Bihar Measles review 2011


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Bihar Measles review 2011

  1. 1. Measles Catch-up Campaign: Lessons learnt and planning for Phase-II<br />State: BIHAR<br />Dr Gopal Krishna, SEPIO<br />
  2. 2. State Perspective regarding MCUP<br />Initially only 2 districts were allotted for first phase<br />Following request by Principal Secretary & Secretary cum Executive Director, SHSB, the state was allowed to go for 5 districts.<br />In 2nd Phase, the State is willing to go for all the remaining 33 districts.<br />
  3. 3. Measles SIA Campaign 2010 at a glance<br />5 Districts, 64 blocks<br />Target population (9m-10yrs): 2,715,743 (25% of Total Population)<br />Total immunization posts: 24,088<br />Total schools: 8,919<br />Total ANMs: 1,899<br />Total health workers (ANMs+ASHAs): 16,700<br />
  4. 4. BIHAR : Overview<br />
  5. 5. Pre activity preparations Status<br />Coordination and high-level oversight <br />A state level co-ordination committee under the chairmanship of Principal Secretary Health was done.<br />Health, Education and WCD (ICDS) participated in this meeting.<br />State level committees and Operation Groups<br />SOG was functional under the chairmanship of Secretary Health cum Executive Director, SHSB<br />The members were SIO, Director ICDS, Director Education, WHO-NPSP, UNICEF & other partner agencies.<br />Stress was put on microplanning, training, AEFI management, waste management, media management, IEC etc.<br />
  6. 6. Pre activity Preparation Status<br />State level TOT was done, where 6 trainers (DIO & 5 MOs) from each 5 districts were trained. <br />Decentralised review meeting at divisional level by SEPIO to assess the preparedness<br />State Level Control Room under the chairmanship of SEPIO was formed.<br />To review the preparedness of each district on day to day basis<br />Timely feedback and follow-up system was established<br />
  7. 7. Constraints which were tackled during the campaign<br />Assembly Elections<br />Strike of the Health Staffs<br />Festivals<br />Shortage of injectors mainy in urban areas<br />Cold Weather conditions<br />
  8. 8. District Task Force Meeting Status<br />First 2 DTFs were done during preparatory phase.<br />Next 2 DTFs during the implementation phase &<br />5th DTF was post campaign to assess the completeness of activity<br />& to plan the repeat activity in areas with poor activity.<br />
  9. 9. State Pre activity preparations: District and Block level trainings<br />
  10. 10. District-wise coverage <br />
  11. 11. Monitoring findings<br />A total of 9724 sessions were monitored<br />Findings are mentioned below-<br />
  12. 12. RCA Findings: Coverage<br />
  13. 13. Reason for not Vaccinating the child during the campaign<br />Left outs can be decreased with better IEC & IPC<br />
  14. 14. Management of AEFIs<br />* Clustering at Nawada in a school following measles vaccination<br />
  15. 15. Communication and social mobilization<br />Activities carried out <br />Distribution of invitation cards to parents by AWW & ASHA<br />Distribution of Flip Charts & FAQs to AWW & ASHA<br />Separate sessions on mobilisation trainings of AWWs & ASHAs<br />State level Media workshop along with divisional & District level media briefings by CS<br />Rally of school children<br />School activity worked in favour of communication and social mobilisation<br />Inauguration of campaign by Minister, Divisional Commissioner, DMs & Civil Surgeons.<br />
  16. 16. Communication and social mobilization<br />Areas for improvement<br />Delayed printing of Invitation cards & other formats<br />Proper use of due list for both school & outreach session sites<br />Sensitisation of Principal of private schools<br />Sensitisation of private practitioners regarding 2nd dose for measles<br />Use of Village Health & Sanitation Committee <br />
  17. 17. Lessons learnt ..1<br />Best practices<br />Co-ordination & oversight<br /><ul><li>Strong oversight from State
  18. 18. Involvement of DM in DTFs</li></ul>Trainings<br /><ul><li> All the ANMs, AWWs, ASHAs, Volunteers & Supervisors
  19. 19. Deployment of DIO and 2 MOs of remaining 33 districts to the implementing districts with support from WHO-NPSP</li></ul>Management of AEFI<br /><ul><li>AEFI kits with MOs while provision of AVIL & DEXONA to each vaccination team</li></ul>Safe injection practices<br />
  20. 20. Lessons learnt ..2<br />Best practices<br />5. Cold chain maintenance <br /><ul><li>even with shortage of vaccine carriers & icepacks</li></ul>6. Safety Pits - Ensuring the availability of Safety pits<br />Fund - Timely release of funds to the blocks<br />Media Management<br /><ul><li>State level media workshop in presence of Principal Sec & Secretary
  21. 21. Media briefing at divisional & district level</li></ul>Monitoring & Feedback<br /><ul><li>Strong Monitoring at field level with daily sharing of feedback at all level along with DCRs at district & State level.</li></li></ul><li>Lessons learnt..3<br /><ul><li>Areas for improvement</li></ul>Strong advocacy for co-ordination among <br /> - Health, Education & ICDS during the preparation & implementation phase.<br />Microplanning & Human resource management in Urban areas<br />Identification & Involvement of private schools<br />Involvement of private practitioners for support in AEFI management<br />
  22. 22. Lessons learnt..4<br /><ul><li>Areas for improvement</li></ul>Timely printing & procurement of logistic<br />Better display of IEC materials and use of Invitation cards for IPC<br />One week before the start of campaign, the bottom-up target of beneficiaries must get fixed at all levels<br />Ensuring availability of reserve teams at PHC to cover the areas with poor activity.<br />
  23. 23. Future Plans for subsequent Phase<br />No. of Districts – All remaining 33 districts<br />Target beneficiaries – 2,32,18,410<br />Plan for addressing shortcomings<br />All the DIOs of remaining 33 districts had been sensitised during their State review meetings.<br />State level review meeting done in April 11<br />Final document to be circulated to all the PHCs<br />Timeline – <br />Anticipating national level meeting for 2nd Phase in June 11<br />Starting of preparation at State & district level in July- Aug 11<br />Implementation of campaign Sep 11 onwards<br />
  24. 24. Support from GOI for Next Phase<br />Letter to concerned departments for co-ordination at State & District level<br />Supply of new vaccine carriers & icepacks<br />AD Syringes must be compatible with the hub cutters.<br />Diluents in plastic containers.<br />Financial support for Monitoring of activity <br />Elaborate financial guidelines, especially for <br />Supervisors per diem & mobility<br />Per diem for cold chain handlers & personnel managing waste at PHCs <br />
  25. 25. DIO of Arwal District in District Microplanning Workshop<br />
  26. 26. State Level Media Workshop before the SIA – Principal Secretary & Secretary<br />
  27. 27. Use of Hoardings <br />
  28. 28. Use of Audio-Visual during training sessions<br />
  29. 29. Rally of School Children at Gaya district – CS Gaya<br />
  30. 30. AEFI Kit<br />
  31. 31. Use of Alternate Vaccine Delivey System<br />
  32. 32. A session site with AD syringes, Hub cutters, keeping vial in hole of icepack<br />
  33. 33. Children waiting for their turn at school session site<br />
  34. 34. A DIO on deployment, from non-implementing district, doing monitoring<br />
  35. 35. Children Under Observation following Vaccination<br />
  36. 36. Monitoring by CS Arwal & WHO-NPSP<br />
  37. 37. RCA – availability of Vaccination & Invitation Cards<br />
  38. 38. Monitoring in a Brick Kiln by State Officials<br />
  39. 39. Thank You<br />