update on progress in 66 hr blocks & other initiatives uttar pradesh
DESCRIPTION
Update on Progress in 66 HR Blocks & other Initiatives Uttar Pradesh. Director General Deptt, of Family Welfare, Uttar Pradesh 23 rd IEAG 13 – 14 July, 2011. Polio Epidemiology. WPV Polio Cases – Uttar Pradesh (2006 – 2011*). 2008. 2006. 2007. - PowerPoint PPT PresentationTRANSCRIPT
Update on Progress in 66 HR Blocks & other Initiatives
Uttar Pradesh
Director General
Deptt, of Family Welfare, Uttar Pradesh
23rd IEAG
13 – 14 July, 2011
Polio Epidemiology
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WPV Polio Cases – Uttar Pradesh (2006 – 2011*)
2006
548 cases 53 districts
2007
341 cases 44 districts
2008
305 cases 44
districts
2009
602 cases 26
districts
2010
10 case 7 districts
2011*
0 case
Most recent P1 case reported from Moradabad on 13 Nov 2009
Most recent P3 case reported from Ferozabad on 21 April 2010
Lowest no of polio cases ever
in 2010
Polio cases - Uttar Pradesh
Polio cases of type 1
Polio cases of type 3
No P1 case for 20 Months
No P3 case for 14 Months
Risks to Polio Eradication in UP
• Risk of re-introduction of poliovirus from areas with recent cases outside the State
• Survival and spread of virus through migrant populations
• Risk of ongoing low level circulation
• Complacency in efforts
1. Ensuring high quality SIA activities in 66 high risk blocks
2. Tracking Migratory population for immunization coverage during each SIA round and in between the rounds
3. Maintaining SIA quality all over the state
4. Sustaining high quality AFP surveillance
5. Preparedness for rapid response in case of any wild poliovirus detection
6. To sustain the gains, need to strengthen Routine Immunization
Programme Priorities in UP
Progress in 66 High Risk Blocks
% Teams identifying and immunizing newborns
<60%
60% - <80%
80% - <90%
>90%
*Monitoring Data
0
20
40
60
80
100
Jan Feb Mar Apr May
95%
May ‘11
2011
Continued focus on most vulnerable population
X houses generated – 66 HR blocks, Uttar Pradesh
Out of all houses visited, an average of 15-18% are X houses
X houses converted – 66 HR blocks, Uttar Pradesh
Following intensive tracking of X to P conversions,
50-60% of X houses are converted to P
X houses left at the end of activity – 66 HR blocks, Uttar Pradesh
Convertible X houses: Reluctant to accept OPV or child unvaccinated due to other reasons
Non-convertible X houses: Permanently locked house (>6 weeks) or child out of village during round
Out of the remaining X houses, nearly 90% are not convertible to P
Improved quality of SIA coverage in Uttar Pradesh
2009 2010 2011
< 2 % Unvaccinated children at end of round in West UP
Intensified support of Partners: 66 HR blocks
• NPSP(WHO)
– 55 SMOs and 99 Field Volunteers assigned– Support in microplanning, training of vaccinators, monitoring of SIAs – RI monitoring
• UNICEF & CORE– 10 convergence consultants deployed
– 344 additional CMCs deployed
– Mobilization for RI sessions / RI monitoring.
– Facilitated conversion of 45000 manual scavenger operated dry latrine to sanitary latrines with district administration support in Badaun. Expanding support to Moradabad, Ghaziabad and in Meerut.
• Rotary
– Polio Block Coordinators deployed in 6 HR blocks
– IEC activities
All partners promoted use of Zinc and ORS
Challenges……..
• Staff vacancies exist: fresh appointments with priority placements in HR blocks
– 36% MO Vacancies exist (state avg. 27%)
– 23% ANM Vacancies exist (state avg. 13%)
• Experienced ANMs being placed in 66 HR blocks
• Increasing Routine immunization coverage in HR blocks
• Additional RI sessions planned
• Need to strengthen ORS and zinc distribution
• Zinc procured and distributed
Tracking Migratory Population in UP
The biggest challenge is to immunize these children repeatedly in every round
Tracking of High Risk Groups – UP Feb 2011
7733*
18627*
11633* 5076*
* No. of sites in each category
No of children vaccinated
Group Meeting for sensitization of Nomads
% Missed children found among migrants – 2011, Uttar Pradesh%
Data Source : End of Round Survey Monitoring
Less than 1% children missed in 66 HR blocks
New initiatives for increasing reach amongst migrant &
mobile populations
KHERI
BAHRAICH
BALRAMPUR
SIDDARTH NAGAR
MAHARAJ GANJ
SRAWASTI
PALIA
MIHINPURW A
NAW ABGANJ
SIRSIYA
SHEOPURA
TULSIPUR
PACHPERW A
GAINSARI
BARHNIBIRDPUR
RATANPUR
NICHLAUL
BAHADURILAXMIPUR
UTTAR PRADESH
INDIA
NEPAL
MWDR
FWDR
WDR
KhajuriyaGaurifranta
Chandan Chowki
Katarniya Ghat Kothiya
Ghat
Murtiha
Achkawa
Balai Gaon
Shivpur Mohraniya
Rupaideeha
Suiya Naka
Rampur Bandha
Bankatwa
NandmahraJarwa
Balapur
Majhgawan (Trilokpur)
Chamanganj
Seema Booth
Khunuwa Bazaar
Aligarhwa
Kakrahwa
Bansgaon Deeh
Kast Khera
Jogia Bari
Hardi Dali
Sonouli
Bargadwa
Toothibari
Regahia
Jhulnipur
Immunizing children in transit along the Indo Nepal border
1 Dot = 1 Entry / Exit Point (As per Actual Location)
30 Booths established with support of UNICEF
Continuing Vaccination along the Indo-Nepal border
10957
6413059063 61423
55670
20603
7556871853
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
Aug.10 Sep.10 Oct.10 Nov.10 Dec.10 Apr.11 May.11 Jun.11
No. of Children Immunized
Children vaccinated at transit booths along the Indo-Nepal border
*Coverage data till 30 June 2011
Children Vaccinated in 2010 – 251,243
Children Vaccinated in 2011* – 168,024
Total No. of Transit Points - 30
Additional vaccination of migrants between Polio Campaigns
Building Immunity in migrant population
Using every opportunity – Vaccinating children at Melas & Congregations - 2011
Activity District PeriodTotal
Children Immunized
Dargah Mela
Bahraich 19 May – 19 Jun 122,908
Magh Mela
Allahabad 15 Jan – 08 Feb 47,864
Mela Karikot
Bahraich 10 Jun – 14 Jun 22,463
Lakkad Shah Baba
Bahraich 02 Jun & 03 Jun 3,998
Ajmer Urs
Agra 09 Jun – 14 Jun 1,045
Total Children Immunized 198,278
16.59 82%
Non-polio AFP rate Stool collection rate
Surveillance performance indicators, UP - 2011*
* data as on 9 July 2011
IndiaLess than 60%60% to 69%70% to 79%80% and aboveNo AFP case
Highly sensitive AFP Surveillance in UP
Preparedness for rapid response in case of any wild poliovirus detection
• State Emergency Preparedness and Response Group formed
• Rapid Response Team (RRT) Members identified and notified
• Senior state officials identified for deployment to districts for supervising mop up at the shortest possible time
• Risk Analysis done in every district to identify the areas at risk of importation: – 19 districts in west UP with 66 HR Blocks– 3855 HRAs identified in West UP districts– 7277 HRAs identified in C/E UP districts
• Commissioners and District Magistrates mobilized for intensification of SIA activity by Principal Secretary:– Video conferencing– DO letters
State Emergency Preparedness & Response Plan
Strengthening Routine Immunization
Strengthening Routine Immunization
• Monitoring data shows positive trend:
– Steps initiated in Jaccha Bachha Suraksha Abhiyan (JBSA) being followed up for immunization days
– Newborn data of SIA campaigns being used for generation of due lists
– Village wise list of beneficiaries used by ANMs for tracking RI coverage
– RI coverage in HR blocks of West UP being monitored for intensification of efforts
• DMs reviewing RI progress in DTF meetings
• District level senior officers involved in monitoring
• Intensified monitoring by NPSP, UNICEF, CORE and Govt officers
– Harmonization of polio SIA and RI microplans
– Ensuring timely vaccine availability before stock-outs
– Building a system for sending alerts through SMS to ANMs as a reminder for due dates
23
30.3
40.9
0
10
20
30
40
50
60
70
80
90
100
NFHS-III [2005-06] DLHS-III [2007-08] CES [2009]
Data sources: CES- Coverage Evaluation SurveyNFHS- National Family Health SurveyDLHS- District Level Household & Facility Survey
Survey evaluated coverage of Fully Immunized – Uttar Pradesh
39% 39% 41% 45% 46% 47% 46% 50% 50% 50% 49% 50% 52% 53% 55% 57%
43% 43% 42% 40% 40% 39% 40% 37% 38% 38% 39% 37% 36% 36% 35% 33%
18% 17% 17% 15% 14% 14% 14% 13% 12% 13% 12% 13% 12% 11% 10% 10%
0%10%20%30%40%50%60%70%80%90%
100%
Jan'
10 (n
=408
7)Fe
b'10
(n=7
142)
Mar
'10 (n
=151
29)
Apr'1
0 (n
=161
89)
May
'10 (n
=110
48)
Jun'
10 (n
=141
76)
Jul'1
0 (n
=223
52)
Aug'
10 (n
=235
20)
Sep'
10 (n
=122
39)
Oct
'10 (n
=189
20)
Nov
'10 (n
=104
04)
Dec'10
(n=2
4545
)Ja
n'11
(n=1
6131
)Fe
b'11
(n=1
7438
)M
ar'11
(n=1
2422
)Ap
r'11 (
n=16
513)
Fully Immunized Partially Immunized No Immunization
Immunization status of monitored children (12-23months) UP (Jan 2010 to Apr 2011)
JBSA from August’10 to March’11
JBSA – Jachha Bachha Suraksha Abhiyan -UP Source: RI monitoring data Jan to May - 2011(NPSP,GOVT,UNICEF & CORE)
Monitoring data shows increase in coverage of fully Imm.
Immunization status of monitored children Jan to May, 2011 Uttar Pradesh
35%
55%
10%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
UP (n=81,655)
Fully Immunized
PartiallyImmunized
No Immunization
n=children 12 to 23 months of age
20%
6%
5%
3%
19%
17%
30%
n=28,384
5%6%
4%
5%
46%
23%
11%
Reason for children not being fully immunized
n=8,511
Source: RI monitoring data Jan to May - 2011(NPSP,GOVT,UNICEF & CORE)
Review of RI monitoring data at least once during last 2 DTFs in HR block districts (May’11 & Jun’11)
17/19 (89%)
Districts where RI monitoring data reviewed
Districts where RI monitoring data not reviewed
Districts with no HR blocks
Data not available
HR Blocks monitored 8 sessions per month (56 blocks)
HR Blocks not monitored 8 sessions per month (10 blocks)Source: RI monitoring data
(Jan – May 2011)
6603 sessions monitored
Intensified RI Monitoring 66 High Risk Blocks (NPSP,GOVT,UNICEF & CORE)
State’s Commitment • State is highly committed for polio eradication
– Strong political and administrative support
• Regular review meetings by Principal Secretary– State task force meeting to review preparedness before each SIA– Regular review in DIOs meeting– Review through video conferencing
• Tracking quality of SIA rounds
• Increasing district administration’s involvement – DO letters to DMs– Holding of DTFs at least 10 days before round
• Increasing awareness through enhanced Media involvement and IEC
High political commitmentHon’ble Health Minister launching SIA on
26 Jun,2011
Support required
• Supply of cold chain equipments
– Repair of ILR and Deep freezers
– Replacement of non serviceable vaccine
carriers
– Supply of ice packs
– Supply of hub cutters
• Regular supply of routine immunization
vaccines
– To avoid stock outs – buffer stock required
IEAG Proposed SIA calendar, 2011
Aug Sep Oct Nov
NIDs
Dec
bOPV
Mar Apr May Jun JulJan Feb
SNIDZone 1 UP/Bihar,
Delhi
SNIDEndemic & risk states
tOPV
SNIDEndemic & risk states
SNIDZone 1 UP/Bihar
& Delhi
tOPV / bOPV
SNIDEndemic & risk states
SNIDZone 1 UP/Bihar,
Delhi
Require an additional round to narrow the gap in this high
transmission period
Lastly……..
• The UP Govt. stands committed to eradicate polio from the State
• Will continue to ensure high quality rounds to maintain high population immunity levels