In , WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives:

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1 VANUATU Vanuatu, a Melanesian archipelago of 83 islands and more than 100 languages, has a land mass of square kilometres and a population of in 2009 (National Census). Vanuatu has a young population, with nearly 50% below 15 years of age. Life expectancy at birth is 68 for men and 70 for women and 3.5% of the population is over 65 years of age. In 2008, the estimated crude birth rate was 31.1 per 1000 population and the estimated crude death rate was 5.5. With an annual growth rate of 2.6% a year, Vanuatu population is expected to double by The Infant mortality rate remains significant as 27 per 1000 live births in Vanuatu is in a geographic zone at high risk for natural disasters and a series of volcano eruptions, floods, cyclones, earthquakes occurred during these two last years. Priorities and Action Agenda for (PAA) defines the main development agendas for the country as follows: expanding the productive sector (agriculture, tourism); maintaining a macroeconomic balance; raising public service performance; cutting costs associated with transport and utilities; and improving access to basic services for health and education. In 2009, urban population accounted for 24.4% of the total population. Urban migration is increasing at an alarming rate, particularly from rural islands to Port Vila and Luganville, as people sought employment or education. Most of the population is employed in subsistence agriculture, the rest being in government departments, private companies and other employment sectors. WHO's programme of technical cooperation supports the Government's commitment to provide equitable and affordable health care. WHO supports many components of The Health Sector Strategy as reflected in the country programme budgets over the last two biennium: health systems development, including renewal of Primary Health Care; health financing; surveillance and control of communicable and noncommunicable diseases; emergencies and disasters preparedness and responses; and human resources for health development. The Vanuatu Government is now engaged in an ambitious programme to eliminate malaria from the country within a period of 10 years; WHO, through its technical assistance, is an essential stakeholder in that process. Finally, WHO, together with AusAID and UNICEF, plays a key role in helping the Ministry of Health to lead and coordinate health partnership in the spirit of the Paris Declaration and Accra Commitment. In , WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: 01 To reduce the health, social and economic burden of communicable diseases WP01 Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. Office-specific expected result (OSER) OSER Indicator Baseline Target WP01.VUT03 Capacity enhanced for prevention and control of neglected tropical diseases (NTDs), including dengue, yaws, lymphatic filariasis and soil-transmitted helminths WP01.VUT03.01 National plan for yaws developed and its implementation initiated WP01.VUT03.02 Routine dengue case notification system in place and data recorded on an ongoing basis. no plan No adequate routine system in place. National Plan for yaws by June Adequate routine system in place WP01.VUT03.03 School-based prevalence surveys for lymphatic filariasis and deworming programmes for soiltransmitted helmints implemented annually according to subregional plans. 1 survey by year Maintain the rythme of 1 survey by year

2 WP01 Advocacy for the International Health Regulations (IHR) (2005) carried out, and the functions and capacities of National IHR Focal Points and Points of Entry (POE) strengthened WP01.VUT022 Adequate policies and programmes developed for surveillance, prevention and control and management of communicable diseases WP01.VUT Percentage of IHR events adequately investigated and reported. 0 75% 02 To combat HIV/AIDS, tuberculosis and malaria WP01 Regional guidelines, policies, strategies and other tools developed for prevention, treatment and care for STI and HIV/AIDS, malaria and tuberculosis (including innovative approaches for increasing coverage of the poor, hard-to-reach and vulnerable populations) WP01.VUT04 Support given to the Ministry of Health for prevention and control of HIV/AIDS and STI and tuberculosis and leprosy WP01.VUT04.01 Availability of new HIV testing and counselling policy and guideline. No New HIV testing and counselling policy/guideline in use nationwide by June WP01.VUT04.02 Availability of revised STI comprehensive package. No New revised STI comprehensive package in use nationwide by the end of WP01.VUT05 Strengthened malaria interventions for improved nationwide prevention and control, and malaria elimination in targeted provinces WP01.VUT05.01 Number of guidelines revised and implementation reports made available. Previous guidelines available but need to be updated. 1) Vector control guideline 2) Treatment guideline 3) 6 monthly implementation report guideline WP01.VUT05.02 Number of WHO supported/guided capacity building activities carried out WP01.VUT05.03 Routine surveillance data and number of malaria programme reports, including survey, available WP01.VUT05.04 Number of targeted provinces with API of <1 per In routine already to be maintained and developed. Annual and 6 monthly reports already in routine - no weekly report in Tafea. In 2011, Tafea is estimated to be <1 per Capacity building in: 1) case management; 2) case surveillance; 3) vectorborne control interventions; 4) monitoring and evaluation. 1) Annual national report; 2) 6 monthly provincial report; 3) weekly report in Tafea Province (only) 1 province only, Tafea

3 03 To prevent and reduce disease, disability and premature death from chronic noncommunicable diseases, mental disorders, violence and injuries and visual impairment WP01 Increased political, financial and technical commitment in Member States in order to tackle chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness WP01.VUT06 Development and implementation of a comprehensive national noncommunicable disease (NCD) prevention and control programme which addresses major NCDs, including an integrated NCD surveillance system WP01.VUT06.01 National and provincial action plans for NCD based on WHO STEPwise approach to NCD surveillance (STEPS) survey results (2011). No plan. National and provincial action plans for NCD revised based on the 2011 STEP survey results by June 04 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals WP01 Enhanced capacity of Member States to develop integrated policies, strategies, and plans towards universal access to effective interventions for improving maternal, newborn, child, adolescent and reproductive health WP01.VUT07 Improved access to integrated nationwide reproductive and maternal and neonatal health services WP01.VUT07.01 Percentage of pregnant women who had their pregnancies checked for at least 3 times during their course of pregnancy. 80% 85% 05 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact WP01 Establishment and implementation of national health emergency risk management plans and WHO readiness plans WP01.VUT08 Leadership role in health sector disaster and emergency preparedness and response WP01.VUT08.01 Response plan for the health sector in place for emergency preparedness and response. HWNC set up in February 2010 but not operational. Operational plan for the health sector preparedness and response for emergency and disasters in use by June

4 06 To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex WP01 Strengthened countries' and areas' health promotion capacity across all relevant programmes, and to establish effective multisectoral and multidisicplinary mechanisms and collaborations to promote health and prevent and reduce behavioural and structural risk factors WP01.VUT09 Health promotion programmes developed for prevention and control of noncommunicable diseases (NCDs), including mental health (MH), injuries and violence, alcohol and tobacco consumption WP01.VUT09.01 Number of health promotion activities related to NCD prevention and control developped by MOH, including mental Health (MH), injuries and violence, alcohol and tobacco consumption in each province of Vanuatu. 0 At least one health promotion activity by category related to NCD, MH, injuries and violence, alcohol and tobacco consumption realized each year in each province of Vanuatu (total 6 x 6 = 36) 07 To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches WP01 Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions WP01.VUT10 Improved access to quality health services in remote areas and for the most vulnerable populations through primary health care (PHC) and applying a gender-based and human rights-based approach WP01.VUT10.01 Realization of a nationwide survey to assess the socioeconomic determinants of health in Vanuatu. no specific survey before Nationwide survey to assess the socioeconomic determinants of health in To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health WP01 Evidence and knowledge base to inform policy available to enable Member States in identifying, preventing and tackling public health problems resulting from climate change WP01.VUT11 Policy and strategy developed for primary prevention interventions that reduce environmental hazards to health, improve water and sanitation facilities and practices, enhance safety and promote good practices for public health issues connected to climate WP01.VUT11.01 Availability of policy and strategy on climate change and health development. No policy and strategy Policy and strategy on climate change for the health sector developed and endorsed by the end of 2012

5 09 To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development WP01 National capacity built to enable countries and areas to set up food-control systems based on riskanalysis principles, and to operate food-safety emergency response systems with links to international systems WP01.VUT12 National capacity to respond to food security/safety issues and other public health threats under the International Health Regulation (IHR) strengthened WP01.VUT12.01 Number of training courses organised and/or attended in-country or abroad WP01.VUT12.02 Number of national and provincial plans, strategies and frameworks for improvements in food security and food safety. No course. Draft national plan and strategy. At least 1 training course organised by province by the end of National Food Safety plan, strategy and framework reviewed and updated by June 2012; 2 provincial plans developed by the end of 2012 and 4 additional provincial plans by the end of To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research WP01 Improved management and organization of health service delivery, through public and non-public providers and networks, reflecting principles of integrated primary health care (PHC) with increased coverage, equity, and quality of health services leading to better health outcomes WP01.VUT13 Improved access to quality health services in remote areas and for the most vulnerable populations through primary health care (PHC) and applying a gender-based and human rights-based approach WP01.VUT13.01 Mid-term and long-term strategy on Healthy Islands and PHC developed and adopted WP01.VUT13.02 Number of provinces adopting primary health care revitalization plans. No strategy. No provincial plan. Mid-term and longterm strategy on Healthy Islands and PHC in use by June Primary health care revitalization plan adopted in each of the 6 provinces WP01 Strengthened country health information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals WP01.VUT14 Development and implementation of an HIS plan and minimum datasets essential for generating relevant health indicators WP01.VUT14.01 Functional HIS in place nationwide based on HIS plan WP01.VUT14.02 Training programmes identified and conducted for newly recruited HIS staff within first year of employment. No operationnal and valid HIS. No staff trained. Functional HIS in place nationwide based on HIS plan by June Training programmes identified and conducted for newly recruited HIS staff by the end of 2012 and 2013.

6 WP01 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society WP01.VUT15 Capacity of MOH in public health research developed WP01.VUT15.01 Status of developing research capacity building plan. No plan. Research capacity building plan developed by June WP01.VUT15.02 Ministry of Health staff trained in research methodology and research proposal development. No staff trained. One, TB national manager trained in research methodology and research proposal development by end of WP01 Competent support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces WP01.VUT16 Development of adequate human resources for health (HRH) to manage and deliver quality health services WP01.VUT16.01 Comprehensive human resources development plan and budget established for mid-term (3 years) and long-term (10 years) period for the health sector. No valid plan. Comprehensive human resources development plan and budget established for mid-term (3 years) and long-term (10 years) period for the health sector developed by end of WP01.VUT16.01 Health workforce database updated and used for planning and management of health manpower by June No valid database. Health workforce database updated and used for planning and management of health manpower by June WP01 Norms, standards and measurement tools used to track resources (National Health Accounts), estimate the financial burden of health payments and barriers to access for households, and estimate the costs and effects of interventions WP01.VUT17 Regular national health account (NHA) reports produced and mechanisms for aid coordination established WP01.VUT17.01 National health accounts survey reported every two years. NHA 2005, 2007 and 2009 NHA 2011 and 2013

7 11 To ensure improved access, quality and use of medical products and technologies WP01 National policies to improve access, quality and use of essential medicines developed, implemented, monitored or revised WP01.VUT18 Improved access to essential medical products, vaccines and technologies of assured quality, safety, efficacy and costeffectiveness WP01.VUT18.01 National strategy and plan for improving functions of CMS and pharmacies WP01.VUT18.02 National strategy and plan for laboratory services at national and provincial level. Draft document. Draft document. CMS strategy and development plan finalized and adopted by June National strategy and plan for laboratory services development finalized and adopted by June WP01.VUT18.03 National medicines policy finalized and operationalized. Draft document. National medicines policy finalized and endorsed by June

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