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Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
Learning from Polio Eradication_5.15.11_Shimp
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Learning from Polio Eradication_5.15.11_Shimp

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  • Routine Admin Report
  • Transcript

    • 1. Lora Shimp Senior Technical Officer – Immunization John Snow, Inc / MCHIP Learning from Polio Eradication: Community involvement in reaching under-immunized in northern Nigeria Acknowledgement of slides from: Nigeria NPHCDA; USAID’s JSI/ TSHIP project
    • 2. Wild poliovirus situation and Nigeria
      • Continuing transmission of WPV in endemic countries ( including Nigeria: 21 WPV cases in 2010; 10 WPV cases as of 1 June 2011)
      • Identification and further analysis of high risk and under-served populations
    • 3. Communication response
      • Country prioritization & analysis
      • Global communication indicators developed by UNICEF, WHO, Communications Initiative, MCHIP, BMGF, and others: used for reporting in priority countries to improve measurement within and across countries.
      • Refined strategies to reach under-served and non-compliant communities: system improvements and community-oriented approaches
    • 4. Nigeria example
      • Continually increasing government commitment to polio eradication and immunization (through National Primary Health Care Development Agency), including mass media and advocacy plans and ensuring ongoing engagement of subnational and traditional leaders.
      • Involvement of partners like JSI/TSHIP (Targeted States High Impact Project – USAID funded) in high risk and lower performing states: Bauchi and Sokoto. Building on experience from previous USAID-funded projects, COMPASS and IMMUNIZATIONbasics
      • Women’s groups, traditional birth attendants (TBAs), and religious/traditional leaders participate in identifying and tracking missed children, non-compliant, pregnant women and newborns -- utilizing communication and PEI indicators.
      Sokoto and Bauchi states; multiple MCH interventions
    • 5. Nigeria national data: cumulative routine immunization coverage for all antigens 2005-2010 Source: Routine Administrative Reports
    • 6. 2005 = 32% 2007 = 59% 2006 = 49% 2005-2010 Routine OPV3 performance at state level Source: Routine Administrative Reports 2008 = 57% 2010 = 69% 2009 = 63% <50% 50-79.9% 80-90% >90%
    • 7. Intensified Ward Communication Strategy Phase 1 (since Nov) Phase 2 (from Jan) Phase 3 (from Feb) Repeat for each round
    • 8. Example: progress in resolving persistent non compliance with a tailored package of interventions Source: IPD Tally Sheet data
    • 9. Trend of children immunized with OPV during IPD Rounds by month in Sokoto State (Jan – Mar 2011) Note: Field reports showed vaccine shortage during Immunization Plus Days (IPDs) in January, resulting in lower coverage compared to February and March. However, the state has been immunizing children above target ( 857,167 estimated children < five in 2011) in every IPD round since the beginning of the year.
    • 10.
      • TBA monthly tracking and referral of newborns and defaulters to HFs, by LGA in Sokoto - Jan to March 2011
      Source: TSHIP monthly data collection LGA # Children referred & immunized (never been vaccinated) # of defaulters tracked & immunized # of newborns seen # of newborns referred for OPV0 # of newborns receiving OPV0 # households visited # of missed children Dange Shuni 769 0 0 0 0 660 159 Goronyo 1239 275 101 101 101 320 138 Gwadabawa 2563 589 399 399 399 1320 143 Illela 761 244 73 73 73 240 109 Sabon Birni 811 0 0 0 0 400 86 Sokoto South 2145 128 85 85 85 2800 334 Wamakko 1095 84 0 0 0 660 1331 Wurno 1323 0 0 0 0 240 147 Total 10706 1320 658 658 658 6640 2447
    • 11. Summary of traditional leader involvement in monitoring SIAs in Sokoto – Jan to March 2011 Total # Wards in state: 244 Total infants < 12 months: 171,433 Source: TSHIP Record Month Number of Sultanate/Emir in the LGAs Number of Sultanate/Emir involved during this round of IPD Number of district head in the Ward Number of district head involved during this round of IPD Number of Village head in the Ward Number of Village head involved during this round of IPD Number of Settlement head in the Ward Number of Settlement head involved during this round of IPD January 1 0 21 17 177 162 2020 1012 February 1 0 21 18 177 163 2020 1497 March 1 0 21 14 177 132 2020 921 Average 1 0 21 16 177 152 2020 1143
    • 12. Settlements, households and children involved in non-compliance during IPD rounds in Sokoto from January-March 2011 The chart beside shows the number of children involved and resolved in non-compliance during IPD rounds in Jan - March 2011 (Source: TSHIP record – Eight LGAs only)
    • 13. Who helped to resolve non-compliance cases? N= sub-sample of 360 Month # of traditional leaders involved # of LGA task force involved # of Women leader involved # of Community Influencer involved # of political leaders involved # of Religious leader involved January 663 18 67 77 33 172 February 692 17 17 140 24 131 March 755 25 17 213 27 286 Total 2,110 60 101 430 84 589
    • 14. Activities conducted Jan-Mar 2011 Activities January February March Total # of ward coordination meetings planned 105 85 104 294 # of ward coordination meetings Held 89 75 88 252 # of community meetings planned 97 62 85 244 # of influencers’ meetings planned 30 22 42 94 # of influencers’ meetings held 23 18 32 73 # of mosque/church announcements planned 1004 1026 1013 3043 # of mosque/church announcements held 773 821 924 2518 # of RI sessions planned 480 469 468 1417 # of RI sessions supported 194 185 196 575
    • 15. SIA Quality in Polio High Risk States Proportion of wards with >10% Missed Childre n Source : Enhanced Independent Monitoring
    • 16. States with reduction in number of under-immunized (DTP3) – comparison of 2009 and 2010 No of un-immunized
    • 17. Results and lessons learned
      • Preliminary results show improvements in reaching special populations and increases in timely routine immunization.
      • Use of these indicators in Nigeria benefiting polio and immunization and demonstrating the potential role of community influencers for other programs.
      • Building upon experience and collaborating with partners within high-risk communities creates access to leaders trusted by and representative of local communities.
      • Describing and quantifying this contribution can be challenging, given the need for social data that are nuanced.
    • 18. Thank you!

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