4 Guideline - UC level microplanning 19-11-12 (Final) ref€¦ · - play an important role as 'influencer' in convincing families who refuse vaccination ... (or senior paramedic if

4_Guideline-UClevelmicroplanning19-11-12(Final)_ref.doc 1

GUIDELINES

UnionCouncilMicro-planningforvaccinationcampaignsPolioEradicationInitiative,Pakistan

November2012


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.


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


- 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-


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:


• 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:


• 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


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.


• 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),


- 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


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.


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.


• 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.


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


• '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


- 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


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


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:


• 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:


• 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:


• 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.

Documents

4 Guideline - UC level microplanning 19-11-12 (Final) ref€¦ · - play an important role as 'influencer' in convincing families who refuse vaccination ... (or senior paramedic if