Application of LQAS for

CGPP India

CORE Group Spring Meeting 2012 Wilmington, Delaware, USA

CGPP Coverage - Uttar Pradesh, India

Description of LQAS study

Area:Districts – 10, Blocks - 56

BeneficiariesHouseholds – 571, 506Estimated children under 5 years – 570,000Estimated population – 4,000,000

Functionaries:Implementing NGOs: 10Sub-regional Coordinators (SRCs) - 3District Team Leader (DTL) - 1District Mobilization Coordinators (DMCs) – 13District – MIS Coordinators - 10District Underserved Coordinators (DUCs) - 5Block Mobilization Coordinators (BMCs) – 95 Community Mobilization Coordinators (CMCs) - 1315

KRI

SBD

STP

LLP

HDO

JAL

JNS

AHB

BJN

BAD

BRC

PIL

SHA

MZP

BRL

FTP

BNA

JNP

UNN

AZG

MZN

AGR

ALG

SHP

BBK

HMP

BLS

GND

PTG

KSN

MRD

BRP

RBL

FAI

GZP

BAL

GRPBST

KPN

CKT

MTR

MAI

KPDSULCSN

MHB

ETA

SDN

MRT

LNO

DOR

JPN

FKB

CND

FER

ABN

RMP

MHG

ETW

KNA

KAN

AUR

GZA

HTR

KSM

SRW

MAU

SKN

VRN

BGT

GBN

BDH

Objectives

To assess reach and quality of IPC activities of CMC (Home visits & mothers’ meeting)

To assess awareness of mothers about routine immunisation (Given and due vaccines, vaccination site, etc.)

To know perceptions of mothers towards polio vaccination

To assess practices related to diarrhoea management

Description of LQAS study

Block A

Block F

Block E

Block D

Block C

Block B

District X

CGPP block

Non-CGPP block

MethodologyDescription of LQAS study

Block D

SA 1

SA 2

CMC area (village/ward)

Non-CMC area (village/ward)

Catchment Areas(CA) Work area of a DMC or CGPP work area in a district

13Supervisory Areas(SAs) Work area of a BMC in a block

94

Block G

MethodologyDescription of LQAS study

Round 1 - ProcessDescription of LQAS study

LQAS-2011* Percentages are weighted by population of supervisory areas

Key Findings - Aggregated weighted coverage of 94 SAs

Full Immunization Status (Source: Govt. RI card/Congratulatory card of CGPP)

n=286n=419

CES- 2009, UP CGPP Midline-2010

n=1112n=605n=135

Fully immunised = Received BCG, 3 DPTs, 3 OPVs and measles dose

* Percentages are weighted by population of supervisory areas

Key Findings - Aggregated weighted coverage of 94 SAs

Vaccination status of children aged 10-11months(Source: Govt. RI card/Congratulatory card of CGPP)

n=286

n=1786 n=603n=1786

CGPP Midline-2010 LQAS-2011

* Percentages are weighted by population of supervision areas

Key Findings - Aggregated weighted coverage of 94 SAs

LQAS-2011

* Percentages are weighted by population of supervisory areas

Key Findings - Aggregated weighted coverage of 94 CAs

Home Visits of CMC

n=1783

CGPP Midline-2010

n=603

LQAS-2011* Percentages are weighted by population of supervisory areas

Key Findings - Aggregated weighted coverage of 94 CAs

Attendance in Mothers’ Meetings

n=1777

CGPP Midline-2010

n=603

* Percentages are weighted by population of supervisory areas

Key Findings - Aggregated weighted coverage of 94 SAs

Mothers exposed to IEC material of CGPP, India

n=1786

Set target 40.0

Midline- 2010 7.0

* Percentages are weighted by population of supervision areas

n=521

* DPT3 Status based on routine immunization card and/or mother's recall

Exploratory data analysis - Determinants of DPT3

DPT3 Coverage, Children > 3.5 Months of Age*

n=1256

DPT3 Coverage by Caretaker’s Attendance at Mothers’ Meetings, Children > 3.5 Months of Age*

* DPT3 Status based on routine immunization card and/or mother's recall

Exploratory data analysis - Determinants of DPT3

** Significant adjusting for clustering and weighting

DPT3 Coverage by Mothers exposure to IEC messages, Children > 3.5 Months of Age*

* DPT3 Status based on routine immunization card and/or mother's recall

Exploratory data analysis - Determinants of DPT3

** Significant adjusting for clustering and weighting

[Among mothers exposed to recent Mother's Meeting or IPC home visit]

DPT3 Coverage by Mothers exposure to RI leaflet, Children > 3.5 Months of Age*

Exploratory data analysis - Determinants of DPT3

** Significant adjusting for clustering and weighting

* DPT3 Status based on routine immunization card and/or mother's recall

[Among mothers exposed to recent Mother's Meeting or IPC home visit]

DPT3 Coverage by Mothers exposure to Flash Cards, Children > 3.5 Months of Age*

Exploratory data analysis - Determinants of DPT3

** Significant adjusting for clustering and weighting

* DPT3 Status based on routine immunization card and/or mother's recall

[Among mothers exposed to recent Mother's Meeting or IPC home visit]

DPT3 Coverage by Mother’s recognition of CMC by designation, Children > 3.5 Months of Age*

Exploratory data analysis - Determinants of DPT3

** Significant adjusting for clustering and weighting

* DPT3 Status based on routine immunization card and/or mother's recall

[Among mothers exposed to recent Mother's Meeting or IPC home visit]

DPT3 Coverage by Gender of Child, Children > 3.5 Months of Age*

* DPT3 Status based on routine immunization card and/or mother's recall

Exploratory data analysis - Determinants of DPT3

** Not Significant adjusting for clustering

and weighting

DPT3 Coverage by Mothers Literacy Status, Children > 3.5 Months of Age*

* DPT3 Status based on routine immunization card and/or mother's recall

Exploratory data analysis - Determinants of DPT3

** Not Significant adjusting for clustering

and weighting

DPT3 Coverage by Recent IPC Visit to Home, Children > 3.5 Months of Age*

* DPT3 Status based on routine immunization card and/or mother's recall

Exploratory data analysis - Determinants of DPT3

** Not Significant adjusting for clustering and

weighting (e.g, recent IPC visits were almost universal, sample size small

among those without recent visit)

Strategic decisions based on findings

Some of the identified areas of concern

Routine immunisation status (% received 0 OPV, DPT3, Measles)

Awareness of mothers about vaccination status (given or due) - 0 dose, 3 DPTs, vitamin A

Receiving and retaining of government RI card (% received and able to show)

Receiving and retaining of congratulatory card & poly bag (Given by CGPP) (% received and able to show)

Attendance at mothers meetings

Decisions and actions New born tracking and focused 1-1 contacts

Listing pregnant women and newborns 1-1 contacts to listed houses for delivering messages related to zero

OPV, routine immunization and other messages related to institutional delivery

Scheduling RI sessions/ Conduct RI Camps/ RI drives Review of missed sessions and reasons Discussion with block and district government officials to reschedule

sessions Weekly sharing of status of RI sessions with govt. functionaries

Ensure message delivery during mothers’ meetingsStandardized norms of monitoring routine immunization

Area of concern – Improve zero OPV coverage indicator - % children received OPV 0 Wtd. Average coverage = 49%

An Example- Strategic Actions based on findings

Thanks…….