MICROPLANNING for the Rural Health Unit of Villanueva

MRSIA Microplanning

1. Lecture on Microplanning

2. Introduction to micro-planning

3. Micro-planning: Identifying WHICH team(s) will vaccinate THESE or THOSE children WHEN & with what resources RHU Iloilo RHU Tagaytay Team Target No. Days Doses Icepacks Transport Pesos Tagaytay 1 530 Tagaytay 2 112 Iloilo 1 72 Iloilo 2 308

4. 1 n B n=59 C n = 4 1 A = 68 D n=18 E n=34 Example: Initial Plan: this barangay will be covered by 1 vaccination team in 3 days. New Plan: Bayanihan strategy BHS: fixed post to be covered by barangay Staff. Temporary posts: Utilizing 5 teams to cover the whole barangay in one day in 5 different locations closer to where eligible children reside RE-STRATEGIZE Bayanihan Strategy

5. Elements in a good micro-plan Eligible population Operational spot map and identification of vaccination sites Human resources (Team members; Supervisors and Mobilisors) and contingency plan Teams Workload: Number of kids / Team / Day; Immunization session plan (daily itinerary) Social mobilization / Communication plan Vaccines, logistics and cold chain capacity (Storage and Daily FROZEN Icepacks for Teams)

6. List of GIDA barangays and mode of transport needed to reach those areas Number and location of refuser households Names of key opinion and religious leaders Lists of partners - NGOs, CBOs in the area COVID-19 issues: cases, lockdown areas O t hers Elements in a good micro-plan - 2

7. MR& OPV SIA Micropla n ni n g

8. Microplanning Microplanning is: a “bottom-up” process of detailed planning is aimed at reaching every target age child during the SIA Determines: ✔ the lo c al needs fo r the SI A and to id e nt i f y w h at is available and w h at is mis sing ✔ the specific actions required to reach all target age children ✔ resource needs required to reach all target age children

9. Microplanning (2) Good microplanning practice entails: making special efforts to identify underserved and hard-to-reach populations the inclusion and engagement of the communities in the microplanning process (e.g, mapping of communities, social mobilization, etc.). The key to successful microplanning is to allow enough time for in- depth planning and consolidation of plans

10. Key Components of Micro-Planning Size and geographic distribution of the target population, including special high risk groups (include maps) Number and distribution of vaccination sites and teams Team composition - vaccinators, tally markers, finger markers, crowd controllers for Vaccine, injection devices, safety box requirements, Cold chain requirements ( Cold chain storage requirements (ILRs, cold boxes), Vaccine carriers Ice packs and freezing capacity (plan for twice the number of ice packs as needed each day to allow for daily rotation)

11. Key Components of Micro-Planning (2) Guidelines, training materials, forms, finger marking pens, communication materials, etc. Transport needs and distribution plan (vehicles, motorcycles, bicycles, boats for vaccine, logistics, personnel) Daily return plan for tally sheets, vaccine carrier/ice pack and unused vaccine, etc. Number, distribution and daily movement of supervisors Estimated operational costs and budget, including for special strategies to reach high risk groups

12. Results of Poor Micro plan Mapping Poor team assignment Areas too large or too small Populations too large to be covered by one team in one day Teams don’t know where to find children Villages or populations are left off the plan entirely

13. Key Components of Micro-Planning and Mapping How to Identify High Risk Populations Epidemiologic analysis ✔ High proportion of historically un-vaccinated children (RI/SIA) ✔ High VPD disease burden ✔ Previous measles outbreaks Profiling ✔ Geographic: populations inhabiting areas with difficult access ✔ Socio-economic/cultural, political, religious

14. “At Risk” Populations & Areas Urban and peri-urban slum dwellers Orphanages Migrants/migrant workers Fishing villages, boat dwellers Refugees, internally displaced persons, other transient populations Populations in border areas (at every level) Nomadic populations High class, affluent, suburban communities Gated, high rising buildings Persons with negative opinions of vaccines Religious, anthroposophical groups who oppose vaccination

15. Information needed for microplanning Each municipality/city micro-plan should include an operational plan for the following SIA components: vaccine, cold chain, transport and logistics management; waste management; AEFI monitoring; training; social mobilization and communication; implementation; and daily data aggregation, reporting and analysis.

16. Information needed for microplanning At municipality/city level, the following background information about catchment areas should be collect : target population estimates, broken down by barangays; lists and descriptions of underserved, hard-to-reach areas and special populations, and suggested strategies to reach them

17. Information needed for microplanning names and locations of schools and day care centres, and if possible the approximate number of students enrolled in each school within the target age groups; Municipality/city maps, showing subdistrict levels and major access routes a detailed cold-chain inventory showing functional and non-functional equipment with respect to numbers, locations, storage capacities, gaps and possibilities of support stocks from other sources e.g. the private sector; needed and available waste disposal facilities in each Municipalities/health facility;

18. Information needed for microplanning needed and available transportation in each cities/municipalities including potential sources for filling the gaps list of transit points, major markets and border crossing points; number of staff needed, available and staffing gaps (health staff, volunteers, supervisors, monitors, drivers); identification of potential venues for fixed site vaccination; list of community leaders to proactively engage in advocacy/social mobilization; list and description of resistant/hesitant groups, and suggested strategies to reach them.

19. LGU Level Micro-plan Template Region: Province: City/Municipality: RHU/HC: Total Population: MANPOWER, VACCINES, AND ANCILLARY REQUIREMENTS D I S TR I CT / B ARA N G AY TYPE (URB A N OR RURAL) MR TARGET POP U L A T I O N ( 9 - 59MO) OPV TARGET POP U L A T I O N ( - 59MO) # OF CHILDRE N TO BE V ACC I N A TED PER DAY # OF DAYS R E QU I R ED # of Vaccination Teams Required TOTAL # S T A FF R E QU I R ED # TEAM S UP E R V I SORS # OPV Vials R E QU I R ED = EP / 2 x 1.15 # OPV D O S E S IN L I T E RS # of Dr o p pe r s = 1 dr o p pe r p e r OPV vial # o f MR V a cci ne Vials R e q ui re d = EP / 1 x 1.20 # MR D O S E S IN L I T E RS # of MR D il u e n t s = # o f MR Vials # MR D il u e nt DOSES IN LITERS # of AD S y r i ng e s = # o f EP x 1.11 # of Mixing Sy r in g e s = # MR Vi a l s* 1 . 11 # of A E F I / E p i ne p h r i ne K i ts = 1 Kit Per VT # Safety Collect or B o x e s = # of ADS + MS/10 Finger Marker s = 1 Marker Pe r 20 Childre n (+50% buffer) # R ef r i g e rators R e q ui e red # C ol d box R e q ui r ed # t emp ra ture mo n i to ring divices # V a cci ne career # ICE PACKS R E QU I RE D F i x e d Post Mobile F i x e d Pos t H2H Total

20. Session Plan template VACCINATION SESSION PLANNING City/Municipality: District: Health Center: Team Number: Date of vacc i na t i on Ta rget area ( B arangay) Strategy MR EP (9- 59 M O ) # of MR Vacc i ne V i a l s Required = E P /10 x 1.20 # of MR D il uen t s = # of MR V i a l s O PV EP (0- 59MO) # O PV V i a l s REQUIRED = EP/20 x 1.15 # of AD Syr i nges = # of EP x 1.11 # of Mixing Syr i nges = # MR V i a l s * 1.1 # Vacc i ne career # of AEFI/Epinephr ine Kits = 1 Kit Per VT Superv i sor ' s Name Vaccinator Recorder

21. Thank you! b it. l y /S I A Work sh o p Q uest i o ns

22. Microplanning Workshop Mechanics

23. Objectives: Ensure that underserved, hard-to-reach and high-risk groups are identified (accuracy of population numbers are based on latest census ). Decide on the appropriate vaccination strategies to reach the target population Ensure equal distribution of vaccination posts taking into account type of terrain, distances, special populations, etc. Ensure that the number of health facilities , fixed post and temporary fixed post identified as vaccination posts is correct. Identify gaps in cold-chain capacity. Identify the number of health workers, supervisors, volunteers and other personnel available and identify gaps. Ensure availability of transportation for personnel and identify gaps. Develop a plan of action to address the identified gaps. Identify AEFI referral sites. Identify various activities for social mobilization and communication. E s t im a te po o r ly - perf orm i n g ar e a s w h i c h m a y n e ed mo p - up , t a k i n g i n t o a c co un t lessons learned from past SIAs to avoid repeating the same mistakes.

24. Microplanning Workshop Proper

25. Presentation of Microplans

26. Comments on Microplans