Emergency Preparedness in Haryana

Dr Suresh Dalpath DDCH / SEPIO Haryana

Contents . . .

• Situation Analysis

• Risks

• Mitigating risks

• Response Plan

• Summary

Location of Wild Polio Virus in Haryana (2000-2010)

District P1 P3

AMBALA 2 0

FARIDABAD 6 2

FATEHABAD 1 0

GURGAON 4 1

HISAR 4 0

JHAJJAR 2 0

KAITHAL 1 0

KARNAL 1 0

KURUKSHETRA 1 0

MEWAT 22 7

PALWAL 7 1

PANCHKULA 4 1

PANIPAT 6 2

ROHTAK 0 1

SIRSA 1 0

SONEPAT 5 1

YAMUNANAGAR 1 0Data as on 8 July 2011

HR Districts District WPV

WPV Cases >=4 Years 3 45

WPV Cases 2-3 Years 7 32

WPV Cases 1 Years 7 7

No WPV Case 4 0

Total 21 84

HR Blocks (WPV)

HR Blocks (Other factors)

Haryana - High Risk Districts & Blocks

Risks . . .

• History of Importations of WPV from other parts of country

• Huge migration from endemic states

• Large number of construction sites

• Mewat had WPV every year for last 10 years

• Polio High risk areas have poor RI coverage ~ Mewat

Importations in >=4 years

Importations in 2-3 years

Importation in a year with multiple cases

No importation or importation in a year with single case

Incidences of WPV importation (2005-2010)

HARYANA MEWAT

HARYANA FARIDABAD

HARYANA HISAR

HARYANA JHAJJAR

HARYANA PANCHKULA

HARYANA PANIPAT

HARYANA SONEPAT

Data as on 8 July 2011

Mitigating Risks…

• Polio on the priority list of state

• Focus on HR districts

• Identification and validation of High Risk Areas (migratory & settle population)

• Prioritization of HRAs for coverage during SIA and RI activities

• Filling up vacant post at HR districts

• State officers closely monitoring activities

Slums with Migrants

Nomads

Brick Kilns

Construction Sites

Others

Field Validation Completed

Field Validation Completed Partially

Field Validation Planned

Field Validation not yet Planned

Total Sites Validated = 8838Total Households = 759834Total Children 0-5 yrs = 451696

Identification and Validation of High Risk Areas

Data as on 8 July 2011

Strengthening SIA activities: Mewat

• Focus on 6 High Risk PHC areas

• Booth and HtH plan segregated

• Extensive revision of microplan.

• Training of Supervisors and vaccinators by experts

• Close supervision and monitoring by Govt officials and partners

Interventions at HR PHC Areas: (Mewat June SIA) i

n %

Source of data: NPSP Mewat unit. Data as on 8 July 2011

Out come at HR PHC Areas: Mewat (June 11 intervention)

Below 25%

25% - 50%

50% - 75%

Above 75 %

OPV 3 Coverage(DLHS III)

Routine Immunization in the State

Fully Immunized Children (DLHS III)

Mewat district had fifth lowest FI coverage in the country

Data as on 8 July 2011

RI Challenges at Mewat• Low socio economic condition with poor

infrastructure

• Vacant post of ANMs & other health staff

• Inadequate public transport and difficult terrain – ANM not moving in the field– Not giving sufficient time for RI activity– Supervisors not moving in the field.

• Less demand generation

Overcoming RI Challenges (Mewat)• Filling up of vacant ANM positions is in process

• Flexibility in requirement of district program officers

• Micro plan revision and work rationalization

• Every PHC is hiring 1-3 vehicles for session days.

• Earmarked vehicle for every 3-4 sessions.

• ANMs and Supervisors move from PHC in the morning with logistics

• Vehicle drops vaccinators one by one, en-route as per plan and collect them after sessions

• Supervisor/MO supervise simultaneously.

• Budget is provided by NRHM and Mewat Development Agency

Vaccinators along with supervisor moving from PHC to Session site in earmarked vehicle

Vaccinator reaches remote minority area for RI activity and stays till the vehicle returns back

Increase in RI coverage at Mewat* (Sept-2010- May10-11)

Antigen % Increase

BCG 21%

DPT-1 29%

DPT-2 42%

DPT-3 49%

Measles 29%

* Based on reported coverage Data as on 8 July 2011

Validation exercise done In May 2011

Emergency Preparedness and Response Plan

• State EPRG notified on 27 May 2011– Principal Secretary Health : Chair person– MD NRHM : Vice Chairperson– DGHS : Secretary

• All Deputy Commissioners appraised in review meeting chaired by Hon'ble CM.

• Meeting of State Steering Committee is planned on 4th of July-2011.

• Plan to orient the heads of key Deptt. i.e. Panchayati Raj, Education, Social Welfare etc.

Status of State EPRAction list Status

State EPRG Formed Yes ( notified on 27 May 2011)

State Rapid Response Team (RRT) identified Yes

No. of RRTs identified Six

Training conducted for RRT Yet to be conducted

HR Districts and HR areas within Districts identified

Yes

Senior Govt Officials identified and assigned to HR Districts

Yes

Communication Risk Analysis Undertaken In process

Communication Plan developed In process

Media Response Plan developed Initiated

Developed a plan to increase polio SIA Coverage in HRAs

Yes

Developed a Plan to increase RI Coverage in HRAs

1st draft ready, being reviewed

Data as on 8 July 2011

Emergency Preparedness Plan notified on 27 May 2011

Events Day

Confirmation of WPV 0

State EPRG Meeting 1

Intensified HR Plan (state , Partners) 2

Operationalize Media Plan 2

District Task Force Meetings 2

Micro plan Review and Orientation of workers 3-5

Inter - Agency Coordination Meeting 3

Procurement of Marker pen & IEC materials 4

Distribution of logistics 5

Mop up activity starts 7

Post activity review and report 12

Proposed Emergency Response Plan

Summary . . .• High risk of importation of WPV cases in

the state

• State has identified HR districts & blocks

• Focus on the HRAs for SIA & RI activities

• State has Emergency Response Plan in place

• State can implement mop up activity on detection of WPV within a week

Thanks

Please be assured!State is committed !! &Together

We will do it……