1. Emergency Preparedness and Response Planning Uttar Pradesh 24 th IEAG 15 – 16 March 2012 Director General, Family Welfare Govt. of UP

2. 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

3. 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

4. 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 2011. –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

5. Risk Assessment

6. N=1242 N=88 N=82 N=341 N=305 N=602N=10 N=29 N=548 20022003 2004 2007 2009 2010 2006 2005 2008 Distribution of Wild Polio Virus cases 2002 - 2010 Western UP is the strategic priority area in the state

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

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

9. Actions in High Risk Areas following Risk Assessment

10. 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

11. Engaging community leaders in pockets of Refusals ~ 70% House to House Teams in High Risk Areas are accompanied by influencers during revisits 20062007 2008 2009 2010 2011 Declining resistance in high risk districts of West UP

12. Using every opportunity – Vaccinating children at Melas & Congregations - 2011 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

13. Special Activity for Coverage of migrants between Polio Campaigns SIA Rounds

14. 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* – 5,85,116 30 vaccination posts

15. Percent children < 2 yrs found unimmunized during end of the round survey, Uttar Pradesh 200920102011 2012 High Coverage Sustained Over SIAs

16. 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

17. 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 ~ 23 000 new areas identified for inclusion in RI Micro plan

18. 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

19. Convergence mission in High Risk Blocks WASH Convergence: 48,540 dry latrines converted into flush toilets in Badaun 51,000 conversions planned in Meerut.

20. Surveillance quality in High Risk Areas

21. * Data as on Wk 09, 2012 High Quality Surveillance in 66 HR Blocks Non Polio AFP Rate - 2011 HR Blocks Average – 58 0 to 2 3 to 5 6 to 9 10 and above

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

23. 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

24. 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)

25. Thanks…