epi and polio related activities district okara pakistan

BRIEF OF DISTRICT FOR NID’s DECEMBER 2014

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Composition….Medical Officer/ in charges of the Health Facility(UCMO) Chairman

Union Councils Secretary Secretary

SHO of respective Police Station Member

Revenue Officer/Patwari Member

School Health & Nutrition Supervisor Member

LHS Member

Area Incharge Member

Head Teacher Member

Leading Religious Person/Imam Masjid Member

Notable Public representative from all localities of the UC Member

UNION COUNCIL POLIO ERADICATION COMMITTEE

(UPEC)

Functions of UPEC

oArea Level micro planning at the UC.

oThe Planning & implementation for teamsoSelection and TrainingoLogistics availabilityoSocial mobilization and communication

activities.

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DISTRICT POLIO ERADICATION COMMITTEE (DPEC)(Slide 01 of 02)

Composition.

District Co-ordination Officer. Chairman

Executive District Officer Health Secretary

District Police Officer

Additional District Collector and AC from each tehsil.

Executive District Officer Education.

Executive District Officer Community Development.

District Officer Health

District Aukaf Officer

District Officer Information

District Khateeb

District Co coordinator IRMNCH5

DISTRICT POLIO ERADICATION COMMITTEE (DPEC) (Slide 02 of 02)

District Head for NGOs

Member PMDC

Member of Parliament (MNA, MPA, Senators)

Local Representative of Partner Organizations (WHO, PEO)

Other Members

MS DHQ Hospitals

Deputy District Officer Health from each tehsil

Traders Organizations (Anjaman e Tajiraan Okara)

Representative from District NGOs

Respectable Religious Leaders

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FUNCTIONS OF DPEC (Slide 01 of 02)

Before the Campaign

o To ensure that specific micro plans for every UC have been updated before each campaign

o To ensure proper selection training and deployment of Vaccination teams according to the criteria

o To ensure that the line departments and local NGOs Help local resources mobilization( Human Resources, Vehicles, POL and Banners etc.)

o Planned activities for social mobilization suited to local culture.

o To ensure a comprehensive campaign monitoring and supervisory plan with the involvement of all the line departments.

o Monitor progress and challenges for routine immunization in the District.

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FUNCTIONS OF DPEC (Slide 02 of 02)

After the Campaign

▪ To review the outcome of the campaign against the set of standardindicators

▪ Review the progress of actions taken against the poor performersin the campaign.

▪ Recommended action to be taken immediately to cover areas withlow vaccination rate and /or missed children to avoid repetition.

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DISTRICT POLIO CONTROL ROOM

o To be based in the office of District Co Ordination officer

o The District level control room is to be led by an Officer (at leastgrade 18 in the Govt. Hierarchy) Designated by the DCO.

o The DCO has to ensure that the District Control room is fullyequipped with all the necessary apparatus and documents(computer Printer Fax, Internet/ Email Phone UC wise map of theDistrict and necessary indicators showing performance displayed)

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REPORTED COVERAGE OF DISTRICT FOR POLIO CAMPAIGNS 2014

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CAMPAIGN

MONTH

TOTAL

TARGETS

DURING CAMPAIGN DURING CATCHUPTOTAL

CHILDREN

COVERED

%AGE0-5

Months

6-59

MONTHS

RECORDED

NA

RECORDED

REFUSAL

COVERED

NA

COVERED

REFUSAL

TOTAL

COVERAGE

Na

covered

REFUSAL

COVERED

TOTAL

COVERAG

E

Jan 511336 47104 471253 64996 43 29940 1 518357 30524 42 30566 548923 107%

Feb 526293 45344 472428 65264 49 30022 4 517772 30554 45 30599 548371 104%

SIAD

March97449 8461 86135 13881 8 6400 1 94596 6167 7 6174 100770 103%

NID

March526293 45177 456067 64580 49 25376 5 501244 33806 38 33844 535088 102%

NID Sep 526293 72039 447806 62701 77 28559 2 519845 33412 75 33487 553332 105%

THIRD PARTY EVALUATION REPORTS OF DISTRICTFOR POLIO CAMPAIGNS 2014

Name of Campaign Target

Reported

Coverage %

age.

Third Party Evaluation Report

By LQAS Method By Market

Survey

NID Jan 511336 107% Accepted @ 90% 98%

NID Feb 526293 104% Accepted @ 90% 98.3%

SIAD March 97449 103% Accepted @ 90% 97%

NID March 526293 102% Accepted @ 90% 99%

NID Sep/Oct 526293 105% Accepted @ 90% 99%

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Province Number of Cases

FATA 160

Khyber

Pakhtunkhwa59

Sindh 29

Balochistan 11

Gilgit Biltistan 0

Punjab 3

District Okara 0Pakistan 262

Polio Situation in Pakistan 2014

AFP SURVEILLANCE 2014

Total reported AFP cases till date 76

Total discarded AFP cases till date 71

Total pending for result 5

Total no. of hot/compatible cases NIL

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Countdown on Polio Campaign 8-10 December NID 2014 (Slide 01 of 03)

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Pre Campaign Activity Cut-off date Guidelines

Make sure that UPECs are well represented

and all the members know about the date of

December campaign

24th November For each UC the committee must be fully represented including the UC MO, UC Secretary, Area-in-

Charges, Senior teacher/Headmaster, Religious leader, SHNS, LHS, UCPW and/or UCCO

Make sure that all the Polio Control Rooms

(PCR) at the DCOs offices are well equipped

and functional

24th November

Designated Polio Control Room for all the micro plans (operational, communication/social

mobilization, logistics/vaccine distribution and monitoring plans) shall be made available for review

and monitoring.

There should be no UC without Medical

Officer (MO) being nominated as focal person

PEI

24th NovemberThe Medical Officer/Facility In-charge has been nominated as the Polio Eradication Focal person in

his respective Union Council to lead PEI activities

Nomination of Revenue staff UC focal Person

PEI24th November

DCO to nominate a representative at UC level as the Polio Eradication Focal person to support

Micro-plan review and polio campaign implementation.

UPEC: UC Polio Eradication Committee

Meeting UCPEC

25th November

26th

November

UC Polio Eradication Committee, comprising Medical Officer (Chairman), UC Secretary ( co-

Chairman) Revenue officer, LHS, Area In-charges, Head Teacher, representatives from each village

and Lead religious persons (Imam Mosque), should meet to review Micro-plan and make plans for

implementation of polio campaign in their Union Council. Issues from previous campaigns should

be discussed and solved

Training of UCMOs/UC In-charges and AICs 25-27 November

Training of all UCMOs / UC In-charges and Area in Charges should be conducted as per guidelines.

EDO and DOH should facilitate some of the trainings and the DDOH must lead every training of

supervisors in his tehsil


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Pre Campaign Activity Cut-off date Guidelines

DPEC Meeting 28th

November

District Polio Eradication Committee meetings should be conducted with attendance

of line departments, religious leaders & CBO/NGOs. EDO (H) shall be responsible for

scheduling the meeting with DCO. Minutes of the meeting should be submitted to the

Provincial EPI office by 29th November 2014.

Revision of Micro Plans28th

November

Accurate and complete Micro-plan should be prepared and submitted to district office

for each Union Council. This Micro-plan must include mapping of mobile and other

priority population. Teams listed in the Micro-plan should be local residents and

Government employees.

Important: Submission of Micro Plan to

Provincial PCR

29th

November

Electronic copy or Hard copy of Micro Plan should be submitted to Provincial PCR

through Fax/email or courier

Trainings of vaccination teams

29th

November-2nd

December

Training of all team members should be conducted by the UCMO. In Union Councils

that performed poorly in the previous campaign, the DDOH should monitor the team

training. Additional monitors of the team training may include DSC, NP Coordinator,

ASV & DSV and UN staff

DDM Cards distribution 1-3 DecemberDistricts must distribute the DDM card to UCMOs/ UC In-charges, Area-In-charge and

Teams.

Vaccine Collection 5/6 December District must collect vaccine / logistics from Provincial EPI store.

Readiness Report :

a) UC Planning Data b) Quality Data c)

District Planning

3rd December

(by 12 Pm

noon)

District PCR to submit district Planning Data, UC Planning Data and Quality Data

(Readiness report) to Provincial PCR including the deferment indicators

Distribution of Social mobilization

material to Schools and Mosques5/6 December

UCMOs/ UC In-charges and Area In-charges should distribute the Social Mobilization

literature to Mosques and schools in their areas of responsibility. Area In-Charges are

responsible for displaying the Campaign posters/banners. Vaccine and campaign

logistics must be distributed from district to UC level.


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Campaign Activity Cut-off date Guidelines

DCO attend campaign evening

meeting during campaign

8-10

December

Campaign evening meetings to be chaired by DCO with the objective of

problem identification and remedial actions taken. Minutes of the meetings

must be submitted to Provincial EPI cell along with issues reported during

each day and PCR data.

Submission of Catch Up Report11-12

December

Regardless of one or two days Catch Up Activity, Cumulative Catch Up

Report shall be submitted once

Catch Up report should be sent daily

5th Day Catch Up report should have cumulative coverage of both 4+5

Days.

DISTRICT PROFILE

▪ No. of Tehsil 03

▪ No. of UC’s 114+Okara Cantt

▪ No. of DHQ HOSPITAL 02

▪ NO. OF THQ HOSPITAL 02

▪ NO. OF RHCs 10

▪ NO. OF BHUs 96

▪ Static center(for EPI) 110

▪ Outreach team 115

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DEMOGRAPHIC PROFILE

▪ POPULATION OF THE DISTRICT 2807285

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CATEGORY ANNUAL MONTHLY

LIVE BIRTH @3.5% 98225 8188

SURVIVING INFANTS @92.30%

90689 7557

12-23 MONTHS CHILDREN@ 3.267%

91517 7626

PREGNANT WOMAN@ 3.57%

100220 8352

Target children <5 years

530628 ---

NAME OF POSTS SANCTIONED FILLED VACANT

DSV 01 01* 0

ASV 03 02 01

I.V.(G) 02 01 01

I.V.(Z.C.) 03 0 03

I.V.(T.M.A.) 03 01 02

VACCINATORS 137 112 25

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VACCINATION STAFF PROFILE

* LPR(Additional Charge of DSV has been assigned to ASV Okara)

RECRUITMENT AND PROMOTION OF EPI STAFF

oRecruitment of EPI Staff.Matter Subjudice. Interviews of vaccinators have been cancelled

with the orders of Honorable Lahore High court Lahore.

oPromotion of EPI Staff.One post of ASV at Tehsil Renala Khurd is lying vacant.

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AVAILABILITY OF P.O.L.

▪ Total Budget Required for the year 2014-15 Rs. 32,29,200

▪ Budget Allocated for the year 2014-15 Rs. 32,00,000

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SUPERVISION PLAN OF EPI TECHNICIANS

oSupervision plan of EPI technicians (DSV, ASV,I.V. and Vaccinators) has been prepared onstructured format on monthly basis andimplemented.

oThey have been directed to submit monthlytour diary to EDO Health office for takingnecessary actions against the defaulters.

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REDUCTION IN VACCINATORS INVOLVEMENT IN POLIO CAMPAIGNS

• Vaccinator’s involvement in poliocampaigns have been reduced accordingto the guidelines from Provincial EPI cell.Only 38% vaccinators will be involved inPolio campaigns in future.

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USE OF TECHNOLOGY AND ANDROID PHONES TO ADDRESS THE ATTENDANCE PROBLEMS OF VACCINATORS

o 110 Vaccinators have received Android phones.

o These vaccinators are using Android phones.

o Feedback of vaccinators attendance was received from Director EPI Punjab.

o Vaccinators having low percentage of attendance were called explanation.

o Problems regarding use of Android phones, billing and internet were discussed in details with vaccinators and these problems were shared with the Provincial EPI cell and PITB.

o Due to sensitization of android attendance with vaccinators the attendance has been improved. During the last week (17-11-2014 to 22-11-2014) overall attendance of the district was 74%.

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IMPLEMENTATION OF BEST PRACTICES.

▪ Identifying two weak UCs in each tehsil and improving its coverage with evidence.

▪ Two weak UCs in each tehsil have been identified regularly and measures have been taken to improve the routine EPI coverage. These UCs have been evaluated and their performance is communicated to provincial EPI cell regularly.

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Sep 2014Sr.# Name of Tehsil Name of UCs Cov. %age1 Okara O-19 Bibipur 85%2 Okara O-90 Okara City 81%3 Renala R-30 Mupalka 73%4 Depalpur D-73 Klair Kalan 72%5 Depalpur D-83 Dhuliana 75%6 Depalpur D-87 Amli Moti 80%

Oct 20141 Okara 36-A4L 93%2 Okara 32-2L 90%3 Renala 22-1AL 78%4 Depalpur Pandat Manfool pur 78%5 Depalpur Qadir Abad 86%6 Depalpur Sher garh 72%

COVERAGE RESULTS OF WEAK UNION COUNCILS

Data Validation and verification.The Data validation and verification of 103 UCs was conducted during the month of October 2014 through the District Data Validation Committee. The results are as under.

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IMPLEMENTATION OF BEST PRACTICES.(Slide 01 of 03)


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Tehsil UC Result Tehsil UC Result Tehsil UC Result

Depalpur D-104 100% Depalpur D-53 100% Depalpur D-70 100%

Depalpur D105 100% Depalpur D-53 100% Depalpur D-71 100%

















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Tehsil UC Result Tehsil UC Result Tehsil UC ResultOkara O-1 100% Okara O-25 100% Renala R-34 100%Okara O-10 100% Okara O-29 100% Renala R-35 100%Okara O-100 100% Okara O-3 100% Renala R-35 100%Okara O-11 100% Okara O-4 100% Renala R-36 100%Okara O-115 100% Okara O-5 100% Renala R-37 100%Okara O-12 100% Okara O-6 100% Renala R-38 100%Okara O-13 100% Okara O-6 35% Renala R-39 100%Okara O-15 100% Okara O-7 100% Renala R-39 100%Okara O-16 100% Okara O-89 100% Renala R-41 100%Okara O-17 100% Okara O-91 100% Renala R-42 100%Okara O-17 100% Okara O-93 100% Renala R43 100%Okara O-17 100% Okara O-94 100% Renala R-44 100%Okara O-18 100% Okara O-95 100% Renala R-45 100%Okara O-2 100% Okara O-96 100%Okara O-20 100% Okara O-97 100%Okara O-21 100% Okara O-99 100%Okara O-22 100% Okara O-99 90%Okara O-24 100% Renala R-32 100%


IMPLEMENTATION OF DATA VERIFICATION AND VALIDATED AT UC, TEHSIL AND DISTRICT LEVEL.

At UC Level Vaccinator, LHV, UCMO on the last day of every Month.

At Tehsil Level DDOH,ASV on the first week of every Month

At District level DOH,DSV on the first week of every Month

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REGULAR MONTHLY MEETINGS AT TEHSIL AND DISTRICT LEVEL FOR DESK ANALYSIS OF THE PERFORMANCE.

•A District validation/desk analysis committee comprising of 22 members have been constituted to assist DDOH for data verification and validation at tehsil level and district level in the monthly meeting of UCMOs and vaccinators.

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PREVENTION OF INFLATED ROUTINE EPI COVERAGE REPORTS.

The inflated EPI Coverage reporting have been discouraged.

All the reports are being validated with permanent register

of the vaccinator. The permanent register data is also

validated by the district monitors.

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MEASURES TAKEN FOR EFFECTIVE VACCINE MANAGEMENT

▪ Provision of ILRs at all Health facilities.

▪ Maintainence of temrature chart at health facility level.

▪ Proper record maintainance of vaccines and other logistics.

▪ Provision of referigerated truck for transportation of vaccines at health facility level.

▪ Provision of Cold boxes at fuctional EPI centers.

▪ Provision of antigens at UC level after getting their demand.

▪ Record validation of vaccine and other logistics during the monthly meeting of UCMO and vaccinators.

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INTEGRATION OF LHWS & EPI PROGRAM TO IMPROVE EPI COVERAGE.

• To make integration of LHWs and EPI program, the followingmeasures have been taken.1. In the covered area of national program the kit station of vaccinator

will be the health house of concerned LHW.

2. LHWs will prepare due and defaulter list of children of her catchmentarea one day before the vaccinator plan and inform the parents aboutthe vaccinator program for their vaccination of children.

3. Master tour program of vaccinator have been integrated with the LHSmonthly tour program.

4. In un-covered area of the same locality the concerned LHW will alsoassist the vaccinator for vaccination of the children.

5. The LHWs have been instructed to inform the birth of childimmediately to concerned vaccinator for zero dose polio and BCGvaccination.

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Measles Surveillance 2014

▪ Total reported cases till date 30

▪ Total discarded cases till date 30

▪ Total pending for result 0

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Routine EPI Coverage %age for the year 2014 Till Date…

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0%6%

12%18%24%30%36%42%48%54%60%66%72%78%84%90%

BCG OPV0 OPV1 OPV2 OPV3 Measle1 Measle2

INDICATORS FOR MONTHLY REVIEW OF ROUTINE EPI IMMUNIZATION (SLIDE 01 of 02)

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INDICATORS FOR MONTHLY REVIEW OF ROUTINE IMMUNIZATION(SLIDE 02 OF 02)

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Indicators Target Percentage

Number of UCs submitting AFP & VPD surveillance report of last month

100% 95%

Number of health facilities screening the visiting target children and pregnant women for vaccination

100% 100%

Funds for POL, Repair of transport & cold chain equipment provided to EPI staff last month from district budget

Yes Yes

No. of tour days of EDO (H) for monitoring EPI approved and implemented with tour diary during last month.

04 Days 08 Days

DO (H) 08 Days 10 Days

Each DDO (H) 12 Days 15 Days

DSV & ASV 20 Days 22 Days

Number of UCs submitting Vaccine utilization ( Receipt, utilization, wastage & balance ) last month

100% 100%

Number of UCs undergone data validation of EPI coverage report during tehsil monthly meeting.

100% 100%

ISSUES..

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Vaccant posts of vaccinators (25) Matter is in the court

Promotion of DSV, ASVs, IVs. DSV has submitted appeal to Secretary Health for re induction in service.Post of ASV at Tehsil Renala recently sanctioned.One post of IV vacant due to terminated IV has submitted his appeal in services tribunal.

High Risk population, especiallay nomaids, Refusal from Routine EPI vaccination

help from Police department.

epi and polio related activities district okara pakistan

Healthcare