Measles Catch-up Campaign Lessons learnt and planning for Phase-II Jharkhand Dr. Ajit Kr. Prasad
MAP OF STATE SHOWING PHASE-1 DISTRICTS [ D u m k a J a m t a r a D e o g h a r G i r i d i h K o d e r m a G o d d a S a h i b g a n j P a k u r D h a n b a d S i n g h b h u m E a s t G a r h w a P a l a m u C h a t r a L a t e h a r L o h a r d a g a G u m l a S i m d e g a S a r a i k e l l a S i n g h b h u m W e s t B o k a r o K h u n t i R a n c h i H a z a r i b a g h R a m g a Deoghar Gumla Jamtara Khunti Lohardaga
Jharkhand : Overview *: DLHS-III 2007-08 # Khunti separated from Ranchi after DLHS-III survey, therefore putting the data of Ranchi district. District Dates of campaign Total population *MCV1 coverage (%) *Fully Immunized coverage (%) DEOGHAR 31 st Jan 2011 1415082 55.9 35.7 JAMTARA 730906 53.5 38.6 GUMLA 983723 84.9 68.6 LOHARDAGA 452572 96.5 81.2 # KHUNTI (Ranchi) 550424 89.0 69.0 State 32,858,434 70.5 54.1
Coordination and high level oversight
All the departments participated in state task force meeting and decided to send a letter to their respective departments for campaign.
ICDS secretary ensured best possible involvement of AWWs.
More support is needed from education department for successful campaign
It will be helpful to state if other departments get the letter from national level.
Coordination and high level oversight Sl. No. Meetings No. of meetings Key Decisions 1 State Task Force Meetings 2
Letter from Education dept. to all district education offices.
Deployment of govt. monitors
Media workshop to be conducted at State level
Refresher training of vaccinators is to be conducted
2 State operational group meeting 2
District will conduct the activity either sector wise or sub centre wise depending on local geographic & human resource situation.
District can extend the activity if there is shortage of manpower.
State instructed district to take precaution in Vaccine wastage and fund calculation
State instructed districts to print IEC in advance
DTF Status District No of DTFs held for MCUP Total no of participants No of DTFs attended by DM or ADM (%) No of DTFs attended by CMO or DIO (%) DEOGHAR 2 48 50% 100% JAMTARA 2 44 100% 100% GUMLA 2 86 100% 100% LOHARDAGA 2 38 100% 100% KHUNTI 2 62 100% 100% Total 10 278 100% 100%
State Pre activity preparations: District and Block level trainings District MCUP planning workshops AEFI workshops Health Worker training sessions No. held No. trained No. held No. trained No. held No. of ANM and supervisors trained No. of ASHA, AWW & volunteers trained DEOGHAR 1 48 1 20 37 255+78 3857 JAMTARA 1 41 1 27 20 216+66 1462 GUMLA 1 53 1 53 12 412+116 2220 LOHARDAGA 1 33 1 20 6 165+48 602 KHUNTI 1 25 1 30 19 140+70 368 Total 5 200 5 150 57 1188+378 8509
Results Data as on 10 th Apr 2011 District Dates of Campaign Target population (9m to 10yrs) Children Covered Children Immunized (%) DEOGHAR 31 st Jan 2011 283016 251072 88.7 JAMTARA 146181 119096 81.5 GUMLA 196745 184555 93.8 LOHARDAGA 90514 77499 85.6 KHUNTI 110085 89356 81.2 Total 826541 721578 87.3
Time of reconstitution is found noted on the label of the vial (92%)
Number of vials used and beneficiaries vaccinated as per tally sheet match reasonably (94%)
Vaccinators know what to do in case of a serious AEFI (primary care, referral and reporting) (92%)
Supervisor visited this session site at least once today (69%)
Functional hub cutter found available at session site (74%)
Vaccination site have visible IEC (Banners / Posters) (73%)
RCA Findings: Coverage Districts No. of children checked No. of Children found missed % Children found missed No. of Area visited No. of Area>=20% missed children % of area with >= 10% missed Children DEOGHAR 6602 803 12.2 332 16.3 77.1 GUMLA 3189 410 12.9 169 14.8 72.2 JAMTARA 6180 1541 24.9 309 59.2 82.2 KHUNTI 6608 613 9.3 381 15.2 36.2 LOHARDAGA 808 190 23.5 47 51.1 68.1 Grand Total 23387 3557 15.2 1238 27.8 64.8
RCA findings: reasons for missing MCUP dose
Travelling (706, 19.1%)
Did not know about the campaign (574, 16.1%)
Parents did not give importance (566, 15.9%)
Fear of injection (517, 14.5%)
Management of AEFIs * Major AEFI: Death, hospitalization, cluster (Includes anaphylaxis) DISTRICT No. Of children Vaccinated Minor AEFI Major* AEFI Count Incidence /million doses Count Incidence /million doses DEOGHAR 251072 4 16 0 0 JAMTARA 119096 0 0 0 0 GUMLA 184555 0 0 3 17 LOHARDAGA 77499 0 0 1 13 KHUNTI 89356 3 34 0 0 TOTAL 721578 7 10 4 6
Communication and social mobilization
Activities carried out
Media workshop at the state level.
Media workshop at one of the districts.
Press coverage of the pre campaign DTFs
Areas for improvement
For 2nd phase, it is important to print the IEC in advance at State level to maintain the quality & timeliness.
Additional emphasis should be given for distribution of invitation slips
Financial guidelines for IEC should be clearer. (For eg. funds allotted for printing of Banners & hoardings)
Media workshop in all the districts.
Fixation of dates well in advance is utmost importance for effective programme implementation.
Centralized IEC material will help to maintain quality and timeliness.
Cold chain assessment should be done in advance so that electrical cold chain equipment & non electrical cold chain equipment will be supplied as per actual need for phase II.
More clear financial guideline required to districts either from central or State level.
Blocks & districts should follow the training guidelines given by Govt. of India.
Inclusion of more private practitioners for AEFI treatment will be beneficial for the programme and in long run also.
For better involvement of schools, there should be letters to concerned departments from higher levels (national-state-district) well in advance.
Grass root level workers should be made accountable for information to schools & AWW into these areas.
Blocks need to learn to implement programme in planned manner & specific instruction should be given to them from higher authorities in this regard.
Future Plans for subsequent Phase
No. of Districts & Target:
19 district / 5,877,284 children
Plan for addressing shortcomings:
State review meeting as early as possible for discussions on lesson learned.
Sensitization of education & ICDS department well in advance.