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GUIDELINES
UnionCouncilMicro-planningforvaccinationcampaignsPolioEradicationInitiative,Pakistan
November2012
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GuidelinesforplanningpolioeradicationcampaignsattheUnionCouncillevel
1 Introduction
1.1PoliosituationgloballyandinPakistan
AsofNovember2012,theGlobalPolioEradicationInitiative(GPEI)hasmadeconsiderableprogress.Ofthefourremainingendemiccountries,Indiahasmadethegreatestprogress,withnowildpolioviruscasereportedsinceJanuary2011.Comparedto2009,Nigeriaalsoreducedcasesin2010by95%,andcasesalsodeclinedinAfghanistan.Unfortunately,thetrendwasreverseinPakistan,whereconsiderablymorecaseswerereportedin2010comparedto2009.In2011todate(mid-July),Pakistanreportedtwiceasmanycases(59)comparedtothesameperiodin2010(29cases).ThesituationinPakistannowrepresentsoneofthehighestriskStoachievingpolioeradicationglobally.
TheGovernmentofPakistan,throughtheMinistryofHealth,andincoordinationwithpolioeradicationpartners,hasreactedtothiscrisisbydevelopingaNationalEmergencyActionPlanforPolioEradication(NEAP),whichwaslaunchedbythePresidentinearly2011.
1.2High-riskdistricts,agencies(FATA)andtowns,andqualitygapsattheUClevel
Monitoringandevaluationofpoliocampaignshasshownthatcampaignqualityinanumberofpersistentlyinfectedhigh-riskdistricts,agencies(FATA)andtownsofKarachiinPakistanistoolowandcontinuestoleavethousandsofchildrenunvaccinated.MainreasonsforthisaretheongoingconflictsituationinFATAandotherareasofK.P.province,aswellasmanagerialandoperationalproblemsreducingthequalityofcampaignselsewhere,particularlyinKarachiandtheQuettaareaofBalochistan.
Thedataalsoshows,however,thatcampaignqualityisnotlowthroughouttheentirehighriskdistrict/agency/town,butthatqualitygapsarepersistingatthesub-districtlevel(agency,town)levelinonlyalimitednumberofUnionCouncils(UCs).Asaresult,theNEAPhasstronglyemphasizedtheneedtostrengthenpoliocampaignqualitydirectlyattheUClevel,andhasmadeanumberofpracticalsuggestionsonhowthisshouldbeaccomplished.
1.3Purposeofthisguideline
ThisguidelineisintendedtogivepracticalguidancetobothdistrictandUClevelpolioteamsonhowtooptimallyplanandprepareforapoliocampaignattheUClevel.Itishere,directlyattheoperationallevel,wherechangesandimprovementsneedtooccurandwillshowimmediateresults.Focusofthisguidelineisonthepre-campaignperiod.
ThebestwaytoassureasuccessfulpoliocampaignistothoroughlypreparethecampaignattheUClevel,through:
• high-qualitymicro-planningandsystematicrevisionandadjustmentofexistingmicro-plans,andthrough
• Information,mobilizationandengagementofthecommunity.
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TheguidelineisparticularlyimportantforpolioteamsinthoseUCsthathavebeendesignatedas'highrisk’(seesection7).Districtpolioteamshavebeenrequestedtopreparedetailedpolioeradicationactionplansforall'highrisk'UCs.TheseactionplansidentifythespecificsetofproblemsandobstaclesencounteredintheUC,andproposespecificinterventionsandactivitiestoovercometheseproblems.
GoodUC-levelplanningwillbeespeciallyimportantinthesehigh-riskUCstoassurethatactionplansarefullyimplemented.
2 TheUnionCouncilPolioEradicationCommittee(UPEC)
2.1WhyareUPECsneeded?
TheUCrepresentsthe'grassroots'levelwherepolioactivitiesareactuallyimplemented.Healthandgovernmentworkers,aswellasothercommunitymembers,haveplayedimportantrolesinUClevelimplementationfromthebeginningofthepolioeradicationinitiative.However,theNEAPhasnowrequestedanevengreater'inter-sectoral'involvementinpolioeradicationthanbefore,fromhealthandothergovernmentstaffandfromcommunities.
TheNEAPcalledforthecreationofUnionCouncilPolioEradicationCommittees(UPECs)inallUnionCouncils.SimilartotheexistingDPECs(DistrictPolioEradicationCommittees),theUPECsshouldincludemembersrepresentingthehealthsector,otherdepartmentsofgovernmentandreligiousandotherlocalleaders.
UPECsareexpectedtocloselyoverseeandcontrolpolioactivitiesintheUC.Becauseoftheirpositionandroleinthelocalcommunity,UPECmembersshouldbestunderstandthespecificobstaclesandproblemsthatexistintheUC;theyshouldalsobeabletoplayamajorroleinsolvingtheseproblems.
2.2TheUPEC:maintasksandmembership
Followingnationalguidelines,andinclosecoordinationwiththedistrictpolioeradicationteams,theUPECshouldplanandcoordinateandreviewpoliovaccinationcampaignactivitiesattheUClevel,inordertoreachandvaccinateeverychildineverycampaign.
ThefollowinglistsUClevelpersonswhoareexpectedtobemembersoftheUPEC,andsummarizestheirroleandthecontributionstheyshouldmake:
• UCMedicalOfficer(orseniorparamedicintheabsenceofaMO)
- chairsUPECmeetings;reportstoandisaccountabletothedistricthealthmanagementteam(DHMT)forallpolioworkdoneintheUC
• UCsecretary(or‘Patwari’,orotherseniorgovernmentofficialfromadepartmentotherthanhealth)
- representsthedistrictgovernment(DCO)intheUC
- facilitateslinkagestoandsupportfromothergovernmentdepartments
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- shouldplayaprominentroleintheUC-levelinaugurationofthecampaignsand
- shouldbefullyinvolvedinthefieldsupervision/monitoringthecampaignactivities,andchairtheeveningreviewmeetingsduringpoliocampaigns
• Poliocampaignfieldsupervisors,or'area-in-charges'–AICs
- dependingonthesizeoftheUCtherewillbeoneormoreAICs,whoareusuallyEPIvaccinators,paramedics,LadyHealthWorkers(LHWs)orLadyHealthSupervisors(LHSs)
- allAICswhoareworkinginoneUCaremembersoftheUPEC;AICsaredirectlyresponsibleforplanning,organizingandimplementingpoliocampaignsintheirassignedareas
- inlargeUCs,aZonalSupervisor(ZS)mayalsobeamemberoftheUPEC
• LadyHealthSupervisor(LHS)
- shouldassurethefullparticipationofallLHWsinpoliocampaigns;theNEAPcallsforthefullinvolvementoftheNationalLadyHealthWorkersProgrammeinallpoliocampaigns
• UCleveleducationsupervisororschoolheads
- facilitatestheparticipationofteachersasvaccinationteammembers
- helpstoraiseawarenessofandparticipationinpoliocampaignsinhouseholdsthroughsensitizingstudents(i.e.throughthedailyschoolmorningassembly)
- canhelptochannelfeedbackfromhouseholds,throughstudents,onwhetherornotimmunizationteamscameandyoungersiblingswerevaccinated
• Religiousleader(s)-thelocallyknownreligiousleaders,representingthereligioussectsintheUC
- providelinkagetotheothermullahsandimamsintheUC
- facilitatesannouncementsonpoliocampaignsthroughmosqueloudspeakersandduringtheFridayprayers
- helptoorganizemeetingsandjirgastoinformthecommunityaboutpolioeradicationandupcomingpoliocampaigns
- playanimportantroleas'influencer'inconvincingfamilieswhorefusevaccination
• UClevelWHOPolioWorkersandUNICEFPolioCommunicationOfficers(FROMFALL2011ONWARDS;inUCsdesignatedas‘highrisk’,WHOandUNICEFwilldesignatefull-timepolioeradicationsupportstaff)
- thesestaffareexpectedtoplayamainroleinallaspectsofpoliocampaignpreparationandimplementationandshouldhaveagoodunderstandingofthegeographical,socio-culturalandreligiousprofileofthelocalareaandcommunity
- theWHO'UCPolioWorkers'willmainlyconcentrateoncampaignplanning,resourcerequirements,teamselectionandtraining,implementationandmonitoring
- theUNICEF'UCCommunicationOfficer'willfocusonworkingwithandengagingcommunities,socialmapping,organizingspecialevents,trainingofteamsininter-
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personalcommunication(IPC),distributionofIECmaterials,andonidentifyingkey'influencers'tohelpwithconvincing'refusal'familiestoacceptvaccine
- however,bothWHOandUNICEFUC-levelstaffwillneedtohaveagoodunderstandingofeachother'sworkareas,andshouldcomplementandassisteachother,ifnecessary
ThemainUPECmeetingshouldbescheduled2weeksbeforeeachpoliocampaign.TheUPEChasoverallresponsibilityforcampaignmicro-planning,theactivitywhichismostcriticalforthequalityofpoliocampaigns.
Theactualmicro-planningisdonenotbythefullUPECbutthroughatechnicalsub-group(MedicalOfficer,AICsandZSs,LHS,andsoontobeappointedWHOandUNICEFsupportpersons,seealsoSection7).
2.3CoordinationbetweendistrictandUClevel
ThedistrictlevelpolioeradicationteamplaysaveryimportantroletoassurethequalityofUC-levelcampaignworkthroughregularmonitoringandsupervisionofUCs,particularlyofdesignatedhigh-riskUCs.
TheexistingsupervisoryandadministrativelinksbetweendistrictandUClevelshouldbeusedtomonitorandinfluencethequalityofworkattheUClevel.Theselinksexist:
- betweenthedistrictadministrativehead(DCO)andtheUCsecretaryand'Patwari'and
- betweentheDHMTandtheMedicalOfficer(orseniorparamedicifthereisnoMO)attheUClevelBHU/healthfacility
Foroptimalcoordination,bothlevelsneedtomaintainalinkofregularcommunicationandfeedback.ExamplesforthiswouldbethattheUCpolioteamneedstoinformthedistrictteamifandwhentheUPECmeetinghashappenedbeforeacampaign;theUCteamshouldalsosendabriefreportabouttheoutcomeofthemeeting,andashort'campaignreadinessreport'afewdaysbeforethecampaign.
ThedistricthealthteamshouldcompileandreviewallupdatedUClevelcampaignplansintimebeforetheround.ThisshouldbringproblemsandgapsincampaignpreparationattheUCleveltotheattentionofthedistrictteaminatimelymanner,sothatcorrectiveactioncanbetakensuccessfully.
3 PersistingproblemswithmicroplanningattheUClevel
Formanyyears,severalknown,persistentproblemsandpitfallshaveaffectedthequalityandusefulnessofpoliocampaignmicroplanningattheUCandarealevel.
8.1Knownproblemswithmicroplanning
Itisimportanttobeawareoftheminordertoimprovethequalityofplanning:
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• campaignmicroplanningupdatesattheUCandarealevelareeithernotdoneorincomplete
- anewtitlepageisproducedtoreflectthenameanddatesofthenewcampaign,butthecontentofthepreviousmicroplaniseitherre-copiedunchanged,orwithonlyminormodifications(changenamesofsometeammembers)
- microplanscannotbefoundatthearealevel
• absenceofwrittenlogisticsdistribution,trainingandsupervisoryplans
• fieldsupervisors(AICs)arenotinvolvedinupdatingthemicroplan(i.e.updatesarenotdone'bottomsup'butbyZSsorathigherlevel)
• improperselectionoffieldworkers(bothteamsandAICs)
- relativesandfriends;under-ageteammembers;noeffortsmadetorecruitfemales;appearanceofuntrainedteamsinthemiddleofthecampaign
• microplansdonothighlightareaswithproblemsduringpreviousround(i.e.missed/poorlycoveredareas)
• microplansdonothighlightthepresenceofhigh-riskgroups(i.e.nomads,IDPsetc.)
• actualfieldimplementationofthecampaignisnotfollowingthemicroplan:
• unannouncedlast-minuteswitchofteammembers–appearanceofnew,untrainedandinexperiencedteammembersonthe1stdayduringthecampaign
• unannouncedlast-minuteminorormajorchangesinday-team-areaassignments,withresultingconfusionanddecreased‘control’andsupervision,makingmonitoringdifficultorimpossible;
- frequentreasongivenformicroplandeviationis‘shortageofteams’,butrealbackgroundisoftenthatAICusefewerteamsthanagreedinmicroplan
3.2Updatingvs.makinganewmicroplan
Whiletheremaybesomereviewandupdatingofmicroplansbeforeeachround,microplansareseldom,ifever,completely'redone'.
Athoroughin-depthreviewofthemicroplan,orre-planningexercise,istime-consuming.However,insomecases,makinganewmicroplan'fromscratch'isnecessaryandwillgivemuchbetterresults.Thisistrueparticularlyinareaswithconstantchangesinthenumberanddistributionofthetargetpopulation,orwithhighhighturn-overofvaccinationteammembers,suchasinthelargeperi-urbanareasofbigcities.
InaccordancewiththeNEAPforpolioeradication,andtoassurethatcampaignmicroplansareofgoodqualityandsufficientlyupdatedforeachround,UClevelpolioteamsshouldtherefore:
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• makesurethattheprocessofupdatingmicroplansconsistsofmorethanchangingthedateontheoldplan,butissufficientlythoroughandresultsinmakinganddocumentingallnecessarychangestotheplan;
• performamorein-depthreviewofUC-levelmicroplans2or3timeseachyear,particularlyinhigh-riskUCs,toassessiftheplan'steamareaandworkloadassignmentsarestillappropriateandmatchwiththerealityontheground
• theremayhavebeenconsiderablechangesinpopulationdistribution,particularlyinurbanareas
Dependingonthenumberofproblemsdetectedintheexistingmicroplan,theUClevelpolioteamshouldmakeadecisiononifandwhenthemicroplanshouldbefully're-done',ratherthanjustupdated.ThatdecisionshouldbemadetakingintoaccounttheriskstatusoftheUC,andinclosecoordinationwiththedistrictpolioteam.
4 Timeline:campaignpreparationatUClevel
Toallowenoughtimeforpreparingthecampaign,includingforcorrectiveactionwhichmaybecomenecessaryifproblemsandgapsarefound,theNEAPsuggeststhatthepreparationsforanewcampaignshouldstartintheUCatleasttwoweeksbeforethenewcampaign.
4.1Twoweeksbeforethecampaign:updatemicro-planandconductUPECmeeting
Atthattime(14daysbeforethecampaign)twoimportantpre-campaignactivitiesshouldbescheduledononeday:
• AmeetingofthetechnicalUPECsub-committee(MOorleadparamedic,AIC(s),LHS,WHOandUNICEFUCpoliostaff)inthemorningtoreviewandupdatetheUCcampaignmicro-plan,
• FollowedbyameetingofthefullUPECintheafternoon.
Theadvantageofupdating(ornewlydeveloping)theUCmicro-planjustbeforetheUPECmeetingisthattheUPECcanbeinformedindetailaboutanynecessarychangesandadditionalresourcesrequired.
Thesemightincluderequestsforadditionalteam(s)orothercampaignlogistics,includingtransportation/cars,orarequestforsupportwithcampaigninauguration,communitymobilization,orinformationofschoolsorcampaignannouncementsfrommosques.
Figure1:TimingofcriticalactivitiesatUnion-Councillevelbeforethestartofthepoliocampaign
M T W T F S S M T W T F S S M T W T F S S M T W T-14 -13 -12 -11 -10 -9 -8 -7 -6 -5 -4 -3 -2 -1 1 2 3 4 5 6 7 8 9 10 11
UPEC meeting / review meetingMeeting with notables/influentialsRevision of the micro-plansTraining of the team membersSocial mobilization material distributionLogistics distributionCampaign inaugurationPolio WalkMosque announcements/mega phoneRedo / Sweeping, if requiredSubmission of readiness report
Campaign Days 1-3 Sundays Activity days
Activities
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4.2Othercriticalpre-campaignactivitiesatUClevel
Otherimportantpre-campaignactivities(seeFigure...)include:
• DistributionofIECmaterial(9daysbefore)
• Trainingofteammembers(7to5daysbefore)
• SubmissionofUC'readiness'reporttodistrict(4daysbefore)
• Campaigninauguration,otheradvocacyactivity(3to2daysbefore)andstartofmosqueannouncements(3daysbefore)
5 Micro-planningforapoliocampaignattheUClevel
Poliocampaignsareverylargeandlogisticallychallengingactivities.Inordertoreachallchildrenaged<5inanarea,thecampaignneedstobepreparedusingthoroughanddetailedplanning.Campaignplanninghasastrongimpactonthequalityandoutcomeofthecampaign.Goodandmeticulousplanningwillresultinhighcoverageandinterruptviruscirculation;continuedvirustransmissionindicateslowqualityofcampaignswhichwerebadlypreparedandplanned.5.1MainelementsofaUCmicro-plan
Campaignmicro-plansforaUCconsistofthefollowingmainelements,listedtogetherwiththeprerequisitesandinformationthatisneededtodevelopthecomponent:
• Operationalmicro-plans,preparedforeach'area'intheUC;anareaiscoveredbyanArea-in-Charge(AIC)andhis4to6teams,theoperationalplanlistsallrequiredresources,includingvaccinationteams,byteamareaandcampaignday
- Prerequisites:targetpopulationfiguresbyarea,maps/geographicalinformation,availabilityofvaccinationteams(LHWs,volunteers)
• Highriskareas/populationplan
Thehighriskareas/populationsinalltheUCsneedtobemapped.Theoperationalplansforthesehighriskareas/populationsshouldbedevelopedinlinewiththeguidelinesandstrategies.
• maps-aUC'basemap',showingallareasintheUC,plusonemapforeachAIC'sarea,showingtheboundariesofareascoveredbyeachteameachday,aswellassimplemapsforeachteamshowingtheirareaofassignment(seealso4.3)
- Prerequisites:abasemapoftheUC,oftenalreadyavailableattheBHU/healthcenter;fordenselypopulatedurbanandperi-urbanareas,printoutsofGOOGLEmapscanbeveryhelpful
• pre-campaigntrainingplan
- Prerequisites:listofallteammembersandsupervisorswhoaretobetrained;availabilityofappropriatetrainers,propermethodologytobefollowed.
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• communicationandsocialmobilizationplan
- Prerequisites:knowledgeaboutthedistributionofethnicgroupsandreligioussectsorotherminoritiesintheUC,alistofcommunityandreligious/triballeadersandother'notables',coordinationwithdistrictleveltoobtainSocMobmaterialsintime
• logisticsdistributionplan
- Prerequisites:knowledgeoftheUC'sneeds(asperoperationalareamicroplanupdate)forvaccine,vitaminA,andallothercampaign-relatedlogistics
• supervisoryplan
- Prerequisites:knowingwhichAICsandZSswillbeactiveintheUCduringthecampaign,andrequestingthemtosubmitdetailedday-by-dayactivityplans
5.2Estimationoftargetpopulationanddevelopinganoperationalareamicro-plan
Thestartingpointforamicro-planisthenumberoftarget-agechildrenestimatedtoliveinanarea.Theseimportant‘planningtarget’figuresareestimatedusingthenumberofchildrenvaccinatedinpreviouscampaignsinthatarea.
• Thenumberofchildrenvaccinatedinanareamayincreaseordecreasedependingontemporarypopulationmovementsinandoutofanarea(example:localwedding-increase,festivalelsewhere-decrease).
- Toavoidusingfalselyhighorlowpopulationfigures,campaignplanningtargetsinPakistanarecalculatedusingtheaverageno.ofchildrenvaccinatedduringthelast3roundsofthepreviouscalendaryeartostartwith.
- Onwards,targetswillbeupdatedbeforeeveryroundaccordingtotheactualfieldtargetdependingonthepopulationmovementandnewsettlements(ifany).
Oncenumbersoftargetchildrenhavebeenestimated,amicro-planningspreadsheetisusedtocalculateallnecessaryresourcestovaccinateallchildreninthearea,including:
• Thenumberofvaccine(andVitaminA)dosesneededbyeachteameachday
• Theamountofothermaterialsandlogisticsthatisneededforeachteameachday,suchasnailmarkerpens,chalk,tallysheets,vaccinecarriers,smallplasticbags,scissorstoopenVitaminAcapsulesetc,and
• Thenumberofmobile(house-to-house)vaccinationteamswhichareneededtocovertheareainthreedays.
• Thenumberoftransitteamsandfixedsitestosupportvaccinationformissedandmovingchildren(ifappropriate).
Calculatingthenumberofteamsneededtakesintoaccountwhethertheteamworksindenselyorsparselypopulatedareas,andhowmanyh-hvisitscanbemade,andchildrenvaccinated,inthatareainoneday.
• BasedonexperienceintheGPEIinPakistanandelsewhere,onevaccinationteamcanvaccinate,onaverage:
- Around200children<5perdayindenselypopulatedurbanareas(G1areas),
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- Around150children/dayinperi-urbanandeasilyreachableruralareas(G2areas)
- Around100children/dayinmoreremote,hardertoreachruralareas(G3areas).
Oncethenumberofrequiredmobileteamshasbeencalculatedforanareaandforsub-areas,eachteamislistedontheoperationalmicro-planningsheet,togetherwithanexactdescriptionoftheassignedareatobecoveredbytheteamonday1,day2andday3ofthecampaign.ReplacingofteamsondailybasistocoverdaywisedistributedareasinthesameUCisnotallowed(example;putting5teamstocoveronethirdoftheUCtargetonday1,replacingnew5teamsonday2tocovernextdays’targetandsoon)
Itisimportantthatthevaccinationteamisnotgiventheplanningtargetfigurefortheirdailyassignedareas,butthattheteamisrequestedtovaccinate'allchildren<5yearsintheassignedgeographicalarea'.
5.3DevelopingmapsfortheUCmicro-plan
MapsareanimportantcomponentoftheUCmicro-plan.Thefollowinghand-drawnsimplemapsshouldbeproducedattheUClevel:
• abasemapoftheUC(oftenavailableatthehealthcenter),intowhichtheboundariesofeachAIC'sareaaredrawn;theUCmapsshouldalsoshow;
- locationswithimportantsettlementsorpresenceofgroupsathigherriskofbeingmissedbythecampaign(slumareas,nomads,seasonalmigrants,IDPs,brickkilns,religiousorethnicminoritygroups,areaswithclustersof'chronicrefusal'familiesorinsecureareas);
- mainpermanentlandmarks,suchasschools,mosques,mainroads,towns,villages,rivers,andmountains,andhealthfacilities,markingthelocationoffixedsitesandteamsupportcenters(TSCs,mostofwhichserveasfixedsite),transitteamsandroamingteams,butalsolocationofcommunity'influencers'
• separatemapsforeachAICsarea,showingwithineacharea(correspondingtooperationalmicro-plan)theboundariesofeachteamassignmentarea,dividedinto3campaigndays(labeled'Team1-Day1','Team1-Day2'etc.);
• andsmallsketchmapsshowingeachteamarea,dividedinto3campaigndays.
TheexistingUCandareapoliocampaignmapsareoftennotofverygoodquality.Duringmorein-depthreviewsofmicro-plansinhigh-riskUCs(seesection7),UCpolioteamsshouldconsiderre-drawingandimprovingmaps.ThebestwaytodothisisforAICsandZSstodoathorough‘walk-through’ofthearea,tonoteandmapallrelevantinformation(seeabove).
Indenselypopulatedperi-urbanorurbanareas,teamsshouldconsiderusingbasemapsoftheUCprintedfromfreelyavailableinternetresources,suchas‘GOOGLEearth’or‘GOOGLEmaps’.
5.4Producingapre-campaigntrainingplan
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TheNEAP'semphasisonimprovingthequalityofpolioworkattheUClevelwillrequirethatplanningforfieldworkertrainingneedstobeevenmorecloselycoordinatedbetweenthedistrictandUCpolioteams:
• themostcapabletrainersinthedistrictshouldbeidentifiedandusedinthemosthighriskUCs,evenifthatmeansthattrainersarenotfromthelocalarea
TrainingandorientationsessionsstartoneweekbeforethebeginningofthecampaignandarescheduledseparatelyforAICs(1day),followedbytrainingofthevaccinationteams(3to4days).
• Inadditiontoimprovingknowledge,thesessionsshouldalsobeusedtoexplainwhyhighqualitypoliocampaignsarestillneeded,andtomotivatefieldworkers.
Mainissuestoconsiderinplanningfieldworkerpre-campaigntrainingare:
• toprepareacleartimeplanfortrainingsessionsatleastoneweeksbeforethecampaign,incoordinationwiththedistrictteam;plansshouldincludedates,venue,facilitatorsandlistoftrainees
• forthedistrictteamtoassurethatthebestavailabletrainerswillbeavailableforthehighestriskareasandUCs(suchasthe‘mastertrainers’whopassedthroughthe3-daypolio'trainingoftrainers'conductedbyCHIPin2009and2010;listofnamesavailablewithUNICEF/WHOIslamabad)
• toworkwiththeUPECandothersinthecommunitytoassurethatappropriatevenuesaswellasothermaterials(blackboards,flipcharts,chalk,nailmarkers,trainingbooklets)areavailableforthetrainingsessions
• thatthenewlyrecruitedWHOUC‘polioworkers’andUNICEFUC‘poliocommunicationworkers’arefullyinvolvedintrainingsessions
• keepingacompleteattendancerecord,withsignatures,toassurethatteamswhodidnotattendthetrainingcanbeidentifiedlater,andthatonlytrainedteammemberswillbeworkinginthefield
Lastly,trainingsessionsshouldbeused,ifnecessary,asopportunitiestofine-tunemicro-plans,andarrangementsforcoldchain,vaccinesupplyandlogistics(supervisors),andtostartdiscussingtheassignmentofteamstotheirareas,i.e.theexactboundariesofareastocoverdaily,beforetheseassignmentsarefinalizedinthefieldonthemorningofthefirstcampaignday.
5.5PlanforSocialMobilizationandCommunicationactivities
Communicationplansarecriticalandintegralcomponentsofanycomprehensivemicro-plan.ThisisespeciallytrueatUClevel,closesttothetargetedcommunities.Campaignmicro-planningisadynamicprocesswhichisadaptiveandresponsivetothechangingneedsofthelocalenvironmentateachmoment.Themicro-planswillneedconstantupdatingandmodificationsasthecampaignapproachesandproceedsandthedetailsoftheactivitiesandeventsarefinalized.Therefore,theactualmicro-plansareworkingdocuments.Communicationplansarecriticalandintegralcomponentsofanycomprehensivemicro-plan.
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ThisisespeciallytrueatUClevelasittheclosestleveltothetargetedcommunitiesandissupposedtoaddressthespecificneedsandchallengesofthatcommunity.
InhighriskUnionCouncils,specialUCCommunicationOfficers(UCO),supportedbyUNICEF,willsupportlocalgovernmentandnationalteamsindeveloping,planningandimplementingcommunicationandsocialmobilizationactivitiestargetingunder-servedandhighriskareasandpopulations.Additionally,UCOswillalsoprovidesupportinmappingoutstakeholdersandbuildinglocalpartnerships.
Inhigh-riskUCs,UCCommunicationOfficers(UC-COs)willprovidesupporttolocalpolioteamsindeveloping,planningandimplementingcommunicationandsocialmobilizationactivities;theywillalsotrytodeveloplocalpoliosupportnetworksandpartnerships.
ThecommunicationcomponentoftheUCmicro-plans,whichshouldaddressthespecificneedsandchallengesofthecommunity,includethefollowing:
• Socialmaps:Itisimportantthatthesocialmapsincludethelocationandmovementroutesofhighriskandunder-servedpopulationsandareas(definethesegroups:seesectiononhighriskgroupsandmigratorypopulations).Thesepopulationsmustbelistedandidentifiedonallmapsincludingtheteamandsupervisorsmap.Specialactivitieswillbetargetingtheseareas/populationstoensurecommunityengagement;buy-inandacceptanceofthecampaign(seeEvents,below).Socialmapsshouldalsoincludekeyareaswheresocialmobilizationactivitiesandinterventions,cantakeplaceincludingmosques,schools,madrassas,healthcentres,railwayorbusstationsetc.Theyshouldidentifywheresocialmobilizationstaffareinplace,andwhereinfluencersorpartnersarelocated.
• SocialMobilizers:SomehighriskareaswithintheUCwillhavesocialmobilizersidentifiedfromthecommunitiesandinvolvedinactivitiespriorandduringthecampaign.Thenamesofthesesocialmobilizersshouldbeupdatedforeachroundandincorporatedintothemicro-planswithinthedailyworkplansoftheteam.Themicro-plansshouldalsoincludethetrainingplansforthesesocialmobilizers.
• Partners:alistoftrustedandinfluentialnon-governmentalorganizations,civilsocietyorganizations,religiousinstitutionsandmadrassasalongwitharesourcemappingforthesepartnerstoidentifyhowbesttheycansupportthePEIactivities.
• Events:alistofplannedsocialmobilizationandcommunityeventsandmeetingsthatwouldbeconductedpriortoandduringthecampaign.Theprimarytargetoftheseeventsandmeetingsarethehighriskgroups(refusals,brickkilns,nomads,migrants,minorities,etc).Eachmeetingshouldhaveclearobjectives,identifiedlocationandtime,requiredresourcesandtargetedaudience.Someofthesemeetingscanbeconductedinbetweenrounds,whileotherswillbeconductedinconjunctiontoandimmediatelypriortothecampaigns.Successfulplanningandpreparationsfortheseeventsandmeetingsusingtheavailableresourceswouldensureattendanceofthetargetedcommunitiesandachievingtheobjectivesofthesemeetings.
• Congregations(weddings,religiousfestivals,haj/umracongrats):Specialactivitiesandinterventionsshouldbeplannedtoaddresstheseopportunitiesduringthecampaign.Itneedstobeclearhowweddingsandreligiousfestivalswillbehandledbetweenrounds.
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• Influencers:alistofkeyinfluencersincludingreligiousleaders,imams,communityelders,teachers,paediatricians,etcshouldbeidentifiedandincludedinmicro-planstohelpconvertspecifictypesofrefusalsandnon-compliance(includingaccessissues).Differentinfluencerswillberequiredfordifferentkindsofnon-compliance,anditshouldbenotedwhichinfluencersshouldbeusedforwhichcommunitiesandissues.Influencersshouldbeinformedwhentheteamsareconductingrevisitstoconvertrefusals,andshouldtravelwithteamstosupporttheseconversions.Thelocationofinfluencersshouldalsobereflectedonthesocialmapsincludedinthemicro-plansandusedbytheteams.
• Informers:listofreliableinformerswithcontactdetailsofincomingmigrants/labourers,nomads,temporaryslumdwellers,etcidentifiedbyvillageandcommunityandincorporatedintothevaccinationteamsworkplans.
• CalendarforUClevelSocialMobilizationWorkingGroupmeetingswithproposedattendance,objectivesandlocation.ThiscouldalsobepartoftheUPECmeetingwhichalreadytakesplace.Thesemeetingwouldhelpfinalizedetailsrelatedtoinaugurationactivitieswhichshouldbeincorporatedintothemicro-plans.
• IECmaterials:DetailedplanforIECrequirementsanddistributionplansincludingthepersonresponsiblefordisseminationandpasting,locationsanddeadlinesfordissemination.
• Refusals:Inareaswhererefusals,non-complianceandchildrenmissedduetosleeping,sickness,ornewbornsisanissue,aconsiderableamountofworkshouldbedonetoaddresstheseissuesinbetweentherounds.Duringtherounds,thereshouldbealistofallchronicandremainingrefusals(covertorovert)bylocationandreasonforrefusalincorporatedonthemapsanddailyteamworkplans.Theseareasandhouseholdsshouldbeprioritizedforinfluencer-accompaniedvisits,togetherwiththevaccinationteamandsocialmobilizers.Theseplansneedtobereflectedinthemicro-planswiththenamesoftheinfluencersandsocialmobilizers.Polio'Information-Education-Communication'(IEC)materials:themicroplanningupdatemeetingshouldbeusedtoderivetherequiredamountsofIECmaterial,tobeincludedintheSocialMobilization/Communicationsplan,whichshouldspecificalsowhen,howandbywhommaterialsshouldbedistributed.
• Reducingnon-compliance/'refusals':whererefusalofvaccinationisaproblem,theplanshouldcontainaplanandscheduleofactivitiestoengageandconvincenon-compliantfamilies,bothduringandbetweencampaigns.Areaswherenon-complianceorrefusalisapersisting('chronic')problemshouldbelistedonmapsandinthedailyteamoperationalplansofteams;teamsshouldbeaccompaniedbysocialmobilizersand/orkey'influencers'.
5.6Logisticsdistributionplan
Asfortrainingandsupervision,thedistributionofOPVvaccines(andVitaminA),ofallothermaterials(tallysheets,chalk,nailmarkersetc.)andofsocialmobilizationmaterials,inappropriateamounts,iscoordinatedmainlyatthedistrictlevel.
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 14
ItistheresponsibilityoftheUCpolioteamtocalculatetherequirementofthelogisticsaccordingtotheoperationsplanandthespreadsheet,andcommunicatetherequirementstothedistrictpolioteamwellbeforethecampaigntoassurethatvaccineandallothermaterialsarriveattheUClevelintimeforthepoliocampaign.
5.7Supervisoryplan
Similartotraining,adetailedtime-planforfieldsupervisoryactivitiesneedstobepreparedinthepre-campaignperiod.UClevelplanningforsupervision,asfortraining,needsclosecoordinationwiththedistrictteam.DependingontheriskstatusoftheUC,theremaybeaneedforcross-assigningqualifiedstaff,particularlyZSs,butalsoAICs,fromotherpartsofthedistricttoahigh-riskUC.
Asupervisory‘masterplan’willcontinuetobemadeatthedistrictlevel.However,itwillbetheresponsibilityoftheUCpolioteamtoproduceitsownsupervisoryplan,followingcoordinationwiththedistrictteam.
Thesupervisoryplanshouldspecify:
• foreachAICanddayofthecampaign,theestimatedtimeatwhichtheAICexpectstovisitaparticularteam(his'tourplan')
• Likewise,eachZSshouldprovideawritten'tourplan'inwhichheorshespecifies,foreachcampaignday,whichAICtovisitatwhichtimeand
• forthedistrictpolioteam,whichareasUCstobesupervised/monitoredtobemonitoredbywhomonwhichdayofthecampaign
6 Vaccinationteams:selection,compositionandtypesofteams
TheselectionofappropriatelyqualifiedvaccinationteammembersisacriticalactivityforwhichtheAICshavebeentraditionallyresponsible,whiletheZSidentifiesandselectsnewAICs.
Particularlyinlargecities,therehavebeenchronicproblemsinrecruitingasufficientnumberof'accountable'teammembers(govt.worker,insteadofcommunityvolunteers),foranumberofdifferentreasons(seesection8).
TheNEAPhighlightsthatteamselectionshouldnotbedonejustbytheAICbutthatthisisaresponsibilityofthewholeUCpolioteam.
Thefollowingaredifferentcategoriesofvaccinationteamsusedduringpoliocampaigns:
• 'mobileH-Hteams',consistingoftwoteammemberswhomovefromhousetohousetoidentifyandvaccinateallchildrenaged<5intheirassignedarea
Children<5whoareoutofthehouseduringtheteam'shousevisitaretargetedby
• 'transitteams'operatingatbusytransitsites,busterminalsorrailroadstations,by
• 'roamingteams'movingaroundinbusymarketareasaswellaslargehospitals,MCHdepartments,childrenparksetc.,andby
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 15
• 'fixedsiteteams'atactiveEPIcentersinhealthfacilities,whoofferOPVtoallchildren<5comingtothefacilityforanyreasonduringthecampaignperiod.
6.1Mobileteams-desiredprofileofteammembers
Toassurethathouse-to-houseteamsreachandvaccinatealleligiblechildren,teammembersshouldbeselectedusingthefollowingimportantcriteria:
• accountabilityandexperience:atleastoneofthetwoteammembersshouldbeagovernmentemployee,preferablyfromthehealthdepartment,andhavepreviouspoliocampaignexperience;thispersonisdesignatedasthe'teamLeader’;
• femaleteammembers:atleastoneteammembershouldbefemale,toassureeasyaccessintohousesandhouseholds
- itisthereforeessentialthatallavailableLHWs,LHVsor'dais'areinvolved
- inculturallyconservativeareasitisessentialtohavefemalesontheteam,butitmaynotbesafefortwofemalestowalkonthestreet;here,the(femaleormale)teammembershouldbeaccompaniedbyafamilymemberoftheoppositesex
• teamsfromthelocalarea:atleastoneteammembershouldbelongtothelocalareacurrentlycoveredbytheteam(i.e.bestifsameethnic,tribalorreligiousbackground,samelanguage)
• a'thirdteammember'-villageelderoradolescentboy-canberecruitedlocallytoaccesshomesinareaswherefemaleteamscannotoperatebecauseofstrictculturalnorms.
6.2Mobileteams:implementinghouse-to-housevaccination
Thisguidelinefocusesmainlyonplanningissuesduringthecampaignpreparationphase.However,thequalityofhouse-to-houseimmunizationiscriticaltothesuccessofthecampaign,andthefollowingsectionincludesthemostcriticalpointsmobileteamsandsupervisorsshouldfocusoninordernottomissanychild;formoredetailedimplementationguidelinesseethecomprehensiveSIAfieldguide.
Mobileteamsshouldworkbetween8amand2pm,orathoursasinstructedbythedistricthealthteam.Thedailyworkload(no.ofhouseholdsintheassignedarea)shouldbeadjustedtoallowtheteamtofinishcoveringtheareaaround2pm,toallowtorevisithouseswherepreviouslyabsentchildrenmayhavereturned.
• importanceofmulti-familycompounds-the'microcensus':
- inallruralareas,butalsoinperi-urbanandurbanareas,multi-familyhousesorcompoundsarecommon;overthelastfewyears,2/3ofreportedpoliocaseswerefrommulti-familydwellings
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 16
- thesecompounds,togetherwiththestrictreclusiveculturalnormsof'purdah'inconservativecommunities,createspecialobstaclesforteamstoaccess,findandvaccinateall<5yearoldchildren
- teamswhocannotenterahouse,orthecompound(all-maleteams)areverylikelytomisssomechildren,particularlytheveryyoungwhocannotwalkyet-newbornsandinfants
- however,experiencehasshownthatevenfemaleteammembersmisschildreninmulti-familycompoundsbecausetheyarenotthoroughenoughinestablishingacomplete'baseline'countofallmothersandchildren<5livinginthecompound
- supervisorsshouldemphasizeintheteamtrainingandinthefieldthat,inmulti-familycompounds,teamsshouldfirstconductasystematic'microcensus'("howmanymotherslivehere?","howmanychildren<5permother?”,etc.)beforestartingtovaccinatechildren,evenifthistakessometime
• completedocumentationofallabsent('non-available')children:
- mobileteamsmustlistthosechildrenonthebackofthetallysheetwhoresideinahousebutareabsent(non-available,orN/A)duringtheteamvisit,forlaterfollow-up
- itisstillacommonmistakethatteamsfailtoaskforanddocument'absentchildren'-theconceptofaskingforchildren'whoarenotthere'iseithernotunderstood,ornotapplied
- post-campaignmonitoringshowsthat'non-availability'isthemostcommonreasonforachildnottohavereceivedvaccine-showingthatthechildwaseithernotlistedas'N/A'andnotfollowedup,orthatfollow-upwasunsuccessful
- thenewhouse-basedtallysheetallowssupervisorsandmonitorstoquicklygaugewhetherornotateamproperlydocumentsandfollowsupN/Achildren;detectingandcorrectingthisproblemshouldbehighpriorityforfieldsupervisors
•samedayrevisittohouseswherechildrenwereabsent:
- dailyworkloadsareintentionallykeptlowenoughtoallowsufficienttimeforteamstorevisithouseswith'N/A'childrenoncefinishedcoveringtheirassignedareaintheafternoon,whiletheyarestillinthevicinity
- mostchildrenareabsentfromhomeforshortperiodsandthereisamorethan50%chancetofindandvaccinateachildifarevisitismadeonthesameday
- failuretofollowthiscriticalruleisstillverycommon,and'pushing'teamsforbettercomplianceshouldbehighpriorityforsupervisorsandmonitors
• howtorespondtonon-compliance/refusals
- ingeneral,numbersofchildrennotvaccinatedduetorefusalarelow,andnotincreasing;failuresandmistakesduringh-himmunization,particularlylackofdocumentationandfollow-upofabsentchildren,contributesamuchlargerproportionof'finallymissed'children
- refusalsarestillanissueinsomeareas,includingsome'chronicrefusalfamilieswhorejectOPVduringeveryround.Itiscriticaltounderstandthereasonsforrefusals
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 17
anddocumentandtrackthisinformationincludingthemaintenanceofadetailedrefusallogbook.
- however,teamsinmostareascanrelyonsupervisors,socialmobilizersorothercommunitymembersand'influencers'tobeavailablequicklytohelpresolvetheproblem.Therefore,itiscriticaltoincludeinformationoninfluencersavailableineachareaandplanongettingtheirsupportinvisitingrefusalfamiliesduringthecampaigns.
- Considerableworkshouldbedoneinaddressingrefusalsinbetweentheroundsthroughappropriatesocialmobilizationandcommunicationinitiativesandactivities.Theseapproachesrelayonlocalinfluencersandsocialmobilizers.
- ingeneral,numbersofchildrennotvaccinatedduetorefusalarelow,andnotincreasing;failuresandmistakesduringh-himmunization,particularlylackofdocumentationandfollow-upofabsentchildren,contributesamuchlargerproportionof'finallymissed'children
• Screeningforzero-routineinfants
- inadditiontoinformingfamiliesabouttheneedforroutineimmunization,theteammembersshouldinquireabouttheroutineimmunizationstatusofthechildren<1yrofage;
- anyinfantwhohasneverbeenvaccinatedotherthanwithOPV('zerodoseroutine')shouldbenotedonthetallysheetandreportedtothelocalEPIvaccinator,forlaterfollow-up
6.3Teamsattransitsitesandroamingteams
Theobjectiveforbothtransitandroamingteamsistoidentifyandvaccinatechildrenwhoaremovingoutsidethehouseduringthecampaign,i.e.thosewhoshouldbedocumentedas'non-available'bymobile(house-to-house)vaccinationteams.
Transit-siteteams:
• pre-campaignplanningshouldincludetheselectionofthose'transitpoints/sites'(entryandexitpoints,transportationterminals)whereenoughfamilieswithsmallchildrenpassthroughtojustifytheplacementofoneormoretransitteams
• Teamsworkingatbusytransitpointsandintransportationterminalsshouldbeenergetic,pro-active,andkeepmovingaroundtoseekoutandvaccinatechildren<5.
• Atthebusiestroadtransitpoints,itmaybenecessarytorequestfromtheUCordistrictadministration,throughtheUPECmeeting,thatapoliceofficerbedeputedtoassistthevaccinationteamsbystoppingbusesorcars,orbykeepingbusesfromleavingaslongasateammemberisstillinsidethebusvaccinating.
Roamingteams:
• Roaming,or'floating'teams,shouldbeassignedtoworkinthosepublicplacesatatimewhenlargenumbersoffamiliesandchildrenarepassingthrough.
• Sitesthatmayneedroamingteamsincludesbazaars,streetmarketsorparks,butalsobusyMCHclinicsandpediatricoutpatientdepartments’atlargehospitals,attimes
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 18
whenthereisalargepatientflow.Itisimportanttoselectthemostpro-active,energeticvaccinatorsforthistask.
6.4Teamsatfixedsites
'Fixedsites'areestablishedduringthecampaigninmosthealthfacilities,includinginallfunctionalEPIcenters;fixedsitesarestaffedwithatrainedEPIworker.Alltarget-agechildrenvisitingthefacilityaregivenOPV,andfunctionalEPIcenterscontinuetoofferotherroutineEPIvaccines.ItisimportanttohighlightthatatthefixedsitesestablishedatfunctionalEPIcenters,tOPVisgiventoallthechildrenregardlessofthetypeofvaccinebeingusedduringthecampaign.Thesesitesremainopenfrom8amto5pmforfivedays.
Allhealthfacilitiesservingas'teamsupportcenters'(dispatchingofteams,storageofvaccinesandotherlogistics)arealsocampaign'fixedsites'andvaccinateallchildrenvisitingthehealthcenterswithOPV.
7 Micro-planningforhigh-riskpopulationsandareas
IneachUC,butparticularlyinthosedesignatedas'highrisk',therearesmallerorlargerareaswherehigh-riskpopulationgroupslive,eitherpermanentlyortemporarily.Thesegroupsaredesignatedas'highrisk'mainlybecausetheirchildrenareatriskofbeingmissedbybothroutineandsupplementaryimmunization.Thepresenceofincreasednumbersofchildrenwhoarenotimmuneagainstpolioputstheareaatriskofcontinuedviruscirculation.
7.1Categoriesofhigh-riskgroupsandareas
Thesehigh-riskgroupsinclude:
• mobileandmigratorygroups,includingnomads,seasonalmigrantsandbrickkilnworkers,andInternallyDisplacedPopulations(IDPs)andrefugees
• inhabitantsofslumareas,ethnicandreligiousminoritypopulations,clustersof'chronicrefusal'families,populationslivingininsecureorphysicallyremote,hardtoaccessareas(i.e.manyriverineareasalongtheIndus)orthoselivinginconservativecommunitiesnotallowingvaccinatorsintothevillage(vaccinatorssitsinguestroom:'utaq/hujravaccination')
Ofparticularconcernaresituationswherepopulationgroupsfitintomorethanoneofthesecategories,forexampleculturallyconservativeethnicminoritieswhoarealsomigratingtoandfrompolio-infectedareas.
7.2Overallmicro-planningapproachtohighriskgroups
ForUCpoliocampaignplanning,themostimportantfactorinfluencingthequalityofthecampaignisthat:
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 19
• AllhighriskgroupsandareasintheUCareidentifiedanddocumentedintheoperationalmicro-planandontheareamap,
• Specialeffortsaremadeincampaignplanningandimplementationtoreachchildrenbelongingtohighriskgroups,
• Specialsupervisory/monitoringplanfortheteamscoveringthesepopulations.
- ifthereareonlyfewsmaller‘pockets’ofhigh-riskgroupsintheUC,itissufficienttoinsert‘alerts’tothesegroupsintheexistingmicro-plan;forlargerhigh-risksettlements,separatemicro-plansshouldbemade
- UClevelcampaignplannersshouldassignthemostexperiencesupervisorsandteamstoworkinthehigh-riskareas
7.3Specialstrategiesformobileandmigratorypopulations
MobileandmigrantpopulationsaremoreimportantforthesuccessofthepolioprogrammeinPakistanthaninanyotherremainingpolio-endemiccountry.
Childreninthesegroupsrepresentahighriskfortheprogrammebecause:
• theyaremuchlesslikelytoreceiveeitherroutineorcampaignvaccinedoses,havelowlevelsofimmunity,andbecomeinfectedwithWPV
• theirhighmobilitybetweeninfectedanduninfectedareasalsomeansthattheyfacilitatethelong-distancetransmissionofWPVnationallyandbetweenPakistanandAfghanistan.
Recognizingtherisksassociatedwithmigrantgroups,thenationalpolioeradicationprogramhasdevelopedaspecificplantoensureimmunizationofmobile/migratorychildren.
Theimplementationofthenationalstrategytoensureimmunizationofmobilegroupsshouldbeprioritizedeverywhere,butparticularlyinthehighriskdistrictsandUCs.
Keyelementsofthemigrantstrategyinclude:
• mappingandlistingofmigrantcommunitiesandsettlementsandtheirinclusionincampaignmicro-plans
- atthedistrictandprovincelevel,healthteamsalsoneedtodocumentandconsidermovementpatternsofmobilegroupswithinandoutsidethedistrictandprovince
- assuringspeciallyrecruitedandwelltrainedvaccinationteamsthatareacceptabletothemigrantcommunity,includingmembersfromthatcommunity
- enhancedsupervisionofteamscoveringmobilecommunities
- specialtargetedcommunicationandsocialmobilizationstrategiesappropriatetothecommunity.
Morespecificcampaignstrategyelementstotargetmobileandmigrantgroupsinclude:
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 20
• adjustingthetimingofthecampaignactivityformobileandmigrantgroupsaccordingtotheirlifestyleandavailability
• developandusespecialcommunicationstrategies(advocacyefforts,jirgas,meetings,inaugurations)toreachmobileandmigrantgroup,whichincludesworkingwithcommunityleadersorother‘influentials’linkedtothegroups
• establishingspecialimmunizationsitesatthetravelrouteofmobilegroupsandnomads,particularlyattheknown‘chokepoints’wheretwoormoretraditionalmigratoryroutesmerge.
8 UpdatingtheUCmicro-plan
UC-levelpoliocampaignmicro-planshavebeenusedformanyyearsandalreadyexisteverywhere.Theyarenotnewlydevelopedforeachround,butreviewed,andupdated,ifnecessary(i.e.additionofteams,changeinareaallocatedtoteams,orchangeofteammembers).However,micro-plansareseldomthoroughlyreviewedorcompletely’re-done'.
Asdiscussedearlier,theUCpolioteam(healthteammembers:MOH,AICs,LHSs,ZS)shouldconductamicro-planningmeetingabout2weeksbeforethecampaignbegins,justbeforethemeetingoftheUPEC.
7.1Activitiesinadvanceofthemicro-planningmeeting
Severalimportantpiecesofinformationwillneedtobecollectedbeforethemicro-planningmeeting,inordertofinalizethemicro-planupdate:
• fulllistofteammembers:allAICsshouldhavecontactedtheirgroupofvaccinationteammembers,andshouldhavefilledpossiblegapswithnewlyrecruitedteammembers.Likewise,inlargeUCs,theZSsshouldhaveidentifiednewAICs,ifnecessary;
• walk-throughthearea:ForAICswhoarenewlyassignedtoanarea,orifadecisionismadetocompletelyre-dothemicroplan(includingre-drawingoftheareamap),theAICsand/orZSshouldalsowalkthroughandinspecthisorherassignedarea,todocumentanychangesornecessaryupdatestobemade(i.e.newslumorIDPsettlement,newlybuilthousesetc.)beforethemicroplanningmeeting.
7.2ActivitiesattheUC'microplanning'meeting
ThemeetingtoupdatetheUCmicroplanshouldbechairedbythechairpersonoftheUPEC(eithertheUCMOoraseniorparamedic)andattendedbyallZSsandAICsand,whereavailable,bytheWHOandUNICEFUCsupportpersons.
Sincemicroplansarearea-based,participantscouldsplitupinsmallergroupsworkingononeareamicroplanupdateeach;inlargeUCswithmorethanoneNID'zone',themicroplanreviewmaybedoneinparallelbytwoormoregroupseachconsistingoftheZSandAICsofonezone.
Thefollowingareimportantactivitiesduringthemicroplanupdatemeeting:
4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 21
• updatingthelistofteammembers/namestoassurethatacompleteworkforceisavailableatthetimeoftheSIA
• reviewingtheUC'sperformanceduringthelastcampaignandtheperiodsincethen,particularlyiftherewereindicationsthatoneormoreadditionalteamswereneededfortheupcominground(i.e.in-migrationofmobilegroupsetc.)
• highlightingmainproblemsthatoccurredduringthepreviouscampaign,suchaswhereareasweremissedorpoorlycovered,withpossibleimplicationsforassigningteamsetc.
• assuringthatimportantinformationaboutthemovementofhigh-riskgroups(nomads,migrantpopulationetc.)inandoutoftheUCsincethelastSIAisnotedinthemicroplan,and,ifappropriate,ismarkedintheUC-levelmaps
• updating,ifnecessary,the‘socialmap’oftheUC(eachzone)
• verifyingthefunctioningandavailabilityofcoldchainequipmentinthemainUChealthfacilitiesandteamsupportcenters(ILRs,vaccinecarriers,icepacks,coldboxesetc.)
• reviewingplansfordistributionofvaccineandlogistics,forpre-campaigntraining,andforsocialmobilization/informationactivities
• establishingwhetheranychangesmade(i.e.additionalteams)willincreasetheUC'sresourcerequirements(vaccine,nailmarker,chalk,formsetc.),andassuringthatthedistrictteamwasinformedaboutthissoon.