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IMMUNIZATION PROGRAMPIP IMPLEMENTATION GUIDELINES

2010-11

[Based On NRHM Part C approved PIP (RI) Component]

Dr Balwinder Singh, Programme Officer- Immunization,

DHS Office, Punjab

18 Aug 2010 DIO/M&E Officers meeting

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Basis of Funds allocation to Districts

• The allocation of funds to the districts based on – geographic extent (big/ small district), – number of sub divisional towns, – number of block PHCs, – number of PHCs & mini PHCs and – number of sub centers. – Estimated data related to number of RI sessions

planned in the district at various levels including in Urban Slums / underserved areas

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• Districts/block to undertake an exercise at their level to rationalize distribution.

• Earlier observed that the districts/ block just distribute funds @ 4 sessions per sub center which may or may not be rational for every sub center in the block/ slums.

• Key Input: – High quality microplans.– Do not just stick to 4 sessions/month ( could be

more/less)

Irrational fund distribution leads to unspent (non utilization) of funds

at various levels.

Next step for districts… distribute funds !!

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Sub component wise PIP guidelines & instructions

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• Supports district level (DIO/DFPO/Urban Nodal Officer in charge RI )

• POL/ Vehicle hiring, no repair• Distribution norm: For calculation purposes

the mobility support (funds) allocated to the districts has been done @ 700 per block level PHC per month.

1. Mobility support for supervision (Budget sheet- column 1)

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Mobility support ..District level tours (monitoring)

• District level monitoring target per DIO/other official per month includes – visits to at least 3 block PHCs+– 6 RI session sites – 6 villages [house to house- at least 5 houses per village,

6x5= 30 children]PHC

PHC

PHC

Session

Session

Village

Village

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• Block level monitoring target per SMO/assigned officials per month includes– visits to vaccine storage points + – 4 to 5 RI session sites +– 4 to 5 villages [house to house - at least 5 houses

per village, 5x5= 25 children].

Mobility support … Block level tours (monitoring)

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Mobility support….

• Collection of forms : Responsibility DIO office, CA to DIO to facilitate

• Cross verification & validation of monitoring at district/block level by state task force/ district officials.

• Share feedback and action taken.

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Indicator for mobility fund utilization

• Number of RI monitoring forms duly filled by DIO/other district officials including Nodal Officer Incharge of urban RI submitted at State EPI HQ.

• Number of RI monitoring forms submitted by SMOs to CS/DIO.

• Number of ANM meetings in which DIO participated in priority blocks.

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2. Cold chain maintenance funds (Budget sheet- column 2)

• Funds allocated for maintenance of cold chain at District Level, PHC/ mini PHC.

• Flexibility to use as per need.• Allocated funds include TA/DA of refrigerator

mechanic for service/repair/maintenance– Observation report to be forwarded to State Cold

chain Officer before 5th of every month• Additional funds can be requested on

exhaustion with necessary justification.

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Indicator for cold chain fund utilization

• Number of visits made by refrigerator mechanic in the district.

• No of units (equipment) etc repaired at different levels.

• Monthly observation reports submitted and received by CS/DIO/State cold chain officer.

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Mobilization of Children through ASHA/ AWW etc. (Budget sheet- column 3)

• Funds @ 150/- per session for mobilization of beneficiaries is to be paid preferably to ASHA.

• In case ASHA is not available or appointed, funds may be paid to AWW or any other link person identified by the ANM for the mobilization.

• In case, more than one ASHA/ AWW is mobilizing children at a session site, 150/- needs to be divided equally.

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• ANMs with support of ASHA & AWW to prepare a due list of beneficiaries supposed to come for next vaccination.– ASHA/ mobilizer to use this list for child tracking

Mobilization of Children through ASHA/ AWW etc. (Budget sheet- column 3)

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4. Alternate vaccine delivery (AVD) funds (Budget sheet- column 4)

• Objective of AVD – Support ANM/health workers in timely delivery of

vaccines and related logistics directly to session site from nearest vaccine storage point through ASHA or AWW or by some reliable person.

– Return of unused vials & session coverage report.– ANM is able to spend adequate time for service delivery

• Purpose of AVD– is to ensure that the vaccines on immunization day reach

the session site on time

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• Distribution norm: For budget calculation purposes, allocation to districts under AVD support has been made @ 50 per immunization session. – Calculation has been made taking an average of 3.1

immunization sessions per sub center per month.– Flexibility based on geographical terrain, distance

from vaccine storage point etc. – Note: Overall budget for the district will not change.

Alternate vaccine delivery (AVD) funds.. (Budget sheet- column 4)

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Immunization microplan should reflect AVD component– Day/Site of RI sessions for which AVD is supported – Distance from vaccine storage store to session site– Person responsible for AVD with name / contact details

(cell number)– Total no of sessions for which each identified ASHA/AWW

or other reliable person is assigned to do AVD– Vehicle /means of transport by which the AVD will be

done eg cycle, motorcycle, jeep, car, three wheeler, other (specify)

Alternate vaccine delivery (AVD) funds.. (Budget sheet- column 4)

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Indicator for AVD fund utilization

• Number of districts with available block wise alternate vaccine delivery (AVD) Micro-plan.

• Number of sessions held with alternate vaccine delivery (AVD)

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5. Support of Computer Assistant (CA) for DIO (Budget sheet- column 5)

• Funds for salary of Computer Assistant for DIO under RI program will be revised subject to notification by NRHM.

• Till receipt of any such notification districts need to adhere to existing funding norms.– Annual performance appraisal (ACR) of existing CA

assigned under RI has to be undertaken by DIO as per NRHM format.

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Broad Job responsibilities of computer assistants (CA) under RI

• CA reports to DIO. • CA should handle all EPI related computer assignments. • Responsibilities (TOR)

– Timely collation, compilation and submission of RI reports following DIO approval to district/state level.

– Coordination with staff like statistical officer, M & E and other as guided by DIO to generate RI related reports .

– Do data entry of revised(tour notes)RI Monitoring forms received from District and Block level

– Updating and forwarding financial expenditure reports,– immunization Coverage reports, reviews & analyze HMIS reports, Polio

campaign reports, cold chain sickness report, ref mechanic observation report , DIO feedback to block / urban

– Other assignments as desired by DIO/CS.

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Indicator for CA fund utilization

• Timely entry of tour notes (monitoring) data (PHC level, Session site, Village level visits)• Completion of assignments based on job

responsibilities mentioned above• Receipt of timely reports at state EPI office• Copy of annual performance appraisals

submitted to the state EPI officer.

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Quarterly Review and feedback meeting at district level (Budget sheet- column 6)

• Support provided has been calculated @ 100 per person for 20 persons ( 2000) per quarter review meeting.– In case number of participants increases,

expenditure needs to be adjusted per head accordingly

– 4 quarterly review meetings exclusively for review of EPI program are to be held at the district level

– Agenda items mentioned in PIP

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Indicator for district quarterly review meeting fund utilization

• Total number of quarter review meetings conducted in the district.

• Agenda, Proceeding reports (minutes) and attendance record of all district level meetings to be timely submitted to the CS and State EPI officer.

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7. Quarterly RI Review meetings at the block level (Budget sheet- column 7)

• Responsibility-SMOs • Four quarterly RI review meetings with ASHAs

and others – Total 80 members (ASHAs 50 + other participants

30)• A sum of 50/- as honorarium including

traveling allowance is to be paid to each ASHA attending meeting (max 50 ASHAs/ per mtg) totaling 2500/- per meeting.

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• Amount of 25/- per person/meeting to be spent on– refreshment, stationary and miscellaneous

expenditure (budget provided in distribution sheet column no. 8).

– Up to a total of 4,500/- to be spent per quarterly for these 4 RI review meeting planned at the block level PHC.

7. Quarterly RI Review meetings at the block level.. (Budget sheet- column 8)

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Indicator for quarterly RI meeting at block level meetingfund utilization

• Total number of quarter RI review meetings conducted in the blocks.

• Agenda, proceeding reports (minutes) and attendance record of all 4 meetings to be timely submitted to the DIO/CS.

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8. Micro-planning at the sub centre, PHC/ CHC and district level

(Budget sheet- column 9)• A good quality (updated) RI microplaning in a

given setting is the key to success of immunization program

• Availability of revised microplans at all levels• Funding support provided for developing/

updating of existing microplans. – The support is meant to cover all the three levels i.e.

sub centre, PHC/ CHC and district level.

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• Support for Sub center (Budget sheet- column 9 a)

– A sum of 100/- per sub centre– Available fund to be spent on logistic support and

meeting of ANM, ASHA/ AWW and members of PRIs if needed.

– The microplaning should include detailed information on alternate vaccine delivery.

8. Micro-planning at the sub centre, PHC/ CHC and district level..

(Budget sheet- column 9)

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• Support for Block PHC (Budget sheet- column 9 b)

• Up to 1000/- is to be spent at each block PHC/ CHC level for– compilation of microplaning and other related

information. – It includes expenditure on such meeting and

logistic support. – The microplaning should include detailed

information on alternate vaccine delivery.

8. Micro-planning at the sub centre, PHC/ CHC and district level..

(Budget sheet- column 9)

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• Support for District PHC (Budget sheet- column 9 C)

• Funding support up to 2000/- is provided for each district for – compilation of PHC data and inclusion of left over

areas including – micro-planning of slum areas. – Expenditure will include funds for– logistic support and computerization. – Submit a copy of revised microplan to state EPI branch

(soft & hard copy)

8. Micro-planning at the sub centre, PHC/ CHC and district level..

(Budget sheet- column 9)

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Indicator for microplan fund utilization

• Total number of updated district Micro-plans submitted to the state EPI branch. – (Updated District level microplanning should

include updated block wise microplanning)

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POL for vaccine delivery at district level (Budget sheet- column 10)

• 10 bigger districts: For vaccine delivery (POL) 24000/- for entire year

• Remaining 10 districts 14000/- for entire year.

• Entries available in vehicle log book• Random verification of log book by senior officers. Funds will be utilized for bringing vaccines under RI

program from state HQ to district or regional store.

Indicator for fund utilization

Note: Funds are for POL

for vaccine

transportation &

delivery.

Do not confuse with

alternate vaccine

delivery

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10. POL for vaccine delivery at block PHC level (Budget sheet- column 11)

• Each block PHC provided 12034/- for entire year for expenditure on POL for vaccine delivery.

• Funds to be utilized for distributing vaccines/ usable under RI program from block to the peripheral cold chain stores throughout the year.

Indicator for fund utilization• Entries available in vehicle log book • Random verification of log book by senior officers.

Note: Funds are for POL

for vaccine

transportation &

delivery.

Do not confuse with

alternate vaccine

delivery

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11. Funds for purchase of bleaching powder/ hypochlorite solution

(Budget sheet- column 12)

• 500/- per block PHC provided for purchase of bleaching powder/ hypochlorite solution for management of waste disposal as per CPCB guidelines.

• DIO/ SMOs to ensure treatment of immunization waste management

Indicator for fund utilization

• No of blocks using bleaching powder/ hypochlorite solution in district.

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Funds for twin buckets (Budget sheet- column 13)

• 400/- per block PHC provided for purchase of twin plastic/ PVC buckets (capacity more than 20litres) for management of waste disposal as per CPCB guidelines.

Indicator for fund utilization• No of blocks using twin bucket as part of waste disposal management in the district.

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Funds for mobile teams for Saturday visit (Budget sheet- column 14)

• District will hire contractual vaccinators @ 300/- per session and keeping in view the increased population in bigger cities, districts are provided support as under

Place Support Provided Ludhiana city 12 hired vaccinator sessions per monthAmritsar, Patiala, Bathinda, Ferozepur and Jalandhar cities

8 hired vaccinator session each per month (8 x 5 = 40)

Remaining 14 district HQ cities 2 hired vaccinator sessions per month (2 x 14 = 28)

Additional 49 sub-divisional level towns (As identified in the Budget sheet)

2 hired vaccinator sessions per month (2 x 49 = 98)

Total178 contractual vaccinators per month i.e. 2136 hired vaccinator sessions for the year

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Indicator for mobile team fund utilization

• Availability of mobile team RI Micro-plan reflecting sessions planned to be undertaken on Saturdays in the identified district/ area.

• Monitoring Findings available following Saturday sessions monitoring by district level officers and above.

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14. ANM training

• In current year 17 districts provided support• Mohall, Fatehgarh Sahib and Patiala have been

excluded as they covered ANM training in year 2009-10.

• Funding details regarding ANM training attached (component wise explicitly explained)

• % ANMs trained in district.

Indicator for ANM Training fund utilization

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Thank you

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