Booklet-health Centre Simple Guide for Reaching Every Purok

7/24/2019 Booklet-health Centre Simple Guide for Reaching Every Purok

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STRENGTHENING ROUTINEIMMUNIZATION

SIMPLE GUIDE FOR REACHING EVERYPUROK


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Adjacent Area

High Risk

Low Risk

Department of Heat!" P!##pp#ne$"

Ma% &'()


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PURPOSE OF THIS GUIDE

This guide is intended for Health Center (HC) or Rural HealthUnit (RHU) sta to help them reach eer! purok" #lock" sitio in a

#aranga! with routine accination$

The Reaching %er! &urok (R%&) strateg! was 'rst introduced in*+ as the ne,t step after the Reaching %er! -aranga! (R%-)strateg!$ The strateg! responds to continued signi'cant immunit!gaps among disadantaged puroks" #locks or sitios in a #aranga!$

The *. /easles0Ru#ella0&olio /ass 1mmuni2ation (/R 3&4/1) campaign proided the 'rst opportunit! to identif! high riskpuroks on a national scale" reach them with the campaign accines"and measure their routine accination status$ The campaignproided a useful #asis for continuing access to regular accinationserices in high risk areas$

The guide shows5 how to use the locall! aaila#le data to strengthen routine

immuni2ation serices how to prioriti2e and reach high risk puroks with accination

actiities how to continue to monitor progress #! purok

*HAT IS NE* A+OUT THIS GUIDE

The R%& 6trateg! puts the focus on the #aranga! atpurok7#lock7sitio leel$ This guide proides simple steps which can#e followed #! RHU7HC sta to reduce the immunit! gap8 in high riskpuroks$ The strateg! includes door0to0door monitoring of accinationstatus within the #aranga!" which is designed to #e well suited todensel! or highl! populated areas" like ur#an #aranga!s$

6imple 9uide for Reaching %er! &urok for Health Centers &age .

Remember:The term purok in this document also refers toany sub-division of a barangay such as block, Sitio, street, zone


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,An #mm-n#t% .ap o//-r$ 0!en $ome #n1#2#1-a$ #n a /omm-n#t% are not f-%

prote/te1 3% 2a//#nat#on

SOME UR+AN IMMUNIZATION PRO+LEMS *HICH CAN +E

ADDRESSED +Y THE REP STRATEGY

(4 Uncertain ur#an population denominators resulting inincomplete TCL7registers

&4 &opulation moement and migration from other regions tour#an areas

54 1nformal ur#an settlements not included in o:cial population64 High cost of transport to the health center for the ur#an poor)4 Ur#an population shared across regional #orders needing

coordinated plans

CONTENTS OF THIS GUIDE

SECTION I4 CLOSING IMMUNITY GAP IN HIGH RISK PUROKS

A$ /aking a health center work plan for Reaching %er! &urokeer! ;uarter using


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A$ uarterl! Rural Health Unit or Health Center immuni2ationcoerage monitoring using


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IMPLEMENTING REACHING EVERY PUROK STRATEGY

T!#$ a.or#t!m $!o0$ t!e 2a//#nat#on a/t#2#t#e$ for !#.!

an1 o0 r#$7 p-ro7$4

6imple 9uide for Reaching %er! &urok for Health Centers &age


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T!e re.-ar /a$$#8/at#on of p-ro7$ a$ !#.! or o0 r#$7is#ased upon the data collected from ;uarterl! door to doorimmuni2ation card checks conducted in high risk puroks$

The following three main actiities for high risk puroks aredescri#ed in detail in this guide5

(4 PLANNING9

Ma$ter #$t#n. to update the TCL with the names andimmuni2ation status of children

&4 TAKING ACTION

Foo0 -p 2a//#nat#on using ',ed site and7or outreachserice delier!

54 MONITORING

:-arter% 1oor;to;1oor /ar1 /!e/7 of childrenEsimmuni2ation status to monitor progress of the purok onmoing from high to low risk categor!


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1f &urok coerage data is not aaila#le5 Use localknowledge a#out communit! situation to select highrisk purok$ Consider criteria such as" #ut not limited

to5 congested ur#an areas" re0settlement areas"remote rural areas or places recentl! aected #!seere disaster$

Re.-ar :-arter% H#.! R#$7 P-ro7 See/t#on

Use the results of the most recent ;uarterl! door0to0doorcard check$

.$


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1n puroks where a signi'cant num#er of children do nothae cards" compute the proportion (K) of Children withno cards using this formula5

High Risk &urok5 PDK of children aged * to + months arewithout cards

6imple 9uide for Reaching %er! &urok for Health Centers &age **

um#er of children without cards O*


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FOR

M(9MAKINGAHEALTHCENTER*ORKPLAN

FORREACHINGEVERYPUROKEVERY:UARTER

Nam

eofRHUan

Fe3

Mar

Apr

Ma%

>-n

>-

A-.

Sep

O/t

No2

De/

Re$-t$

ofate$t

/ar1

/!e/7

?HR"L

R"

ND@

:UARTER(

Re$-tof

pre2#o-$

/ar1

/!e/7$

?HR


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+4 MAKING A +ARANGAY MAP SHO*ING HIGH RISK PUROKS

-elow is an e,ample of a -aranga! /ap that can #e displa!ed

on the wall of the -aranga! Health 6tation$ 1t shows high risk puroks

shaded red$ 1f known" it is also helpful to indicate the num#er of

households per purok$ The map can #e updated to reQect changes in

the risk status of each purok$

C4 DECIDING *HEN A FOLLO* UP VACCINATION SHOULD +E

DONE

A follow up immuni2ation is needed in a high risk purok wherecard check shows IJK of children are completel! immuni2ed$

6imple 9uide for Reaching %er! &urok for Health Centers &age *+


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=$ MAKING A MASTER LIST OF CHILDREN *ITH THEIR

IMMUNIZATION STATUS IN HIGH RISK PUROKS USING FORM &

*HAT IS A MASTER LIST

A master list is a list of names of children including theirdate of #irth or age e,act address and the doses of accines

the! hae receied$

1deall!" the master list is made #! going door0to0door in highrisk puroks and asking for the immuni2ation cards of childrenunder !ears of age and their mothers$ 1t is ideal for a healthworker to #ring the TCL while doing the master listing to allowalidation of childEs immuni2ation in cases of lost immuni2ationcard$

The information gathered on the master list is thentransferred into the TCL$

This ta#le is an e,ample of


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*HEN TO USE A MASTER LIST

A master list is er! useful when there are uncertainties

a#out the true num#er of children in a purok" and when theirtrue immuni2ation status is not known$

1deall!N make the master list #! going door0to0door in highrisk puroks and asking for the immuni2ation cards of childrenunder !ears of age and their mothers$

1n areas with unsta#le populations (dense ur#an areas"disaster areas" regular population moement)5 repeat the

update of the master list regularl! (;uarterl!) 1n areas with sta#le populations5 repeat the update of master

list as needed (annual update as minimum)

Here are e,amples of dierent scenarios where a masterlisting will #e helpful$

S/enar#o (0 a #ig cit! with a er! mo#ile population whereman! children ma! not hae immuni2ation cards and ma! not #e

registered in the TCL$ 1n this case" making a master list is a goodwa! to alidate and update the TCL$

S/enar#o & an area aected #! a natural disaster whereTCLs and other immuni2ation records hae #een lost and hae to#e re0made$

S/enar#o 5 an area where a follow up immuni2ation is #eingplanned and managers need to know the num#er of eligi#le

children and ;uantities of accines needed$

6imple 9uide for Reaching %er! &urok for Health Centers &age *>

Remember: Making a master list needs training andsupervision. The master list should be of good detailed uality,


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HO* TO USE THE MASTER LIST

Ea/! ma$ter #$t form #$ for one p-ro7 ?$ee Form &@

*$ 9o from door0to0door in the purok and ask if there is a childaged under !ears of age in the house$

$ 1f !es" write the name" date of #irth or age of the child"motherEs name and the detailed address$ 1f man! children areliing in the house" list all children under !ears of age$

The master list can #e initiall! prepared #! adding namesand accination details of children from that purok who arealread! in the TCL$ Howeer" going from door0to0door is stillrecommended to include children who are not !et in the TCLor to determine children who permanentl! left the purok tolie in another place$

+$ Ask the mother to show the immuni2ation card of each child$

a4 If an #mm-n#at#on /ar1 #$ a2a#a3e9 &lace a checkmark (S) on the form against each accine that has #eengien from the record on the immuni2ation card$

34 If no #mm-n#at#on /ar1 a2a#a3e9

If t!e mot!er /an remem3er 0e" place a check mark(S) against each accine on the form and indicate recallunder the column for remarks$ This shall prompt the healthworker to check alidit! of motherEs recall against the TCL$

Then" proide a new card" place a check mark (S) on the cardagainst accines alread! gien (dates will not #e known)$

Tr! to 'nd the name of the child in the TCL to alidate themotherEs recall and add on the new card the dates that theaccines were gien$ Update accination data in


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1f childEs name cannot #e found in the TCL" proide a card to#e used for follow up accinations and enter the name in the

TCL$ Update accination data in


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This photo sho!s an e#ample of T$%s prepared by purok&block' being used in one health center in the $ity of Manila.These T$%s are grouped and (led per barangay. )f the ne! T$%for children under-(ve is available, data recording shouldideally be maintained by purok*sitio*block.

TCL Mana.ement Opt#on &9

6u#0diide and mark the pages of one TCL so that eachpurok" #lock or sitio will hae dedicated separate pages$ Theseparate pages can also #e diided #! month of #irth$

/ake sure to proide su:cient pages to enter all of theeligi#le children for each purok7sitio7#lock #ased on the masterlist and add few more pages to include the estimated num#erof future #a#ies that ma!#e #orn in or transfer to the purokwithin the !ear$

TCL Mana.ement Opt#on 5 ?ea$t preferre1@9

Use one TCL per RHU7 HC #ut ensure that the column foraddress in the TCL will #e completel! 'lled out (which shouldinclude purok7#lock7sitio7 street and een landmark near thehouse of infant) to ensure eas! tracking of target children$

6imple 9uide for Reaching %er! &urok for Health Centers &age *D


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OPTIONS IN UR+AN AREAS *HERE THE POPULATION IS

VERY MO+ILE AND TCL IS INCOMPLETE

*$ The midwife can keep the master list and update itperiodicall! #! returning to the same purok and updating theform with accination data from the same children$

$ Consider whether it is possi#le to do outreach accination atthe same time as master listing$

*HAT TO DO FOR ZERO DOSE CHILDREN

6ome children under !ears of age ma! hae no

immuni2ation records #ecause the! are lost or damaged #!

Qood7're etc4

If t!ere #$ no re/a an1 no re/or1 of 2a//#nat#on9

6imple 9uide for Reaching %er! &urok for Health Centers &age *J

This is an e#ample of a T$% !ith pages divided perbarangay and per purok used in one health center in +egion))). $olor-coded tags are used to mark records per barangayand per purok. ello! tags mark the beginning of therecording for a barangay follo!ed by green tags to separatethe records per purok !ithin the same barangay. This !as


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a$ /ake a new accination card#$ %nter the name and address in the TCLc$ =etermine which accines to gie to the child5

For /!#1ren UNDER (& MONTHS91t is prefera#le to gie the whole immuni2ation series

of accine doses" according to age5 -C9 (* dose)" &enta (+doses)" &C4 (+ doses)" 3&4 (+ doses)" 1&4 (* dose)" and/C4 (* dose)$

For /!#1ren (& TO &5 MONTHS9

6ince the child at this age is likel! to #e partiall!immuni2ed gie onl! 3&4 (* dose)" &enta (* dose)" &C4 (*dose) and /C4 (ideall! doses)$

F4 LISTING CHILDREN FOR FOLLO* UP IMMUNIZATION +ASED

ON TCL AND MASTER LISTING USING FORM 5


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Use the TCL and other lists" including master lists" to write thenames of children and women who are due for their ne,t scheduleddose$

The ta#le #elow is an e,ample of


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G4 CONDUCTING :UARTERLY CARD CHECK IN HIGH RISK

PUROKS USING FORM 6

Using form ." the ;uarterl! card check measures the risk statusin one purok with door0to0door isits for children aged * to +months$

The ;uarterl! card check is a means of monitoring progress

in high risk puroks$ 1t does not need to #e as detailed as themaster list" #ecause its purpose it to monitor high or low riskstatus of a purok$ 1t is easier to use from door0to0door #ecausethe target is children aged * to + months who should all #ecompletel! immuni2ed alread!$

Tr! to check a minimum of houses with eligi#le childrenaged * to + months in each high risk purok eer! ;uarter$ 1fthe purok has less than houses" check eer! house$

Form 6 #$ -$e1 for /ar1 /!e/7$4

6imple 9uide for Reaching %er! &urok for Health Centers &age


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HO* TO DO DOOR;TO;DOOR CARD CHECKS

*$ %er! ;uarter isit eer! high risk purok and go door0to0doorto check childrenEs immuni2ation cards$

$ Ask if there are an! children aged * to + months (#etween

* and two !ears)$+$ 1f !es" write the num#er of children aged * to + months in

that door$.$ Ask the mother to show !ou the immuni2ation card of each

child$>$ Frite the num#er of children with card for that door$

If t!ere are #mm-n#at#on /ar1$9 Check the card forimmuni2ation status and write the num#er of children in

each categor!5

a$ Compete% Imm-n#e1 G child receied + doses of&enta plus /C4* and /C4

#$ Part#a% Imm-n#e1G child missed an! one dose of&enta or dose of /C4

c$ Zero 1o$eG card is aaila#le #ut no doses marked oncard$ Frite the name of the child on the #ack of


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If t!ere #$ no /ar1 or no ot!er re/or1 of 2a//#nat#on 5Frite the num#er of children under the no card categor!and write the names of children on the #ack of


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SUPERVISOR DECISION ON RISK STATUS

The superisor should reiew the ;uarterl! results on

and make decisions using the following information$

Results of card check5

High Risk &urok5 IJK completel! immuni2ed or DKhas no card

=ate of follow up immuni2ation conducted in high risk purok(if needed)

um#er of doses of &entaalent and /C4 accines gien

during follow up immuni2ation if needed and done

-ased on the a#oe information" the superisor will decide

(*) whether to classif! a purok as high risk or low risk and ()

where and when follow up immuni2ation is needed$

If a p-ro7 #$ $t# !#.! r#$79determine if a follow upimmuni2ation actiit! needed

If foo0 -p #mm-n#at#on 1one9enter the date that thefollow up immuni2ation was conducted

*!en t!e foo0 -p #mm-n#at#on !a$ 3een/ompete19enter the results showing the total num#er ofdoses of &entaalent and /C4 gien

1nformation from can also #e used to monitorindicators (see &age +) of progress using R%& strateg!$

6imple 9uide for Reaching %er! &urok for Health Centers &age >

Remember: $ard check measures risk status. There is noneed to calculate coverage per purok. $overage should be

Remember:)t may not be possible to change a purok status

from high risk to lo! risk status based upon only on one or t!o

months data. )t is more reliable to follo! progress for /0


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FORM)9CON

SOLIDATEDMONITORINGOF:UAR

TERLYCARDCHECKINGINHIGHRISKPUROKS

Heat!CenterName9

+aranaN

ame9

Date9

No4of

C!#1

ren

C!e/

7e1

No4of

Compete%

Imm-n#e1

No4of

Part#a%

Imm-n#e1

No40#t!ero

1o$e

no40#t!No

Car1

De/#$#ono

n

H#.!orLo0

R#$7

DateFoopUp

Imm-n#at#on

DoneforH#.!

R#$7P-ro7

No4Penta

Do$eG#2en

No

4MCV

G

#2en

NameofH#.!R#$7P-ro7

DateofCar1

C!e/7

Re$-t$ofCar1C!e/7$

Re$-tofFoo0UP

Imm-n#at#o

n

I4


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MONITORING AND SUPERVISION OF IMMUNIZATION

PROGRAM USING FORM

1mmuni2ation program superisors at the RHU7HC will conduct

;uarterl! monitoring using


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HR puroks Results of card check

documentedLow

performing

-aranga!s

Coerage #! -aranga!

recorded Low performers

inestigated #! reiew

of TCL

SURVEILLA

NCE Reports of

suspected

4&=s

6uspected cases

reported and

inestigated on timeCase

1nestigation Case inestigation forms

aaila#le in health

center

COLD

CHAIN"LOGISTICSAND

SUPPLY Check

Refrigerator Refrigerators

functioningN if not has

report #een made and

follow upTemperature

monitoring Temperature record

twice per da!

Check

accine

suppl!

4accine log #ook in use

An! stock out7oer stock

AEFI 1mmuni2atio

n 6afet! An! pre'lling or re0

capping of s!ringes

&oster with

national

schedule

1mmuni2ation 6chedule

&oster displa!ed

/others /others correctl!


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COMMUNICATION

knowledge informed a#out ne,t

dose7isitames and

phone

num#ers of-HFs

=irector! of -HFs

names and phone

num#ers

6ession plan

displa!ed 4 MONITORING AND MANAGING VACCINE SUPPLIES USING

FORM


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K4 MONITORING PROGRESS +Y PUROK

1deall!" a data#ase ma!#e deeloped to monitor high risk purokprogress at the proincial or cit! leel$ An e,ample of a data#asedeeloped during the /R03&4 mass immuni2ation campaign in6eptem#er *. in Region 111 which can still #e used forimplementing R%& is shown on &age >$

3ne can seek support from regional" proincial or cit! 1Tpersonnel for the deelopment of a simple (/icrosoft %,cel0#ased)data#ase for this purpose$ Haing an electronic data#ase facilitateseasier data anal!sis and tracking of progress$

3nce aaila#le" transfer the data from (Consolidatedmonitoring of ;uarterl! card checking in high risk puroks) into thedata#ase$

PUROK INDICATORS TO MONITOR

*$ High Risk &urok5IJK of children with cards hae completeimmuni2ation 3R DK hae no card

$ Low Risk &urok5 JK of children with cards hae completeimmuni2ation

+$ &urok needing follow up immuni2ation5 #ased on theinformation on the (*) date last follow up immuni2ation was


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done and () total num#er of pentaalent and7or measlesaccines gien$


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FORM9MANAGINGANDMONITOR

INGVACCINESUPPLY

Nam

eofHeat!Center9================================

Nam

eofMon#tor9==========================

Date/ompete1

9==========

Item

Tota2#a$

EBp#r%Date

TotaV#a$

EBp#r%Date$

Stat-$ofVVM

?("&"5"6@

TotaNo4of

Mont!$

mont!

reJ-#rement

+CG

(%

&

,*

dose

,$>

77*

)

HEP+

(%

&

,*

dose

,*$*

7*

)

PENTA

(%

&

,+

doses,*$*

7*

)

PCV

(%

&

,+

doses,*$*

7*7*

)

OPV

(%

&

,+

doses,*$?

A

77*)

IP

V(%

&

,*

dose

,*$

>7*7*7*

)

ROTAVIRUS

(%

&

,

doses,*$*

7*7*

)

M

MR

(%

&

,

doses,$

7>7*

)

TT

(%

&

,

doses,*$?

A

77*)

Prep

arat#onper

2a//#ne

*

dose7ial

*

dose7ial

>

dose7ial

dose7ial

dose7ial

*

dose7ial

*

dose7ial

dose7ial

*

dose7ial

Mont!%

Nee1$

?V#a$@

*r#tet!ea/t-an-m3eran1ot!er

#nformat#on#n1#/ate1oft!e2a//#ne$

a2a#a3e#nt!e!eat!fa/##t%

E#.#3ePop?EP@9TotaPop-at#on

B&4

Ca/-ate

t!en-m3erof

mont!$ofa2a#a3e$to/74

D#2#1etota2#a$/o-nte1

3%t!e/a/-ate1mont!%

orJ-arter%nee1$4

Re/or1t!efoo0#n.

-$#n.t!e

Va//#neSto/7

Car1

IfeBp#r

%1ate#$not

a2a#a3e#nt!e$to/7

re.#$ter"t!en0r#teNA

#nt!eree2ant/o-mn


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SECTION II4 MAINTAINING HIGH POPULATION

IMMUNITY IN LO* RISK PUROKS

A4 :UARTERLY RHU< HC IMMUNIZATION COVERAGEMONITORING USING FORM

High population immunit! can #e maintained in low risk puroks#! regular anal!sis of reported coerage data #! #aranga!$ Low riskpuroks ma! #ecome high risk during the course of the !ear for man!reasons" so it is essential to reiew data on a regular #asis$

uarterl! data anal!sis at the RHU7HC will identif! low coerage#aranga!s (with or without high risk puroks) where additional actionsare needed" such as conducting outreach immuni2ation actiities$

A sample of


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T!e REP C%/e9 from !#.! r#$7 p-ro7 to o0 r#$7 p-ro74


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NOTE


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S9

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Booklet-health Centre Simple Guide for Reaching Every Purok

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Transcript of Booklet-health Centre Simple Guide for Reaching Every Purok