1. COVERAGE IMPROVEMENT PLANNING (CIP)

2. Infant Immunization Coverage 1998 - 2002

3. TARGET COVERAGE & ACHIEVEMENT

4. OBJECTIVE To improve immunization coverage in selected areas by implementing extra activities to vaccinate extra children

5. PROCESS OF CIP 1)- Selected areas: Kg. Som, Kien Svay, Mong Russey, Battambang, Sangke, Ochrov, Mongkulborey, Tbaung Khmum, Pognea Krek, Kg. Cham, Lech, Tbaung, Choeung, Kandal 2)- Number of children < 1 missed DPT3 in these 14 ODs: 41,918 2)- CIP meetings were conducted to discuss micro-planning with health center staff in all 14 ODs. 3)- 8 ODs have submitted the proposals to NIP. On average it will cost approximately US$ 4 to vaccinate an extra child 4)- There will be agreement made for the payment for the 3 rd and last quarter of 2003. The agreement will be clearly defined ROLE and RESPONSILITY of health center staff, OD, PHD, and NIP

6. SELECTED AREAS top 14 Ods with many children missed DPT-3 in 2003 NAME OF OD# UN-IMMUNIZED DPT-3 IN 2002 - Battambang + Sangke:6,367 - Kg. Cham:4,289 - kandal:4,072 - Lech:3,812 - Pognea Krek:3,772 - Kien Svay:3,678 - Mong Russey:2,777 - Tbaung Khmum:2,769 - Tbaung:2,753 - Mongkulborey + Ochrov: 2,700 - Choeung:2,488 - Kg. Som:2,441 TOTAL:41,918

7. SUMMARY OF FINDING FROM CIP PLAN I. REASONS FOR LOW VACCINATION COVERAGE -Poor community participation due to knowledge, poverty, site effect, etc... -Poor involvement from volunteers / local authority -Not enough outreach sessions -Houses are scattered -Lack of transportation to remote villages -Lack of transportation during rainy season -Minorities -Mobility -Slum -Insecurity

8. SUMMARY OF FINDING FROM CIP PLAN (Cont.) II. EXTRA ACTIVITIES PLANNED TO INCREASE COVERAGE -Conduct IEC (mass media, inter-personal communication, meeting with community, meeting with volunteers/authorities) -Increase number of outreach sessions -Conduct catch-up activities -Transportation to remote or flooded areas -Transport vaccine -Conduct special outreach activities in slum and remote areas -Conduct quality supervision and Post Activities Assessment -Conduct meeting with health staff

9. SUMMARY OF EXPECTED EXTRA NUMBER DPT3 & EXTRA FUND REQUIRED

10. COMPARISION OF GOVERNMENT FUND TO EXTRA FUND REQUIRED

11. BENEFITS AND RISKS POTENTIAL BENEFITS -HC can map out areas where children were missed -HC can identify reasons why children were missed -HC can prepare a perfect plan of activities to cover well its responsibility areas -HC can cost properly its plan of activities POTENTIAL RISKS -It costs very expensive to vaccinate and extra child ($4 per an extra child) -Government budget may not be able to support some of these extra activities, even in the future -Not sure will be able to expand to ALL ODs -Sustainability depend on DONNERS

12. WHAT ELSE NEED TO BE DONE IN THE FUTURE Need to follow-up the progress of CIP implementation Need to expand CIP implementation to other operational district Need to modify CIP strategy ???