1. Microplanning to ensure RED (Reach every child for immunization)

2. The purpose of microplanning To utilize one operational field guide that was adopted and being used at nation-wide. To ensure that regular and reliable immunization services with high vaccination coverage reaching 95% (80% for PNG) To close the immunity gap, that has resulted in recurrent outbreaks of Vaccine Preventable Diseases (VPDs) in several provinces. To focus efforts on improving the management and quality of MNCH and nutrition services especially for high risk, priority district and health centres (HC).

3. Key 5 operational components of RED strategy Re-establish mobile and outreach services Supportive supervision Linking services with communities Monitoring and use of data for action Planning and management of resources

4. Steps of Microplanning development (RED strategy)

5. Microplanning development Enumerate Village Wise Population Area map Display the map in the health center Prepare session plan to reach every village Vaccines and MNCH supplies Annual plan including budget Monitor village- wise Immunization Performance Social mobilization and communication Prepare monitoring chart Conduct integrated fixed site and outreach sessions Target Beneficiaries

6. Steps of the Micro planning Orientation of province and district levels to implement, supervise, support and monitor micro planning processes and results. Introduce through group work between district and HC staffs followed by visits with on the-job-technical support by Province/district to HCs. Identify priority HCs and villages, monitor their progress and provide adequate resources (staff, funds, equipment and others) to conduct regular outreach with a basic MNCH integrated package. Visit priority villages to understand issues of demand and supply and how to address them for improved EPI and other MNCH and nutrition service delivery

7. Strategies for Implementation The micro-plans should be developed every year following government planning process, reviewed and adjusted on a quarterly basis in order to reflect any changes on costing and logistic needs. Technical oversight, initial training of district and health centres, financial support, regular supervision to district level. Monitor results of improved micro planning and service delivery Health centre submit MP to district, district summarise and submit to Provincial, Provincial conclude with all district and submit to NDOH.

8. Strategies for Implementation Fixed-site service ◦ Delivered at health centers and hospitals level,either daily or on fixed days; monthly or quarterly basis. Mobile service (same day visit) ◦ Organized within the catchment area of the health facility at popular/public locations (e.g. Church, School, Marketplace, Village chief’s house, ) ◦ The vaccinator team should vaccinate children and return on the same day Outreach/Patrols service (overnight stay) ◦ Involves health workers going to remote or hard-to-reach parts of an area and staying there for more than one night to deliver immunization. ◦ The vaccinators may stay 3-5 days in the field

9. Example of Health facility map

10. Strategies in PNG StrategyMinimum session frequency WhereWhoCost Static sessionDailyProvincial/district hospitals or large HC/Church-based HWs in the HFs No cost Once in a week Health centers/sub center/CHP or Aid post in rural areas HWs in the HFs No cost Mobile sessionQuarterlyCatchment areas same day visit OICs, HWs and Volunteers Fuel Outreach/Patr ol sessions Three times/year Stay overnight for more than one night outside catchment areas or H-T-R in catchment areas for 3-5 days OICs, HWs and Volunteers Allowance + accommodat ion in the village + Fuel

11. 1) Health Facility Microplan forms 2) District/Provincial level summary forms 11 New Microplan Templates for RI in PNG

12. 1) Health Facility Microplan forms

13. Form 1: Calculating the target population. Enter the name of first settlement/village in the ‘‘A’' column and the total population in that settlement/village in the ‘’B’' column, then target population for each age group from column “C-D” will be calculated automatically. 13

14. Form 2: Map of health facility catchment Map. Draw sketch map of the health facility catchment area showing roads and geographical landmarks (rivers, streams, mountains); institutions (church health facility school etc.), vaccination sites, hard to reach areas, and target population per village. The map can be simple and hand-drawn, you do not need a computer to draw the map. You may be able to use a map by revising already prepared for MR/OPV campaigns. 14

15. Form 3: Session plan. Step 1: Write name of the vaccination sites in column “A”, vaccination site is the place where vaccination team will provide the vaccination service. It can be a health facility name for static site and a village/ settlement name for mobile and outreach site. Step 2: Write down the name of the village or villages in column “B” to be served under the vaccination site you mentioned in column ‘’A’’, you can group two or more villages to be served in one vaccination sites based on the proximity of the villages. Step 3: Write down the total population of the villages under that vaccination sites in column “C” and the under 1 year target population will be calculated automatically in column ‘D” Step 4: Choose the vaccination strategy in column “E” and decide the number of sessions per year in column “F”, list if other interventions planned in column “G” and indicate if the area is hard to reach in column “H” 15

16. Form 4: Special activities for hard to reach and problem areas. Step 1: Transfer all hard to reach areas that you indicated in the session plan (form 3) and list down in order of highest target to the lowest in column “A” Step 2: Write how many times that area was reached in the last calendar year (or 12- month period) in column “B”. Step 3: Decide session type in column “C” and session frequency in column ‘’D’’ Step 4: Indicate the activities to be conducted by the health facility in column “E” and any support needed from the district and higher to increase the RI coverage in column “F:. Step 5: Write down other interventions planned in column ‘’G’’ (ANC, Nutrition screening, Vitamin A supplementation, Deworming, bed nets distribution, etc 16

17. Form 5: Health facility work plan for one quarter. Step 1: Transfer the name of the vaccination sites, the name of villages to be covered from the session plan in column and number session planned in column from the session plan in column “A-C” respectively Step 2: Write down the date vaccination planned, means of transport and responsible persons for vaccination and social mobilizations for one quarter in column ‘’D,E & F” 17

18. Form 6: Health facility budget for routine immunization. Step 1: Transfer the name of vaccination site, villages, target population under 1 years, session type and session frequency per year in ‘’A-E” column Step 2: Enter the number of immunization days including travel days for outreach sessions in column “F’’ Step2 : Select the transportation mode in column “G-J” and estimate fuel and transportation cost for round trip in column “K-P” Step 3 : Enter the incentive rate per day ( enter only the daily rate ) and the accommodation rate per night in column “Q-U” then the unit cost and the total cost will be calculated automatically in column “X-AD” 18

19. Form 7: Vaccine and supplies required. Step 1: Enter the health facility total population Step 2: The template automatically estimate one month consumption of vaccine and supplies based on the monthly target and 80% coverage. If you want to calculate for more than one month change the number of months you need the supply to be calculated. 19

20. Form 8: Social mobilization plan. 20

21. 2) District/province Microplan forms

22. Form 1: Calculating the target population- District /Province Enter the name of the health facility in the ‘A' column and the total population of the health facility catchment in the ‘B' column, then target population form column “ C-G” will be calculated automatically. 22

23. Form 2: Immunization data analysis. Column “A-C” will be filled automatically form the target population sheet. Fill number of children vaccinated for Penta 1, Penta 3 and Measles in 2018 column “D-F“ and the number of pregnant women vaccinated for TT Column H-R will be calculated automatically. Rank the health facilities based on their number of Penta 3 unvaccinated children from the highest to the lowest in column “S” 23

24. Form 3: Map of District. Draw sketch map of the district catchment area showing important land marks, vaccination sites, session type and target population per village. 24

25. Form 4: District/ Province activity quarterly plan Step 1: Write the health facility name in column “A’’ Step 2: write down activities that require district / province support in column “B” and indicate at which month the support will be provided in column “C- D” Step 3: Write person responsible to support or follow up the support by the district /province in column ‘’E’’. Step 4: Write the district /province activities on the space provided at the bottom of the template. 25

26. Form 5: District /province budget summary for routine immunization. Step1: Column ‘’A-C’’ will be filled automatically fro the target population sheet Step 2: Summarize the strategies, means of access to the area and budget needed in column ‘’D-E”. Step 2; List down the district /province activities requiring budget and amount of budget required on the bottom of the template. 26

27. Form 6: Vaccine and supplies required- District/Province Step 1: The template automatically estimate 2 months consumption of vaccine and supplies based on the 2 months target and 80% coverage. Sept 2: If you want to calculate the vaccine and supplies needed for more than two months change the number of months indicated in the “red” box on the top of the template to increase/decrease the number of the months you need the supply to be calculated. 27

28. Form 7: Social mobilization plan. 28

29. Thank you!