Emergency Preparedness and Response Planning

Uttar Pradesh24th IEAG

15 – 16 March 2012

Director General, Family Welfare Govt. of UP

Outline of Presentation• Formation of State Emergency Response Group

and Rapid Response Team Members

• Risk Assessment to identify High Risk Areas

• Actions following risk assessment

– Sustaining high Immunity levels

– Routine immunisation & Convergence

– Strengthening AFP Surveillance

• State preparedness for undertaking emergency mop up

Status of Polio in UP• The state of UP has always been one of

the 2 endemic states in India for polio• The transmission of polio virus was

however interrupted twice in the state– No polio case has been reported for the past

23 months• However the threat of re-introduction of

polio virus remains and hence the state has prepared an elaborate plan to deal with such a situation

State Emergency Response Group and Rapid Response Team

• The Govt. of UP has formed a State Emergency Preparedness And Response Group under the chairmanship of Principal Secretary through notification on 1st Jul 2011.

– This group includes 9 members from the State Govt. and other members from partner agencies

• Also a Rapid Response Team has been formed through notification on 1st Jul 2011 which includes 5 senior experienced DIOs

– They have been prepared to move to the affected districts as and when the need arises for supporting the district authorities

Risk Assessment

N=1242 N=88 N=82

N=341

N=305 N=602 N=10

N=29 N=548

2002 2003 2004

2007

2009 2010

20062005

2008

Distribution of Wild Polio Virus cases2002 - 2010

Western UP is the strategic priority area in the state

High Risk Districts in UP* 66 HR Blocks - West UP

* Source : 20th IEAG Jun 2009

High Risk Areas of UP

MIGRATORY

44,130

SETTLED

11,491

1 dot = 10 Sites

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Actions in High Risk Areas following Risk Assessment

Strong oversight to programme

• Regular review meetings by Principal Secretary– State task force meeting before each SIA– Review with DMs and CMOs through video conferencing – Review of SIA and RI quality in monthly/ quarterly DIOs

meeting

• Increasing district administration’s involvement – DO letters to DMs of High risk districts– District Task Force meeting before round chaired by DMs– Daily evening review meeting at district level by the DM /

CMO and block level by the Medical Officer In charge

Engaging community leaders in pockets of Refusals

~ 70% House to House Teams in High Risk Areas are accompanied by influencers during revisits

2006 2007 2008 2009 2010 2011

Declining resistance in high risk districts of West UP

Using every opportunity – Vaccinating children at Melas & Congregations - 2011

Activity DistrictTotal

Children Immunized

Dargah Mela Bahraich 122,908

Magh Mela Allahabad 47,864

Mela Karikot Bahraich 22,463

Lakkad Shah Baba Bahraich 3,998

Ajmer Urs Agra 1,045

Mudiya Poornima Mela

Mathura 3,192

Jai Gurudev Mathura 1,202

Garh Ganga Mela

Ghaziabad 12,771

Total 215,744

Special Activity for Coverage of migrants between Polio Campaigns

SIA Rounds

Vaccination postBlocks with vaccination post

Continuous vaccination along Indo-Nepal border

Total No. of Children Immunized in 2010 – 2,51,243

Total No. of Children Immunized in 2011* – 5,85,116

30 vaccination posts

Percent children < 2 yrs found unimmunized during end of the round survey, Uttar Pradesh

2009 2010 2011 2012

High Coverage Sustained Over SIAs

• Merger of Polio SIA and RI micro plans completed

• Additional immunization camps organized in low coverage areas

• Special RI campaign conducted- 14 Dec to 15 Feb 2012

• Due list of beneficiaries being used by ANMs for tracking Village wise RI coverage

• RI monitoring in all districts, especially in HR blocks

Strengthening Routine Immunization

Cykd@izk0 Lok0 dszUnz@'kgjh {ks= % l #jiqj [kqnZ Ik; Zos{kd dk uke % izHkkjh fpfdRl k vf/kdkjh % Mk jkds'k pUnzk l SDVj bapkt Z % Mk fouksn dqekj pj.k &fnl Ecj 2009Ø0 l a0 Vhe l nL;ks ds uke in i zFke fnu f}rh; fnu rr̀h; fnu prqFkZ fnu

vkcknh dk i zdkj

vkPNknu gsrw p; fur {ks= gjkZ (HRA) gjkZ (HRA) gjkZ (HRA) gjkZ (HRA)i zFke ?kj ds eqf[k;k dk uke igpku

l hy l fgr eqxyhl iq= dYyu

fcuksSSyh jksM bLykfe; k cMkenjl s ds

vUnj l s uQhl ukbZ pkSd ckt kj l knsvyh xksVdk jksM vafre ?kj ds eqf[k;k dk uke igpku

l hy l fgr vkt e iq= 'kq#nnhu ek

vyhiqjk dYyu /kksch egy ds i kl Mk bnzh'k cMh efLt n i kl

dkfle iq= vuoj cMh efLt n ds i kl

dk;Z {ks= esa vkus okys Ldwy enjl ks ds uke bLykfe; k cMk enjl k xqMfou i fCyd Ldwy & &

vuqekfur ?kjksa dh l a[;k 97 86 73 98

LFkkuh; rr̀h; l nL; dk uke t Scqefu'kk vk ck t Scqefu'kk vk ck t Scqefu'kk vk ck t Scqefu'kk vk ck

LFkkuh; i zHkko'kkyh O; fDr dk uke bjQku vkl eksgEen ukbZ ekS vuhl i znhi

nksigj ckn ehfVax dk LFkku jkds'k v/; kid ds ?kj jkds'k v/; kid ds ?kj jkds'k v/; kid ds ?kj jkds'k v/; kid ds ?kj

l h0,e0l h0 dk uke uhjt uhjt uhjt uhjt

1- midsUnz gjkZZ midsUnz gjkZZ midsUnz gjkZZ midsUnz gjkZZ

2- deys'k 'kekZ fczt s'k fczt s'k fczt s'k

3- midsUnz gjkZZ xqMfou i fCyd Ldwy eat wj <sdsnkj rkfgj i Vokjh dh cSBd

4- f}rh; cq/k o prqFkZ

'kfuokj f}rh; cq/k prqFkZ 'kfuokj prqFkZ cq/k

5- csch csch js'kek mfeZyk

6- & & & &

7- t Scqefu'kk vuhrk csch ukt ek

8-

9 jkt chj flWg jkt chj flWg jkt chj fl Wg jkt chj flWg

midsUnz dk uke

,0,u0,e0 dk uke

l = fnol

vkaxuckMh l gkf;dk dk uke

l = LFky dk irk

l ?ku iYl i ksfy;ks vfHk;ku 2009?kj&?kj Vhdkdj.k gsrw dk;Z;kst uk

{ks=h; fu; fer Vhdkdj.k dh t kudkjh

44

J herh fczt s'k , ,u ,e

ekS fjt oku LoSå

l = l EcfU/kr vk'kk dk uke

l = l EcfU/kr eksfcykbZt j dk uke

l = l EcfU/kr vkaxuckMh dk uke

LokLF; i ; Zos{kd dk uke

Using information from Polio microplans for updating RI microplans to ensure all populations are covered

Polio Microplan

RI Microplan

100000

150000

200000

250000

Areas in included in RI micro plan Areas identified for inclusion in RI Plan from SIA micro plan

~ 23 000 new areas identified for inclusion

in RI Micro plan

2330

41

5257 57

0

10

20

30

40

50

60

70

80

90

100

NFHS-III [2005-06] DLHS-III [2007-08] CES [2009] Jan-11 Aug-11 Dec-11

Data sources: CES- Coverage Evaluation SurveyNFHS III - National Family Health SurveyDLHS- District Level Household & Facility Survey

Evaluated coverage of fully immunized

RI monitoring through NPSP,GOVT,UNICEF, CORE, MCHIP & MI

Initiatives improving RI coverage

Convergence mission in High Risk Blocks WASH Convergence:

• 48,540 dry latrines converted into flush toilets in Badaun

• 51,000 conversions planned in Meerut.

Surveillance quality in High Risk Areas

* Data as on Wk 09, 2012

High Quality Surveillance in 66 HR BlocksNon Polio AFP Rate - 2011

HR Blocks Average – 58

0 to 23 to 56 to 910 and above

Strengthened AFP Surveillance in Migratory Population

* Data as on Wk 09, 2012

299

399

485

0

100

200

300

400

500

2009 2010 2011

AFP Cases in Migrants

Day 0- Alert to State EPRG, RRT, District

Day 1- State EPRG meeting, Order logistic, RRT deployment, Media management

Day 2- RRT in district, MO meeting, Partner meeting,Training schedule

Day 3- DTF, Micro plan review, District official assignment, media briefing

Day 4- BTF, TOT, Cold chain starts, Social mob activities begin

Day 5 & 6- Vaccinator Supervisor trainings, Microplan review, BTF Completion

Day 7- DTF- II, Vaccine & Logistic to block, scale up IEC & Soc mobilization

Day 8- Vaccinator & Sup training completed, IEC display

Day 9- Media release, Monitors briefing

UP Emergency Mop up Timeline

Day 10- Campaign starts

Summary

• Risk assessment completed in the state

• Efforts to sustain high immunity levels

• Intense surveillance for earliest detection of transmission

• State committed to start emergency mop up with in 10 days (if needed)

Thanks…