1 flagging of suspicious values

district level performance coverage for some districts

a  255%, 196%, 205%, 142 and 135% and 48%

b Feb and march report repitation for some districts

c un expectidly high monthly report  for may grandtown and district 4

Task 2  I concluded that national and subnational data has consistency of adminreport but report at low level(some district has data quality issues)

Task 3 it does not change my view, because no significant discripancy between evaluation coverage survey and national administrative report including grandtown report is reasonable

Task 4 it tells me that the national administrative coverage is realistic and can not be justifay that the measles outbreak atributed due to coverage problem

Task 5 The immunization program of the country is on the right direction as per strategic plan as evident by administrative report(national and subnational) and has consistency evaluation coverage survey and measles outbreak is affected grandtown as most cases is from the town.This can be explained by 

1, acumulation of sustible persons complicated by influx of unimmunized immigrants from rural to urban and fuled by bad living condtion due to poverity.

2, due to ow capacity of health worker at lower level may lead to dataquality problem which mis lead decision making on poor data in turn contributed for the small scale outbreak

3 weak disease surveillance program which is sensitive enough to capture cases early and inform program manager to take action

Recommendation

1 strengethen  measles surveillance activity all over the country and in the grandtown and other affected area in particular and case management and work on public awarness to intrupt transmision

2 improve capacity of staff at lower level on quality data generation and use to improve service quality

3 work on to improve lively conditions including reaching the undersurved community with health services in grandtown to improve immunity gap

4 conduct evaluative coverage survey since it is long time as feasible to validate the current adminstrative coverge

5 immprove vaccine management system to realize avialability, saftey and poteency at all level