1. PERFORMANCE AUDIT FOR TRIGGERING IDA BUY-DOWN Dr.Mizan Siddiqi, Principal Investigator PUBLIC HEALTH SERVICES AND SOLUTIONS (PHSS) NOW MORE THEN EVER: STOP POLIO FOREVER www.thephss.org

2. BACKGROUND PARTNERSHIP FOR POLIO ERADICATION PROJECT (PPEP) was funded by WB since 2003 through “IDA Buy-down mechanism” The buy-down will be triggered based on the results of performance audit by an independent auditor PHSS has been awarded to conduct the audit NOW MORE THEN EVER: STOP POLIO FOREVER

3. STAKEHOLDES MEETING: PURPOSE Present objective, methodology, timeline and details of the plan Agree on the plan, objective, methodology and timeline Define Roles and Responsibilities of partners in the exercise Provide feedback on the instruments, analysis and outcome of the exercise NOW MORE THEN EVER: STOP POLIO FOREVER

4. APPROACH Participatory Consultative Objective: Evidence Based Both qualitative and qualitative information will be used to analyze performance and conclude findings NOW MORE THEN EVER: STOP POLIO FOREVER

5. OBJECTIVE To determine if the IDA funds achieved intended results against agreed indicators. The achievement will be measured by two indicators. These are: NOW MORE THAN EVER: STOP POLIO FOREVER

6. INDICATORS INDICATOR A: Timely arrival of OPV vaccine at national level (3 weeks before SIA) INDICATOR B: OPV Immunization coverage of SIA (at least 80 percent in endemic states) NOW MORE THAN EVER: STOP POLIO FOREVER

7. METHODOLGY: INDICATOR A Timely arrival of OPV vaccine at national level (3 weeks before SIA) Review of documents Stake-holders’ Interview Analysis of Vaccine Arrival Report (VAR) NOW MORE THAN EVER: STOP POLIO FOREVER

8. LIST OF STAKEHOLDERS S/NOrganizationPosition 1NPHCDAED 2NPHCDADirector, DC and Imm. 3ICCMember 4UnicefEPI Team Leader 5UnicefEPI Logistics 6UnicefCountry Represntative 7UnicefContract Specialist 8UnicefSharif S Alam 9Rotary InternationalTeam Leader, Polio Plus 10WHOTeam Leader, EPI 11WHOCountry Represntative 12DfIDHealth Specialist 13BMGFHealth Specialist 14BMGFHealth Specialist 15World Bank 16World BankHealth Specialist 17World BankHealth Specialist 18JAICAHealth Specialist 19USAIDHealth Specialist 20CDCPolio Team Leader

9. EXPECTED OUTPUT (INDICATOR A): VACCINE ARRIVAL TIME The analysis of Vaccine Arrival Time will be influenced by external and internal factors: NOW MORE THAN EVER: STOP POLIO FOREVER FactorExternal/Internal Delay in forecastingInternal Delay in fund transferInternal Availability of vaccine in global marketExternal Change in epidemiology of WPVExternal Registration of new type of vaccineInternal Delay in transportation of vaccine (availability of flight)External Delay in clearing of vaccine on arrivalInternal Storage capacity in the countryInternal The assessment will look into these factors of vaccine procurement to determine if the IDA funds achieved intended results against the Indicator A (Vaccine Arrival Time). External Factors will not be considered as a failure by GON for delay in vaccine arrival.

10. INDICATOR B OPV Coverage of SIA (at least 80 percent in selected endemic states) NOW MORE THAN EVER: STOP POLIO FOREVER

11. INDICATOR B: OBJECTIVE To determine OPV coverage among 0-59 months old children in four high risk endemic states -Katsina, Zamfara, Kano and Borno (19 th ERC) NOW MORE THAN EVER: STOP POLIO FOREVER

12. INDICATOR B: METHODOLOGY Four individual cluster surveys one for each state will be conducted during the week of October 29, 2010 (October 29-31) after the IPD is completed (Oct 23-28, 2010) WHO 30-cluster coverage survey methodology will be used to select sample at the household level (WHO Immunization Coverage Cluster Survey- Reference Manual 2005) NOW MORE THAN EVER: STOP POLIO FOREVER

13. INDICATOR B: METHODOLOGY SAMPLE SIZE State Number of survey unit Number of Clusters Number of 0 to 59 Months Old Children (OPV coverage in October 2010 IPD) Katsina130210 Zamfara130210 Kano130210 Borno130210 Total4120840 NOW MORE THAN EVER: STOP POLIO FOREVER

14. INDICATOR B: METHODOLOGY SELECTION OF CLUSTERS 30 clusters will be selected using stratified cluster sampling method from three strata of wards i.e. VHR, HR and LR wards. The number of clusters in each stratum (sample size of each stratum) will be allocated proportionally to size of the strata. NOW MORE THAN EVER: STOP POLIO FOREVER

15. INDICATOR B: METHODOLOGY (contd.) SELECTION OF HOUSEHOLD Households will be selected strictly randomly. WHO-30 cluster methodology will be used to select starting and subsequent household. NOW MORE THAN EVER: STOP POLIO FOREVER

16. INDICATOR B: METHODOLOGY (CONTD.) SELECTION OF RESPONDENT AND CHILD One child under five years of age per household will be selected The vaccination status of the child will be checked from the marking on the little finger of the child’s left For all eligible children (one per household), the parent/caregiver will be interviewed of the selected child questions. NOW MORE THAN EVER: STOP POLIO FOREVER

17. INDICATOR B: METHODOLOGY (CONTD.) SURVEY INSTRUMENT The questionnaire will be developed based on the recent LQAS and Outside monitoring survey. In addition to OPV status, few additional questions will be asked to find reasons for non-vaccination. NOW MORE THAN EVER: STOP POLIO FOREVER

18. INDICATOR B: METHODOLOGY (CONTD.) FIELD WORK Training A one day training will be given to interviewers on sample selection and data collection instrument. An operational manual will be developed to guide training and filed work. Data Collection Six teams (one interviewer and one recorder) will collect data in each state. They will be supervised by State Coordinator and Senatorial District Monitors. NOW MORE THAN EVER: STOP POLIO FOREVER

19. SMS Receiver Modem Public Health Services and Solutions (PHSS) SenderSMS Sent to Web Data analysis Dashboard PHSS Real Time Monitoring System using web/sms will be deployed www.thephss.org MONITORING NOW MORE THAN EVER: STOP POLIO FOREVER

20. FILED WORK (Contd.) Quality Control The state monitor will conduct supervised interviews in his/her designated clusters with the teams on a daily basis State coordinator will conduct random spot checks for all teams in the state. NOW MORE THAN EVER: STOP POLIO FOREVER

21. Data Management and Analysis All data will be entered in a computerized data base and analyzed using Epi-Info software Various tables and charts will be produced using MS Excel and MSWord The analysis will be limited to key indicators and expected output NOW MORE THAN EVER: STOP POLIO FOREVER

22. INDICATOR B:Expected Output OPV Coverage in 4 Endemic States (Katsina, Zamfara, Kano and Borno) NOW MORE THAN EVER: STOP POLIO FOREVER

23. Report Outline The report will have 4 chapters: Chapter 1 Background, objectives, design and implementation of the audit Chapter 2 Analysis of the findings of Indicator A including comments on results against target Chapter 3 Analysis of the findings of Indicator B received from cluster survey in four states including comments on results against target Chapter 4 Discussions and Conclusion

24. TEAM Principal Investigator Dr.Mizan Siddiqi Co-Principal Investigator Garry Presthus Other Staffs: - M&E Specialist -Immunization Specialist -Biostatistician -Data Management Specialist -State Coordinators, State Monitors, Interviewers.

25. WORKPLAN Item No.Activity WK 1 WK 2 WK 3 WK 4 1. Presentation of work plan, methodology, reporting format and timeline to WB and FGoN and make adjustments as necessary, recruitment of staff X Indicator A (Vaccine Arrival) 2.Review of documentsX 3.Key Informant InterviewXX 4.Analysis of information XX Draft Report on Indicator A X Indicator B (Cluster Survey) 5.Collection of population data by ward and risk category from states for sampling X 6.Design, develop and host web site and survey monitoring softwareX 7.Training of field staffX 8.Data Collection in 4 states X 9.Design of data entry screenX 10.Data entry X 11.Data Cleaning and analysis X 12.Draft Report on Indicator B X 13.Presentation of overall draft report X 14.Final Report X

26. Assistance from Stakeholders NPHCDA 1.Leadership, Coordination and Facilitation of the study 2.Support at the State and LGA level WHO 1.Review of methodology, sampling frame and data collection instruments 2.Out side and inside monitoring data of OPV coverage (2007-2010 by SIA) four states 3.LQAS data of OPV coverage for four selected states (2009-2010 by SIA) 4.Support for survey at the State and LGA level 5.ERC Recommendations and SIA schedule (2007-2010) 6.Assign Technical Staff to support the team Unicef 1.VAR report (2007-2010) and information surrounding global vaccine market, availability and reasons for delay in arrival due to external factors 2.Stakeholder Interview 3.Documents related to vaccine procurement 4.Assign Technical Staff to support team World Bank 1.Project Documents 2.Coordination with stakeholders All partners 1. Stakeholder Interview 2. Review of draft report

27. NOW MORE THAN EVER: STOP POLIO FORVER Please visit www.thephss.org/ppepwww.thephss.org/ppep  Register  Join the forum and post comments  If we can not meet you because of your busy schedule/travel etc. please fill up the online questionnaire and submit.  All materials related to the exercise are posted for your information and support.  For any question please send an e-mail to: mizansiddiqi@thephss.org or call 07067275270 mizansiddiqi@thephss.org