablet 991,756 L.L
G03AA09 MARVELON B Ethinylestradiol - 0.03mg, Desogestrel - 0.15mg Tablet 319,835 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 204,554 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE F G Potassium chloride - 3.914g/l, Magnesium chloride, 6H2O - 3.558g/l, Calcium chloride, 2H2O - 7.719g/l, Acetic acid 100% - 6.010ml/l, Sodium chloride - 208.631g/l Injectable solution L.L
C09DB04 TWINCARD 80/10 G Telmisartan - 80mg, Amlodipine - 10mg Tablet 1,460,309 L.L
G03AA12 YASMIN B Drospirenone - 3mg, Ethinylestradiol - 30mcg Tablet, film coated 616,824 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 154,450 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE SG G Potassium chloride - 3.92g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 166.7g/l, Sodium chloride - 214.76g/l Injectable solution L.L
C09DB04 TWYNSTA B Telmisartan - 80mg, Amlodipine - 5mg Tablet 991,756 L.L
G03AA12 NAJAT G Drospirenone - 3mg, Ethinylestradiol - 0.03mg Tablet, coated 417,935 L.L
B05BB01 R-SOL G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS L G Potassium chloride - K+:1.5 mmol/l, Magnesium chloride - Mg++:0.75 mmol/l, Calcium chloride - Ca++:1.75 mmol/l, Sodium acetate - Cl-:106.5 mmol/l, Sodium chloride - Na+:135 mmol/l Injectable solution L.L
C09DB04 TWINCARD 80/5 G Telmisartan - 80mg, Amlodipine - 5mg Tablet 1,131,387 L.L
G03AA12 YAZ B Drospirenone - 3mg, Ethinylestradiol - 20mcg Tablet, film coated 1,193,332 L.L
B05BB01 SERUFLEX RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 204,554 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS LM G Potassium chloride - K+:2.00 mmol/l, Magnesium chloride - Mg++:0.75 mmol/l, Calcium chloride - Ca++:1.75 mmol/l, Sodium acetate - Cl-:112 mmol/l, Sodium chloride - Na+:140 mmol/l Injectable solution L.L
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 10mg Tablet 1,044,358 L.L
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