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Update on Progress in 66 HR Blocks & other Initiatives Uttar Pradesh

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.

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Update on Progress in 66 HR Blocks & other Initiatives Uttar Pradesh

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  1. 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

  2. Polio Epidemiology

  3. WPV Polio Cases – Uttar Pradesh (2006 – 2011*) 2008 2006 2007 305 cases 44 districts 548 cases 53 districts 341 cases 44 districts 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 2010 2011* 2009 602 cases 26 districts 10 case 7 districts 0 case

  4. Polio cases - Uttar Pradesh Polio cases of type 1 No P1 case for 20 Months Polio cases of type 3 No P3 case for 14 Months

  5. 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

  6. Programme Priorities in UP • Ensuring high quality SIA activities in 66 high risk blocks • Tracking Migratory population for immunization coverage during each SIA round and in between the rounds • Maintaining SIA quality all over the state • Sustaining high quality AFP surveillance • Preparedness for rapid response in case of any wild poliovirus detection • To sustain the gains, need to strengthen Routine Immunization

  7. Progress in 66 High Risk Blocks

  8. <60% 60% - <80% 80% - <90% >90% Continued focus on most vulnerable population % Teams identifying and immunizing newborns 95% May ‘11 2011 *Monitoring Data

  9. X houses generated – 66 HR blocks, Uttar Pradesh Out of all houses visited, an average of 15-18% are X houses

  10. 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

  11. X houses left at the end of activity – 66 HR blocks, Uttar Pradesh Out of the remaining X houses, nearly 90% are not convertible to P 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

  12. Improved quality of SIA coverage in Uttar Pradesh < 2 % Unvaccinated children at end of round in West UP 2010 2009 2011

  13. 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

  14. 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

  15. Tracking Migratory Population in UP The biggest challenge is to immunize these children repeatedly in every round

  16. Tracking of High Risk Groups – UPFeb 2011 No of children vaccinated 7733* 18627* 11633* 5076* * No. of sites in each category

  17. Group Meeting for sensitization of Nomads

  18. % Missed children found among migrants – 2011, Uttar Pradesh % Less than 1% children missed in 66 HR blocks Data Source : End of Round Survey Monitoring

  19. New initiatives for increasing reach amongst migrant & mobile populations

  20. Immunizing children in transit along the Indo Nepal border FWDR Gaurifranta Khajuriya Chandan Chowki 1 Dot = 1 Entry / Exit Point (As per Actual Location) Katarniya Ghat Kothiya Ghat NEPAL Achkawa Murtiha Balai Gaon MWDR Shivpur Mohraniya Rupaideeha Rampur Bandha Suiya Naka Bankatwa Majhgawan (Trilokpur) WDR Nandmahra Toothibari Jarwa Balapur Chamanganj Khunuwa Bazaar Hardi Dali Regahia Sonouli Seema Booth Kakrahwa Jhulnipur Bargadwa Aligarhwa Kast Khera UTTAR PRADESH Bansgaon Deeh INDIA Jogia Bari 30 Booths established with support of UNICEF Continuing Vaccination along the Indo-Nepal border

  21. Children vaccinated at transit booths along the Indo-Nepal border Total No. of Transit Points - 30 Children Vaccinated in 2010 – 251,243 Children Vaccinatedin 2011* – 168,024 *Coverage data till 30 June 2011

  22. Additional vaccination of migrants between Polio Campaigns Building Immunity in migrant population

  23. Using every opportunity – Vaccinating children at Melas & Congregations - 2011

  24. Highly sensitive AFP Surveillance in UP Surveillance performance indicators, UP - 2011* Non-polio AFP rate Stool collection rate 82% 16.59 * data as on 9 July 2011

  25. Preparedness for rapid response in case of any wild poliovirus detection

  26. State Emergency Preparedness & Response Plan • 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

  27. Strengthening Routine Immunization

  28. 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

  29. Survey evaluated coverage of Fully Immunized – Uttar Pradesh Data sources: CES- Coverage Evaluation Survey NFHS- National Family Health Survey DLHS- District Level Household & Facility Survey

  30. Immunization status of monitored children (12-23months) UP (Jan 2010 to Apr 2011) JBSA from August’10 to March’11 Monitoring data shows increase in coverage of fully Imm. JBSA – Jachha Bachha Suraksha Abhiyan -UP Source: RI monitoring data Jan to May - 2011(NPSP,GOVT,UNICEF & CORE)

  31. Immunization status of monitored children Jan to May, 2011 Uttar Pradesh Reason for children not being fully immunized n=8,511 n=28,384 No Immunization Partially Immunized Fully Immunized n=children 12 to 23 months of age Source: RI monitoring data Jan to May - 2011(NPSP,GOVT,UNICEF & CORE)

  32. 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

  33. Intensified RI Monitoring 66 High Risk Blocks (NPSP,GOVT,UNICEF & CORE) HR Blocks monitored 8 sessions per month (56 blocks) HR Blocks not monitored 8 sessions per month (10 blocks) (Jan – May 2011) 6603 sessions monitored Source: RI monitoring data

  34. 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

  35. High political commitmentHon’ble Health Minister launching SIA on 26 Jun,2011

  36. 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

  37. IEAG Proposed SIA calendar, 2011 tOPV tOPV / bOPV bOPV NIDs Require an additional round to narrow the gapin this high transmission period SNID Endemic & risk states SNID Endemic & risk states SNID Endemic & risk states SNID Zone 1 UP/Bihar, Delhi SNID Zone 1 UP/Bihar, Delhi SNID Zone 1 UP/Bihar & Delhi Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

  38. 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 ...Thanks

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