Emergency Preparedness in Haryana Dr Suresh Dalpath DDCH / SEPIO Haryana

Contents... Situation Analysis Risks Mitigating risks Response Plan Summary

Location of Wild Polio Virus in Haryana ( ) DistrictP1P3 AMBALA20 FARIDABAD62 FATEHABAD10 GURGAON41 HISAR40 JHAJJAR20 KAITHAL10 KARNAL10 KURUKSHETRA10 MEWAT227 PALWAL71 PANCHKULA41 PANIPAT62 ROHTAK01 SIRSA10 SONEPAT51 YAMUNANAGAR10 Data as on 8 July 2011

HR DistrictsDistrictWPV WPV Cases >=4 Years345 WPV Cases 2-3 Years732 WPV Cases 1 Years77 No WPV Case40 Total2184 HR Blocks (WPV) HR Blocks (Other factors) Haryana - High Risk Districts & Blocks

Risks... History of Importations of WPV from other parts of country Huge migration from endemic states Large number of construction sites Mewat had WPV every year for last 10 years Polio High risk areas have poor RI coverage ~ Mewat

Importations in >=4 years Importations in 2-3 years Importation in a year with multiple cases No importation or importation in a year with single case Incidences of WPV importation ( ) HARYANAMEWAT HARYANAFARIDABAD HARYANAHISAR HARYANAJHAJJAR HARYANAPANCHKULA HARYANAPANIPAT HARYANA SONEPAT Data as on 8 July 2011

Mitigating Risks… Polio on the priority list of state Focus on HR districts Identification and validation of High Risk Areas (migratory & settle population) Prioritization of HRAs for coverage during SIA and RI activities Filling up vacant post at HR districts State officers closely monitoring activities

Slums with Migrants Nomads Brick Kilns Construction Sites Others Field Validation Completed Field Validation Completed Partially Field Validation Planned Field Validation not yet Planned Total Sites Validated = 8838 Total Households = Total Children 0-5 yrs = Identification and Validation of High Risk Areas Data as on 8 July 2011

Strengthening SIA activities: Mewat Focus on 6 High Risk PHC areas Booth and HtH plan segregated Extensive revision of microplan. Training of Supervisors and vaccinators by experts Close supervision and monitoring by Govt officials and partners

Interventions at HR PHC Areas: (Mewat June SIA) in % Source of data: NPSP Mewat unit. Data as on 8 July 2011

Out come at HR PHC Areas: Mewat (June 11 intervention)

Below 25% 25% - 50% 50% - 75% Above 75 % OPV 3 Coverage (DLHS III) Routine Immunization in the State Fully Immunized Children (DLHS III) Mewat district had fifth lowest FI coverage in the country Data as on 8 July 2011

RI Challenges at Mewat Low socio economic condition with poor infrastructure Vacant post of ANMs & other health staff Inadequate public transport and difficult terrain –ANM not moving in the field –Not giving sufficient time for RI activity –Supervisors not moving in the field. Less demand generation

Overcoming RI Challenges (Mewat) Filling up of vacant ANM positions is in process Flexibility in requirement of district program officers Micro plan revision and work rationalization Every PHC is hiring 1-3 vehicles for session days. Earmarked vehicle for every 3-4 sessions. ANMs and Supervisors move from PHC in the morning with logistics Vehicle drops vaccinators one by one, en-route as per plan and collect them after sessions Supervisor/MO supervise simultaneously. Budget is provided by NRHM and Mewat Development Agency

Vaccinators along with supervisor moving from PHC to Session site in earmarked vehicle

Vaccinator reaches remote minority area for RI activity and stays till the vehicle returns back

Increase in RI coverage at Mewat* (Sept May10-11) Antigen% Increase BCG21% DPT-129% DPT-242% DPT-349% Measles29% * Based on reported coverage Data as on 8 July 2011 Validation exercise done In May 2011

Emergency Preparedness and Response Plan State EPRG notified on 27 May 2011 –Principal Secretary Health : Chair person –MD NRHM : Vice Chairperson –DGHS : Secretary All Deputy Commissioners appraised in review meeting chaired by Hon'ble CM. Meeting of State Steering Committee is planned on 4 th of July Plan to orient the heads of key Deptt. i.e. Panchayati Raj, Education, Social Welfare etc.

Status of State EPR Action listStatus State EPRG FormedYes ( notified on 27 May 2011) State Rapid Response Team (RRT) identifiedYes No. of RRTs identifiedSix Training conducted for RRTYet to be conducted HR Districts and HR areas within Districts identified Yes Senior Govt Officials identified and assigned to HR Districts Yes Communication Risk Analysis UndertakenIn process Communication Plan developedIn process Media Response Plan developedInitiated Developed a plan to increase polio SIA Coverage in HRAs Yes Developed a Plan to increase RI Coverage in HRAs 1 st draft ready, being reviewed Data as on 8 July 2011

Emergency Preparedness Plan notified on 27 May 2011

EventsDay Confirmation of WPV0 State EPRG Meeting1 Intensified HR Plan (state, Partners)2 Operationalize Media Plan2 District Task Force Meetings2 Micro plan Review and Orientation of workers3-5 Inter - Agency Coordination Meeting3 Procurement of Marker pen & IEC materials4 Distribution of logistics5 Mop up activity starts7 Post activity review and report12 Proposed Emergency Response Plan

Summary... High risk of importation of WPV cases in the state State has identified HR districts & blocks Focus on the HRAs for SIA & RI activities State has Emergency Response Plan in place State can implement mop up activity on detection of WPV within a week

Thanks Please be assured! State is committed !! & Together We will do it……