Location of poliovirus by type, 2009* ** One case reported mixture of P1 wild & P3 wild * data as on 30 January, 2010

Centre State District Chief Minister Chief Secretary Principal Secretary, H&FW District Magistrate Chief Medical Officer Medical Officers Supervisors Vaccinators Minister Secretary Ops Group Program Structure

Supplementary Immunization Activities in India Strategy and Implementation

Key Eradication Strategy IMMUNISATION is one of the key strategies Every year : –Two nation-wide immunisation rounds called National Immunisation Days are held –Almost every month immunisation rounds called Sub National Immunization Days are held in states and areas at risk of polio (UP, Bihar and Delhi and Mumbai and their surrounding areas) 2 drops of OPV given to children under 5 yrs

SIAs in India During each NID : –172 million children immunized –209 million houses visited by vaccination teams –2.3 million vaccinators deployed –155,000 supervisors deployed

Vaccine Vial Monitor (VVM) on each vial to assure quality vaccine is delivered The square is lighter than the circle. If the expiry date is not passed, use the vaccine The square is lighter than the circle. If the expiry date is not passed, use the vaccine The square matches the circle. Do not use the vaccine. Inform your supervisor The square is darker than the circle. Do not use the vaccine. Inform your supervisor

Booth Day on Day 1 (Sunday) Strategy for NIDs

Vaccinators go house to house & look for unimmunised children from day 2 to 6

Each team is composed of 2–3 members Vaccinator Record-keeper/guide Local community Vaccination Teams H-T-H

Vaccinators need good inter personal communication skills to enable entry into households to accurately determine the number of < 5 year children for vaccination

House to house vaccinators identify unimmunised children & give them two drops of OPV

After vaccinating Marking left little finger with indelible ink marker pen Filling newborn booklet & tally sheet House marking

Marking Houses P Date All 0-59 month children of this house got OPV dose of this round and no child is left or no 0-59 month child in this house X Date One or more 0-59 month child of this house did not get OPV dose of this round: child is absent or house is locked or uncooperative family

House markings 11/01/10 X – 68 P – 67 T. No. – 5 Houses marked with chalk or geru Team No. House No. Date of visit

Each Household marked Revisits to X houses also marked House Marking

Programme focus :Repeated visits to households to ensure all children get OPV First visit by A team Revisit late afternoon on same day (biphasic activity) Repeated visits on following day Visit by supervisor B team visit

UP X tally sheet

Bihar X tally sheet

Programme focus : newborns

Immunization of the youngest children RI card to track polio SIA doses Vaccinators booklet to track polio SIA doses in new borns Newborns being identified, vaccinated and tracked for 8 SIAs in UP and Bihar

Vaccination teams deployed to cover children in transit – bus stands, highways, markets etc. 450 teams in running trains on major routes Additional teams at platforms Coverage of children in transit 5 million children in transit immunized in UP, Bihar, Mumbai each round

Transit Teams Proactively seek & immunize children in transit

One or two member vaccination teams on two wheelers to immunize children at brick kilns, construction sites, isolated nomadic populations, hard to reach areas like river banks, orchards etc. Teams visit each site twice during each round due to frequent turnover of families Mobile teams

1.Brick Kilns 2.Construction sites 3.Slums 4. Nomads Programme focus : Migrant population at

Programme focus :Access compromised areas in Bihar

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