Tremendous progress has been made in the Global Polio Eradication efforts. There has been a 99% reduction in cases globally since 1988. Nearly 6 million cases of childhood paralysis have been averted. In 1988 more than 1000 polio cases per day were reported in more than 125 countries. Today, only 4 countries are now considered polio-endemic. (India, Pakistan, Afghanistan, Nigeria). 10 countries have re-infections in circulation, down from 19 countries last year. Stopping virus transmission is a top global priority with a goal of certifying the world polio-free 3 years after the last case. The investment thus far has been $8 billion from a large coalition of UN, foundations, bilateral donors, civil society and host countries.
Year of KAP Study????
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What year was child tracking introduced?
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Core Group India has begun to map its operations using GIS based tools. The experimental initiatives have been taken for Ward 46 of Howrah Municipal Corporation, West Bengal. The mapping will continue through subsequent rounds of polio eradication program to track the progress.
Purple Pinkies Dr. Roma Solomon, Director Mr. Manojkumar Choudhury, M & E Officer CORE Group Polio Project India CORE Group Spring Meeting 3 May , Wilmington, DE
Social Mobilisation for Hard to Reach Populations• Brief introduction through narrative & slides• Role Play• How we reach the unreached• Using LQAS for improving social mobilisation activities• Short film – ‘A drop of dialogue’
Polio cases (thousands) 0 100 200 300 4001985198619871988198919901991199219931994199519961997199819992000 the world in India Last type 2 polio in2001200220032004 1988 200820052006 1&3 Monovalent2007200820092010 Bivalent20112012 Polio Eradication: Historical Context 2012: 14
Progress in Polio Eradication 1988 – 20121988 2009 Type 1 125 endemic countries 4 endemic countries 1000 cases per day Type 3 (India, Nigeria, Pakistan, Afghanistan) 350,000 cases per year 1604 cases/year 2010 2012 1292 cases -20% reduction since 46 cases; 43 in endemic 2009; 99% reduction since 1988 & 3 in non-endemic countries Source: WHO 17 04 2012
IMAGINE THE• 394 million people live in U.P., Bihar & W. Bengal• 500,000 children are born every month in U.P and Bihar• 2.3 million vaccinators used in one National Immunization Day• 500,000+ vaccinators cover about 45 million children in each SNID• 900 million doses of OPV were used in 2011• 9,125 community mobilisers visit over 3 million families each month in the three states• In 2011, the SM Net tracked 30,000 migrant families and helped vaccinate 1,814,266 children on the move in transit and border areas.
Field Operations Small mop-up in India 4,200,000 children under age 5 280,000 vials of vaccine 50,000 square miles 37,000 vaccinators 4,000 supervisors 2,500 mobilizers 2,000 vehicles18,000 vaccine carriers/ice/markers/chalk/tally sheets 3 days
Two National Immunization Days (Booth-based) Much fanfare in a campaign mode
172 million children under 5 immunized in every NID ButMore than 15% children continued to be missed in every Round…
Community Resistance grew in W. Uttar Pradesh,2001 Hindu and Muslim mothers in Western U.P. felt strongly Muslim mothers that polio program targets a reported the specific community highest rates of hearing rumours/ concerns about OPVCommunities believed that… (Unicef KAP study)o Polio immunization led to impotencyo It was a family planning programo Different color of polio vaccines were used for different communities
Shift from extensive mass awareness approach to addressing specific conditions/needs of specific groups
Communication response initiatedCORE volunteersfrom schools,nursing schools &NGOs in Highrisk areas of UttarPradesh tackledresistance to OPV Increase in female vaccinators
Community Mobilisation Coordinators (CMCs) were Born • Selected from the same communities • To overcome resistance and • Sustain community participation for polio eradication and routine immunizationUnicef & CORE set up the Social Mobilisation Network inUttar Pradesh, deploying hundreds of CMCs in High risk areas to tackle resistance
Analysed ‘Resistance to develop ‘Negotiation strategiesShift from instructive to negotiation approach Focus on skill building of communicators (CMCs & Vaccinators)
Shift to localised mobilisation activities• Government mobilization – Formation of district core groups on polio & RI – Involvement of other departments like education, women & child welfare, etc.• Religious and opinion leaders’ mobilization – Regular and continuous meetings – Izthema meetings (Meetings of Muslim ladies)• Targeted IPC & mother/influencer meetings with resistant families/pockets
Migrants • Brick Kilns Children of parents working in brick kilns • Construction sites Children of parents working on construction sites 6. Slums Migrants in urban/peri-urban slums 4. Nomads Communities who travel from place to place for livelihood, setting up temporary homes on empty tracts of land near railway stations, market places, etc. Often work as blacksmiths, basket weavers, puppeteers, acrobats, fortune-tellers, singers and dancers.
CMCs conduct special IPC sessions with migrant families on the importance of polio & routine immunization More than Soap strips distributed to 4000 promote hand washing behavior informers enrolled Barbers, shopkeepers, etc. engaged as informers on migrant groups
201080% polio cases contributed by only 2% (107) of India’s blocks
Revised Communication Package for Polio Developed
Revised Communication Package for the very High Risk Blocks Get 2 drops of OPV + polio plus messages
% Resistant Houses (XR) in UP - CMC areas 2007- 2011 Source:Tallysheet
Mapping for Monitoring Relevance and Use•Lack of detailed maps in rural & urban areas•Need to map growth momentum•Desire of wider audience to view the locationand data concurrently
CORE Work Area Map of Ward 46, Howrah, W.Bengal Booth Locations