b'IMPACT STATEMENT 2022HEALTH Combating vaccine inequityin South Sudan Over the last year, Crown Agents has played a key role in strengthening immunisation service delivery in IMPACT South Sudan, with an intensified focus on identifying and reaching unvaccinated children and missed communities. The Crown Agents immunisation technical team has worked tirelessly alongside the Ministry of Health, key stakeholders and implementing partners to ensure that essential routine STORIES immunisation services continue despite funding cuts to the Health Pooled Fund 3 programme. With UNICEF funding, Crown Agents has been at the forefront of the equitable rollout of COVID-19 vaccinations in South Sudan in eight out of ten states.To achieve this, we developed a detailed immunisation strategy and pioneered the use of Child Health and Mortality PreventionTackling Neglected Tropical Diseasesintegrated COVID-19 and routine immunisation mobile outreach efforts in the most marginalised Surveillance (CHAMPS), Sierra LeoneOur work supporting governments Neglected Tropicalcommunities. This did not only maximise results, One in every 32 babies born in Sierra Leone dies withinDiseases (NTD) programmes showed the importancebut also ensured the best use of limited resources. the first 28 days of life, and one in 10 children diesof building and sustaining information managementReaching 47 counties across eight states, our before their 5th birthday.and making it easier for governments to use dataCOVID-19 vaccination campaign contributed to over In 2017, the Ministry of Health and Sanitationas part of evidence-based decision-making. Active30% of the countrys fully vaccinated population.partnered with the CHAMPS programme to trackcase management of Visceral Leishmaniasis inThe team also piloted an innovative defaulter-tracing the causes of the countrys high incidence of childNepal helped our team identify new cases of themechanism in Juba County to identify and follow-mortality and stillbirths through epidemiologicdisease in mountainous areas previously thought toup with children who missed their immunisation surveillance. Funded by the Bill and Melinda Gatesbe non-endemic. To assess whether climate changeappointments, leveraging the relationship between Foundation, Crown Agents is contracted by Emorywas playing a role in new reported cases, Crownhealth facilities and local health workers. To support University as the Fiscal Agent for CHAMPS in SierraAgents, together with Oriole Global Health, designedlast-mile vaccine delivery work in rural and remote Leone while also providing management oversight. a research project to look at meteorological dataregions, we celebrated the launch of the Gavi-funded alongside the epidemiological information. We are20.5 millionToyota Vaccine Vehicle pilot study, which is ongoing CHAMPS includes post-mortem sampling andalso working with the Government of Nepal to createdrug administrationand will increase our reach even further.reporting within 24 hours of death. Initiallya risk dashboard to support planning based treatments delivered established in Bombali District, in the last year ouron this data. across Tanzania, Uganda, work expanded to Bo District, where more than 200In East Africa, we worked with the KenyanKenya, Mozambiquechildren so far have been enrolled for research.Government to identify large numbers of womento fight NTDs2021 saw the opening of a brand-new CHAMPSsuffering from Female Genital Schistosomiasis (FGS), histopathology laboratory, the first such lab in Sierraa complication of Schistosomiasis. Through our Leone. It is now a referral centre for clinicians, whoadvocacy campaigns we identified that some 70% of can send biopsy samples from their patients in all 16women infected with the chronic parasitic disease districts for testing. of schistosomiasis had symptoms of FGS, which can This year, our teams started supporting adultcause severe fertility and sexual health problems and research as well, assessing the extent to whichmake women vulnerable to cervical cancer and HIV. malaria is a leading cause of death. CHAMPSYet the healthcare systems lack of coordination on work in the Makeni area is already contributingNTDs means FGS is not well understood, and women to opportunities for data-to-action and policysuffering from it are often misdiagnosed with sexually interventions to reduce such deaths. The governmenttransmitted infections and therefore go untreated. In580,000people in is using findings to prioritise resources and improveKenya, the ARISE (Accelerating Resilient InnovativeSouth Sudan vaccinated policies to reduce deaths from preventable causes.Sustainable Elimination of NTDs) project bolsteredagainst COVID-19 in our This involves counselling families, improving accessmainstream NTD management by integrating it with2022 campaignto power and water, repairing utilities and equipment,public health efforts, bringing together screening for improving clinical records and their storage andcervical cancer and gynaecological services with FGS mentoring medical staff. testing and treatment. To detect cases of FGS and raise awareness of the problem, we also helped the government train health workers.28 29'