Part1: Data Analysis

Task 1:

 The cells like the following are outliers:

September of district 1

Novemmebr of district 3

Coverage of district 3

May of district 4

September of district 8

Novemeber of district 14

April of district 15

May cell of Grand town district.

Task 2:

Grandtown has a consistently high coverage of MR1. Its always greater than 100% from 2011 to 2017 ranging from 114% to 121%. Thus it raises a suspicion towards data reliability else there might be high influx of childen from the adjacent districts.
Nemo & Westtan are the two provinces which have low coverage as compared to the other provinces of Vacciland.
Most of the provinces as well as the National coverage are way above the targeted measles coverage, thus indicating Measles outbreak in these areas unlikely barring pockets of low immunization coverage.

Task 3:

There is a huge gap in coverage between the regular administrative data and the coverage evaluation survey with regards to Grandtown (40 % approx.)
The National average is in line with the CES 2013.
Alu, grandtown, Nemo, remo Chello have a wide variation with the CES 2013.

Task 4

Maximum number of cases is reported in the age group of 1-4 years thus it creates a doubt in the vaccination coverage in the last 4 years whereas the administrative data suggests a contradictory high coverage.
There are also increased cases reporting in the age group above 20 years. Thus the extremes of age group have reported significant number of cases.

Part 2: Brief the Minister

Task 5:

Need to conduct a situation analysis followed by the Outbreak investigation of the cases of Grandtown
Sample collection followed by confirmation of the outbreak (Measles/Rubella/Mixed Outbreak)
Case management of the Measles cases followed by vitamin A oil administration.

Task 6:

Outbreak Analysis- case based surveillance and daily trend analysis of the cases.
Data analysis followed by identification of low coverage areas. Microplan evaluation based on the infant population.
Data improvement planning exercise needs to be conducted based on the huge gaps between the CES and the administrative data.

Task 7:

Desk review of the existing data followed by the validation of the data with an independent survey data.
Building an online data generation at source to reduce the cascade data loss. (using tablet by the frontline workers to capture data).
Universal data management information system
Periodical weekly review of the data and providing feedback to the sources about the discrepancies.