Emergency Preparedness and Response Planning Uttar Pradesh 24 th 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 1 st Jul –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 1 st 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=602N=10 N=29 N= Distribution of Wild Polio Virus cases Western UP is the strategic priority area in the state

High Risk Districts in UP* 66 HR Blocks - West UP * Source : 20 th IEAG Jun 2009

High Risk Areas of UP MIGRATORY 44,130 SETTLED 11,491 1 dot = 10 Sites

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 Declining resistance in high risk districts of West UP

Using every opportunity – Vaccinating children at Melas & Congregations ActivityDistrict Total Children Immunized Dargah Mela Bahraich122,908 Magh MelaAllahabad47,864 Mela Karikot Bahraich22,463 Lakkad Shah Baba Bahraich3,998 Ajmer UrsAgra1,045 Mudiya Poornima Mela Mathura3,192 Jai Gurudev Mathura1,202 Garh Ganga Mela Ghaziabad12,771 Total215,744

Special Activity for Coverage of migrants between Polio Campaigns SIA Rounds

Vaccination post Blocks 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, vaccination posts

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

Using information from Polio microplans for updating RI microplans to ensure all populations are covered Polio Microplan RI Microplan Areas in included in RI micro plan Areas identified for inclusion in RI Plan from SIA micro plan ~ new areas identified for inclusion in RI Micro plan

Data sources: CES- Coverage Evaluation Survey NFHS III - National Family Health Survey DLHS- 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 Blocks Non Polio AFP Rate HR Blocks Average – 58 0 to 2 3 to 5 6 to 9 10 and above

Strengthened AFP Surveillance in Migratory Population * Data as on Wk 09, 2012

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)

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