Emergency Preparedness and
Response Planning
Uttar Pradesh
24th 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 1st 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 1st 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
Distribution of Wild Polio Virus cases
2002 - 2010
2002
N=1242
2003
2004
N=82
N=88
Western UP is the strategic priority area in the state
2006
2005
N=548
N=29
2008
N=305
2007
N=341
2010
2009
N=602
N=10
High Risk Districts in UP*
* Source : 20th IEAG Jun 2009
66 HR Blocks - West UP
High Risk Areas of UP
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44,130
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11,491
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MIGRATORY
SETTLED
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
4,500
Declining resistance in high
risk districts of West UP
3,500
2,500
1,500
J J SN J FM AM J A S O N FM A J J SN D F MM J A S O N D J F M A M J N J F M A M J A SN
2006
2007
2008
2009
2010
2011
Using every opportunity – Vaccinating
children at Melas & Congregations - 2011
District
Total
Children
Immunized
Dargah
Mela
Bahraich
122,908
Magh Mela
Allahabad
47,864
Mela
Karikot
Bahraich
22,463
Lakkad
Shah Baba
Bahraich
3,998
Ajmer Urs
Agra
1,045
Mudiya
Poornima
Mela
Mathura
3,192
Jai
Gurudev
Mathura
1,202
Ghaziabad
12,771
Activity
Garh
Ganga
Mela
Total
215,744
Special Activity for Coverage of migrants
between Polio Campaigns
120000
90000
60000
30000
0
F e b.10 M a r.10 A pr.10
M a y.10 J un.10 J uly.10
S e p.10 N o v .10 J a n.11
F e b.11 M a r.11 A pr.11
SIA Rounds
No. of children immunized
M a y.11 J un.11 A ug.11
S e p.11 N o v .11 J a n.12
Continuous vaccination along Indo-Nepal border
30 vaccination
posts
Total No. of Children Immunized in 2010
– 2,51,243
Vaccination post
Blocks with vaccination post
Total No. of Children Immunized in 2011*
– 5,85,116
High Coverage Sustained Over SIAs
5
Percent children < 2 yrs found unimmunized during end of the
round survey, Uttar Pradesh
4
3
2
1
0
2009
2010
66 HR blocks
Rest of West UP
2011
Central East UP
2012
Strengthening Routine Immunization
• 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
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Initiatives improving RI
coverage
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90
80
70
60
52
50
57
Aug-11
Dec-11
41
40
30
57
30
23
20
10
0
NFHS-III [2005-06]
DLHS-III [2007-08]
CES [2009]
Data sources:
CES- Coverage Evaluation Survey
NFHS III - National Family Health Survey
DLHS- District Level Household & Facility Survey
Jan-11
RI monitoring through NPSP,GOVT,UNICEF,
CORE, MCHIP & MI
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
High Quality Surveillance in 66 HR Blocks
Non Polio AFP Rate - 2011
SHP
MZN
BJN
MRT
BGT
JPN
GZA
RMP
MRD
GBN
PIL
BRL
BLS
BAD
ALG
SHA
KAN
MTR
HTR
ETA
FKB
AGR
FER
MAI
HR Blocks Average – 58
ETW
0 to 2
3 to 5
6 to 9
* Data as on Wk 09, 2012
10 and above
Strengthened AFP Surveillance in Migratory
Population
485
500
399
400
299
300
200
100
0
2009
2010
AFP Cases in Migrants
* Data as on Wk 09, 2012
2011
UP Emergency Mop up Timeline
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
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)
Thanks…