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Emergency Preparedness and Response Planning – risk analysis, actions taken in HR areas & preparedness status for mop ups : West Bengal. 24 th Meeting of India Expert Advisory Group on Polio New Delhi 15-16 March 2012. Dr Rashmi Kamal,IAS

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Emergency Preparedness and Response Planning – risk analysis, actions taken in HR areas & preparedness status for mop ups : West Bengal

24th Meeting of India Expert Advisory Group on Polio

New Delhi 15-16 March 2012

Dr Rashmi Kamal,IAS

Addl State Mission Director, NRHM & Jt Secy to Govt of West Bengal


Outline of the presentation
Outline of the presentation analysis, actions taken in HR areas & preparedness status for mop ups :

  • Risk assessment

  • Sustaining high population immunity in HRAs

    • SIAs

    • Routine Immunization

  • Status of AFP Surveillance

  • Preparedness for responding to importations


Risk assessment analysis, actions taken in HR areas & preparedness status for mop ups :


Risk assessment in West Bengal analysis, actions taken in HR areas & preparedness status for mop ups :

WPV cases

HR districts

Location of wild polio cases

(2002 to 2011)

HR districts


Sub district risk assessment analysis, actions taken in HR areas & preparedness status for mop ups :

(based on past epidemiology & performance)

Howrah

HR Gram Panchayats/ wards identified in each district

9 districts

36 blocks/ urban areas


Identification of high risk areas wb
Identification of High Risk Areas, WB analysis, actions taken in HR areas & preparedness status for mop ups :

= 10 Migrant site

= 10 HR site

High risk areas in settled population

Migrant sites

~ 5,200 Migrant sites

~ 10,122 HR areas in settled population


Progress on emergency preparedness response plan
Progress on Emergency Preparedness & Response Plan analysis, actions taken in HR areas & preparedness status for mop ups :

  • EPRG constituted – Two EPRG meetings held since December to assess progress

  • RRT members selected and trained

  • High Risk districts allocated to RRT members

  • EPRP prepared and implemented

Dr Soumitra Roy

Dr Kalyan Mukherjee

Dr J K Mehta

Dr Amabasu Das

Dr Dipankar Maji

Dr S S Basu

Dr Prasanta Biswas

Dr Pramit Ghosh



Intensive government oversight

Urban area task force meeting in progress at Maheshtala analysis, actions taken in HR areas & preparedness status for mop ups :

District Magistrate Howrah monitoring activity

Intensive Government Oversight

  • Regular video conferences by Principal Secretary for polio SIAs with DMs /Mayors & Chair persons of urban bodies and Health / ICDS officials

  • Senior state officials assigned to HR districts for monitoring

  • District, sub divisional and block task forces to review preparedness & supervise operations

  • Daily evening review meetings at districts & block PHCs


Intensification of underserved strategy
Intensification of underserved strategy analysis, actions taken in HR areas & preparedness status for mop ups :

Polio advocacy at Urs

  • Endorsement from religious institutions

  • Compilation of appeals for teams working in HRAs

  • Announcement from mosques

  • Advocacy in religious gatherings

  • Inauguration by religious leaders

  • Sensitization of Hajis before and after return from Haj pilgrimage

  • Rally by Madarsa students

Sensitization of Hajis

Rally by madarsa students


Special initiatives to reduce missed children in hr districts of west bengal

Health camps : Murshidabad analysis, actions taken in HR areas & preparedness status for mop ups :

Clinic booths: Howrah

Impact of health camps : Khargram

Sick children vaccinated at clinic booths

123 clinic booths

Special initiatives to reduce missed children in HR districts of West Bengal

Remaining houses with reluctance to vaccination


Partner supported social mobilization advocacy
Partner supported Social Mobilization / Advocacy analysis, actions taken in HR areas & preparedness status for mop ups :

  • 1600 Field volunteers and supervisors from 23 NGOs deployed by Unicef in 6 HR district

  • Social Mapping is being done in HR areas for planning appropriate area specific intervention

  • Sensitization meetings with all PRI members and urban councilors

    • 24 Pgs South

    • Howrah

  • SIA inauguration and advocacy by Cricketers

    • Kolkata Knight Riders

    • West Indies team


Special immunization plans for Congregations analysis, actions taken in HR areas & preparedness status for mop ups :

  • Ganga sagar Mela

  • Urs in different Mazars

  • Eid congregations

  • Other religious festivals

Vaccination at Ganga sagar mela

Vaccination at Urs

~ 20,000 children vaccinated at various congregations in 2012


Social mobilization to overcome refusals
Social mobilization to overcome refusals analysis, actions taken in HR areas & preparedness status for mop ups :

Number of houses with reluctance to vaccination: 2011 vs 2012

North Bengal districts

South Bengal districts


Vaccination of children in transit
Vaccination of children in transit analysis, actions taken in HR areas & preparedness status for mop ups :

> 500,000 children vaccinated in transit during each campaign in the state

Children vaccinated at transit points: 2011 vs 2012


Other special initiatives to improve coverage

Trend in remaining X houses – Kolkata & Murshidabad analysis, actions taken in HR areas & preparedness status for mop ups :

Other special initiatives to improve coverage

  • Targeted X-P conversion : Doctors from Medical colleges visit reluctant families (X houses) with medicines immediately after the round.

  • Distribution of Motivational items from booths

  • ICDS feeding on booth day

Medical college doctors visiting an X house

Outcome : Reduction in remaining X houses

ICDS feeding on booth day


Northern districts, West Bengal analysis, actions taken in HR areas & preparedness status for mop ups :

Percent unvaccinated children End-of-round survey

Percent

6,890

8,924

6,461

7,996

N=

1,371

4,490

2,996

4,020

3,515

6,556

7,574

7,686

7,065

10,320

6,651

Southern districts, West Bengal

Percent

12,602

11,343

11,816

10,919

17,450

7,525

6,665

8,193

11,933

11,027

11,787

N=


Strengthening routine immunization
Strengthening Routine immunization analysis, actions taken in HR areas & preparedness status for mop ups :

  • Merger with SIA microplans in process

    • Identification of new RI/VHND sites through SIA microplan

    • Incorporating RI session plan in SIA microplan

    • Identification of newborns during SIA and their inclusion in RI

  • Training of MOs and Cold chain handlers

  • Quarterly review of RI performance at state level


RI sessions planned vs held – West Bengal analysis, actions taken in HR areas & preparedness status for mop ups :

May 2011 – January 2012

Reason for session not held (N=57)

State N = 1,582

Source: Session RI Monitoring data (May 2011-January 2012)


Immunization status of monitored children, analysis, actions taken in HR areas & preparedness status for mop ups :

West Bengal, May 2011 - January 2012

Reasons for children not being fully immunized

Not aware of need

Fear of AEFI

Unaware of session site

N= 1,629

Beneficiary not available

Programmatic Reason

Other Reasons

State N (children 12 to 23 months of age)= 6,223



AFP Surveillance is sensitive enough to pick any transmission in the state

Status of AFP Surveillance - 2011

Non-polio AFP rate

Stool collection rate

87%

7.18

* data as on 3 March 2012



Preparedness for responding to importation
Preparedness for responding to importation transmission in the state

Prepared to hold first mop up within 7 days of detection of transmission, as demonstrated in the past.

Mop up conducted

Vaccine & other logistics reach blocks

  • National level partners meeting

  • Media plan operationalized

  • Vaccine arrived in district

  • State & District Task Force Meetings

  • 14 additional SMOs arrive in districts

  • IEC plan developed

  • Marker pens & other logistics procured

  • Field Investigation (NCDC/NPSP/UNICEF)

  • National Technical Group Meeting

  • Decision on mop up

Chief Minister & Chief Secretary WB informed by GoI

WPV notified

Day 0

Day 1

Day 2

Day 3

Day 4

Day 6

Day5

7 Feb 2011

13 Feb 2011


Preparedness for responding to importation1
Preparedness for responding to importation transmission in the state

Logistics plan

Running rate contract exists for marker pens – supplies expected to districts within 7 days of placing order

Printing of formats have been decentralized to districts – may be done in 5 days

Vaccine distribution to block PHCs (including hard to reach areas) within 4 days of receipt at state

Communication plan

Running rate contract exists for printing of banners/posters and delivery to districts

UNICEF is ready with the prototype IEC materials, will be updated in minimum time


Preparedness for responding to importation2
Preparedness for responding to importation transmission in the state

Cold chain

Adequate vaccine carriers available in High risk blocks and urban areas

Repair of cold chain equipments has been decentralized to district level to minimize delay

Microplanning

Microplans of all high priority planning units are reviewed and rationalized before each round

Manpower & training

Training of all high priority teams will be conducted within 6 days of notification


Preparedness for responding to importation3
Preparedness for responding to importation transmission in the state

EPRG & RRT

EPRG is meeting from time to time to assess ongoing activities for increasing / sustaining population immunity and maintaining sensitive AFP surveillance

can be activated within 24 hours

District, Sub division and Block / Urban area task force

will meet as soon as campaign is decided.


Highest level of transmission in the state

political commitment

to keep West Bengal

polio free

Thank You


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