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IDCF 2014 Intensified Diarrhoea Control

Fortnight 28 July – 8August 2014

OPERATIONAL PLAN

FOR STATES, UTs AND DISTRICTS

Ministry of Health & Family Welfare,

Government of India

Intensification of efforts towards “zero” deaths due to childhood diarrhoea and reduction in

malnutrition across all States & UTs of India

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1. Introduction & rationale:

Reduction of childhood mortality is one of the prime goals of National Health Mission and Millennium

Development Goals. Childhood diarrhoeal diseases continues to be one of the major killers among under

five children in many states contributing to 11 per-cent of under five deaths in the country. Around 2 lakh

children die due to diarrhoea annually in the country. Diarrhoeal deaths are usually clustered in summer and

monsoon months. The worst affected are malnourished children and children under two year of age.

Almost all the deaths due to diarrhoea can be averted by preventing and treating dehydration by use of ORS

(Oral Rehydration Solution), administration of Zinc tablets along with adequate nutritional intake by the

child. Diarrhoea can be prevented with safe drinking water, sanitation, breastfeeding/appropriate nutrition

and hand-washing.

Diarrhoea is common and more severe in children with malnutrition. Repeated diarrhoeal episodes result in weight loss and malnutrition in children who were previously well nourished. There is thus a close relationship between diarrhoea and malnutrition. Age appropriate infant and young child feeding (IYCF) practices are key to prevention of malnutrition.

As the effect of diarrhoeal mortality is highest in children, hence special campaign to prevent and control childhood diarrhoeal deaths is undertaken every year for three months from April to June. Besides this it has been decided to organise an Intensified Diarrhoea Control Fortnight (IDCF) this year from 28th July to 8th August 2014, with the ultimate aim of ‘zero child deaths due to childhood diarrhoea’.

2. About Intensified Diarrhoea Control Fortnight (IDCF) 2014

Intensified Diarrhoea Control Fortnight (IDCF) is a set of activities to be implemented in an

intensified manner from 28thJuly to 8th August 2014 to prevent deaths due to childhood diarrhoea

across all districts of all States & UTs. These activities mainly include- intensification of advocacy

activities, awareness generation activities, diarrhoea management service provision, establishing

ORS-Zinc Corners, ORS distribution by ASHA, detection of undernourished children and their

treatment, and promotion of Infant and Young Child Feeding activities.

The core IDCF is divided over two weeks to focus on dedicated thematic areas that affect diarrhoeal

mortality as below:

Week wise details of IDCF

Dates Theme

16th - 27th July Preparatory activities

28thJuly- 02nd August Week 1: Focus on diarrhoea control related activities

04th- 08th August Week 2: Focus on Infant and Young Child Feeding Practices (as child nutrition status is a major factor deciding occurrence and intensity of diarrhoea)

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3. Elements of IDCF: Week 1 (28thJuly- 2nd August):

IDCF would focus on activities of awareness generation and simple proven interventions that have

large impact towards control of childhood diarrhoeal morbidity and mortality. The key activities are:

1. Home visit by ASHA to every household that has under-five child to

a. provide prophylactic distribution of ORS packets

b. age appropriate IYCF counselling

c. demonstrate & counsel on preparation of ORS

d. counsel on seeking care in case of diarrhoea so that Zinc can be provided by the ASHA

e. in case the child is in red zone of the MCP card, refer to NRC

2. Establishment of ORS- Zinc corners - at Medical Colleges, District Hospitals, Block health facilities

and other treatment sites of government. Similarly, in partnership with IAP establishment of these

corners in every clinic of paediatrician and indoor wards.

3. Hand washing demonstration and practices in schools

4. Ensuring prescription of ORS with zinc dispersible tablets by all healthcare providers

Week 2 (4th- 9th August):

The second week would be observed in continuation as Infant & Young Child Feeding week with key

activities as below:

1. Home visitation by ASHA -for detection of undernourished children and deliver key IYCF messages

to households with under-five children

2. Establishing IYCF counselling sites - at Anganwadi and health facilities

3. Referral and medical management of undernourished children at health facility

Common Activities for Week 1&2:

1. Capacity building of all Health workers in Diarrhoea management and IYCF prior to Fortnight.

2. Intensive Awareness generation through TV, radio, miking, banners, posters at strategic locations.

3. Multi-sectoral involvement for better impact such as rallies, competitions at schools, state and

district level launch by leaders, involvement of IAP, involvement of PRIs, mother meetings and IYCF

demonstrations at Anganwadi Centres

OPERATIONAL FRAMEWORK OF IDCF

1. ORS ditribution & counselling through home

visits by ASHA to families of all

underfive chilren2.

Establishment of ORS-Zinc

Corners

3. Handwashing demonstration and practice in

schools

1. Initiation of breastfeeding

immediatley or within 1 hour

2. IYCF demosntration and counselling

sites

3. Medical management of under nourished

children at health facility

WEEK 2 WEEK 1

5. Multisectoral

involvements-

AWCs, Schools

PRI, etc

4. Intensive

Awareness

generation

Common Activities for week

wise theme

KEY

ELE

MEN

TS F

OR

ICD

F

4. Capacity

building for

implementation of

IDCF

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4. Preparatory activities from 16th to 27thJuly 2014

1. IDCF Secretariat & Steering Committee:

National level IDCF Secretariat has been established at the MoHFW, Government of India to

oversee the implementation of this fortnight. Similar structures should be established at State and

District level. At the State level, Principal Secretary Health or MD – NHM should preferably be

leading the IDCF Steering Committee with support from key staff from Directorate of Health and

Family Welfare. At the District level, IDCF Steering Committee should be formed, preferable led

by District Magistrate with support from Chief Medical and Health Officer of the district. At both

the State and District level, Program Officer for Child Health and IEC Officer should be included in

the Committee.

IDCF Steering Committee meeting: The lead official from State and District shall call a meeting

of the Committee before, during and after the fortnight to ensure effective implementation of the

IDCF.

Departments to be invited for the meeting: Health and Family Welfare, State Health Resource

Centre / ASHA Resource Centre, DWCD, Tribal Welfare, State / District IEC / Publication

Bureau, song and drama division, NYK, etc

Partners to be invited for the meeting: IAP, UNICEF, MI and Development Partners having

expertise on the subject or assisting the State in monitoring of RMNCHA activities.

Suggested agenda points for meeting:

1. Clarity on role of each department to make IDCF a success

2. Selection and role of nodal officer from each department to coordinate with other departments

3. Stock assessment of essential commodities viz: ORS sachets and Zinc dispersible tablets

4. Stock assessment of IEC materials: already available materials on ORS – Zinc use, hand

washing, and malnutrition etc. should be listed and distribution plan prepared. Additional

materials should also be used after replication and adaptation to local context. Prototypes of

additional IEC materials are available on the website www.nrhm.gov.in

5. Involvement of mass media e.g. TV, radio, etc.

6. Mechanism for involvement of other sectors- WCD, Education, PRI, Water & Sanitation,

IAP, private practitioners, noted NGOs

7. Chalk out daily monitoring and troubleshooting mechanism

8. Plan for State/District level inauguration of the IDCF by elected representatives in a

prominent general hospital.

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9. Micro planning: Micro plan has to be prepared to facilitate ASHA visits during the Fortnight.

Available resources such as micro plans of Pulse Polio Campaign and Routine Immunization

can be used to identify the houses of Under five children and prepare the visit plan during the

Fortnight. Micro plan should also contain details on ORS – Zinc Corners/ IYCF counselling

sites/ Health Facilities/ Schools, etc which are part of the IDCF Fortnight. Micro plans to be

reviewed by the respective nodal officers and IDCF steering committees for the successful

implementation of the campaign.

10. Capacity building of stakeholders:

A one day orientation workshop of various categories of stakeholders need to be carried out.

Who would be trained/oriented:

Location Participants Contents of orientation State/Regional level

RDD, CS, DIO, RPM, DPM, DCM Technical insights into diarrhoea control & IYCF ; Managerial and monitoring aspects of IDCF

District level BPO/ MOs / BCM / BHM/CDPO/MO- CHC/PHC etc

Block/PHC level

AYUSH, ANM, ASHA& AWW Orientation on activities that need to be carried out in the field. Technical aspects on preparation of ORS – Zinc, hand-washing, and IYCF counselling

During the capacity building exercise, distribution of recording, reporting and monitoring formats

and IEC material should also be undertaken and plan of activities should be explained to all

frontline workers.

Responsibility allocation to each BMO/MO should be done for various IEC activities.

Modules for technical orientation on diarrhoea management and IYCF along with IEC

material are in IDCF toolkit provided with these guidelines.

4. Logistics assessment:

Following are essential commodities: ORS sachets and Zinc dispersible tablets

During the IDCF, all facilities should have sufficient availability of ORS and Zinc dispersible tablets

in all health facilities. Assessment of the procurement and distribution status should be done as

logistic failure can lead to collapse of the IDCF and hence the State and District Programme

Managers need to pay special attention to availability of supplies.

For a district of 20 lakhs population, around 2 lakhs ORS packets (10 percent of the total

population) for prophylactic distribution and around 10,000 ORS packets for ORS-Zinc corners are

required. Zinc dispersible tablets should be made available at all health facilities and with every

ASHA. In case sufficient stocks are not avaibale, the state or district should undertake procurrment

on an urgent basis as per relevant rules and regulations.

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5. Gearing up of facilities:

Outdoor and indoor diarrhoea treatment facilities should be geared up for establishing ORS –

Zinc corners. In addition indoor diarrhoea treatment facilities should also be geared up for

management of diarrhoea with severe dehydration.

All birth facilities (institutional deliveries) should be geared up to initiate breastfeeding

immediately or within one hour of birth. Dedicated IYCF counselling corners should be

established at all health facilities during the second week of IDCF.

Schools should be geared up for hand washing demonstration.

AWCs and other health facilities should be geared up for establishing IYCF demonstration and

counselling sites.

6. Assessment of availability of IEC materials:

The State and District IDCF Steering Committee should undertake assessment of available IEC

materials such as videos, hoardings, posters, pamphlets and other materials. These should be

distributed for display at key strategic locations like prominent locations (e.g. bus-stops for

hoardings), ORS – Zinc corners (banner, video) and IYCF centres for placement at strategic

locations, prior to the IDCF. IEC material should be available with facilities at least 3 days before

start of the campaign.

6. Replication and adaptation of National IEC materials:

Prototypes of additional IEC material are available on the website www.nrhm.gov.in and

http://nrhm.gov.in/nrhm-components/rmnch-a/child-health-immunization/child-health/iec-

material.html.It is encouraged to use these materials widely for the IDCF campaign. If necessary,

adaptation may be carried out at the local level for better awareness generation in the communities.

5. Target beneficiaries

a. All Under five children for distribution of ORS and IYCF counselling

b. Under five children with diarrhoea and Children who are malnourished

c. Care-givers (Mother, father, guardian) of under five children for counselling on use of ORS –

Zinc, whom to contact for availing ORS and Zinc and counselling on IYCF

However, for sensitisation of this core audience, a large number of secondary audiences that

influences them would be involved such as Teachers, School children, PRI members, Health &

ICDS functionaries etc.

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6. Core activities during IDCF- WEEK 1

The first week of the IDCF would be observed for awareness generation and advocacy on use of

ORS and Zinc during diarrhoea towards achieving ‗zero deaths due to childhood diarrhoea‘.

Activities in Week 1

1. Home visit by ASHA to all families with under five children a. During the home visit ASHA will perform the following tasks

o Distribute ORS packet (one per under five year old child) o Demonstrate and explain the mother on how to prepare ORS in case the child

suffers from diarrhoea by holding meeting of 3-4 mothers during home visits o Deliver all key messages for Diarrhoea management (on page 11) o Counsel the mother on age appropriate feeding practices and hand washing

b. Every ASHA would be provided Rs. 1 per ORS distributed to under-five children by home visit.

c. At the end of IDCF, a report will be submitted by ASHA→ANM→BCM (Block DEO will compile the data)→ DCM (DM&E will compile the data)→State Health Society

Community level activities provide the last mile connectivity and complete execution of the programme and hence must be implemented effectively. Special emphasis need to be given to hard to reach areas and marginalized communities.

2. Establishment of ORS- Zinc corners a. ORS- Zinc corners should be established at Medical Colleges, District Hospitals, Block

health facilities and selected clinic / hospital of private practitioners b. Refer annexure on how to establish ORS – Zinc corner

5. 3. Hand washing demonstration in schools a. This activity needs to be carried out in all primary and middle schools b. Each school should have poster pasted at the hand washing area on steps for effective

hand washing c. After the morning assembly / prayers, message on importance of hand washing should be

delivered to all the students d. Before mid-day-meal, all children should be taught to wash hands following the steps in the

poster with water and soap.

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7. Core Activities in IDCF WEEK 2

The second week of IDCF would be celebrated as Infant & Young Child Feeding Practices

(IYCF) week for awareness generation on correct child feeding practices, creating

awareness on problem of under nutrition, detection and treatment of under nutrition and

providing effective IYCF counselling services

Activities in Week 2:

1. Home visits by ASHA and detection of undernourished children: In the Home visit, ASHA would identify -undernourished children such as children in grade 2 & 3 i.e. moderate and severely underweight by seeing MCP cards if available and also visibly severely wasted children. ASHA would facilitate growth monitoring through the Anganwadi Worker for all under-five children whose weight has not been plotted or their MCP card is not available. ASHA would also maintain line listing of these beneficiaries and refer these children to nearest health facility and follow up for ensuring treatment. ASHA would be provided an incentive of Rs. 100 for this activity.

2. Setting up of IYCF demonstration and counselling sites IYCF demonstration and counselling sites would be established at

each health facility i.e SC/PHC/CHC/DH/Medical College and

Anganwadi Centres.

Such a site is a visible place in the facility with following in place: child weighing scale and MCP cards for growth monitoring, mock food recipe and bowls for demonstrating consistency and measurement of child feed, an oriented counselling provider such as ANM/SN having job aides, posters, and pamphlets carrying IEC material for IYCF counselling. On the site, growth monitoring and feeding counselling would take place for all under-five children visiting the centre along with awareness generation activities for visitors of the facility. There should be a dedicated corner ensuring privacy for breastfeeding for mothers coming for RI session. All the health facilities, government as well as private, should ensure that babies born are initiated breastfeeding immediately or within one hour of birth.

3. Referral and medical management of undernourished children at health facilities/NRCs The undernourished children identified and referred by ASHA to health would be examined by ANM or Medical Officer for comorbidities such as tuberculosis, malaria, HIV, other chronic underlying diseases etc. and referral to centres where appropriate treatment is available would be done. Treatment and management of malnutrition and anaemia among children would be provided by ANM/MO. Effective nutritional counselling with demonstration of recipe as per correct nutritional norm or counselling for breastfeeding, components of WASH will also be undertaken for such children. The beneficiaries will be appropriately referred based on presence of any co-morbidity, severity of deficiency, non-responsiveness to treatment and requirement of specialist diagnostic/treatment modalities to higher centres.

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8. Involvement of IAP, Development Partners and other

relevant NGOs

IAP and Development partners should be part of the IDCF steering committee

IAP may be involved in this fortnight. The various activities proposed are :

- Facilitating launch District level launch though State and District Health Mission

- Organising sensitisation meeting of Chemists, local Practitioners regarding ORS and zinc use

and rational use of antibiotics in case of diarrhoea

Organising sensitisation meeting of chemists, local medical practitioners regarding ORS and

Zinc use and rational use of antibiotics in case of diarrhoea (IAP)

Establishing ORS – Zinc corners in clinics and hospitals of private paediatricians (IAP)

Sourcing prototype IEC materials in local language (development partners)

Effective reach to hard-to-reach areas and marginalised populations (local relevant NGOs)

Support in monitoring of IDCF (development partners)

9. Awareness generation activities a. State level launch: The IDCF should be launched by a Minister at state level and by

noted elected representative at district and sub-district level. Raise visibility of the

IDCF by involving Chief Minister/MPs/MLAs/PRI members. CM may be asked to lead

the movement and address the public through media with the message that (i) No child

should die in the state due to diarrhoea and (ii) Combat malnutrition for healthy development

b. District level launch: The IDCF should be launched at district level by MLA/MP

which will be facilitated by IAP. The launch should be widely publicised

c. Awareness generation on IDCF using mass and mid media along with folk lore and other

means of communication as per population needs should be undertaken in local language.

d. Television and radio should be used to increase reach of the messaging among the target

audience. Involve Doordarshan/ AIR and other TV and radio channels with clear messages

e. Posters, banners, hoardings should be put at strategic locations

f. Miking and school rallies should be organised

g. Munadi / drum-beating should be in every message. The message should be: In case of

childhood diarrhoea give ORS and Zinc immediately to the child. These are available free of cost with

ASHA. Wash hands with soap and water before eating food and after defecation. Mothers should

exclusively breastfeed their children till six months age. Contact the ASHA or AWW for advice on age

appropriate complementary feeding.

h. For sites at Anganwadi Centres, mothers meeting should be organised every day where

Behaviour Change activities related for childhood Diarrhoea should be undertaken

i. All the IEC materials &reporting formats should be available with the relevant stake

holders three days before the IDCF.

j. It is encouraged to use relevant IEC materials that have already been developed at the state

/ district level as they had been developed keeping the local context in mind. Additional

relevant materials for the IDCF has also been developed at National level and would need

to be printed at state / district level and distributed accordingly. These materials are are

available on MoHFW website www.nrhm.gov.in and http://nrhm.gov.in/nrhm-

components/rmnch-a/child-health-immunization/child-health/iec-material.html.

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AWARENESS ACTIVITIES SHOULD BE TAKEN THROUGH ABOVE MENTIONED

MODALITIES IN WEEK 1 & 2 BASED ON THE RESPECTIVE THEMES.

IEC activity to be undertaken Key person

State level a) T.V/ radio advertisements b) State level launch of IDCF by CM/ HM by inaugurating

activities in a General Hospital by administering ORS and Zinc to a child with diarrhoea in presence of media

c) Engage with private paediatricians and chemists for appropriate prescriptions and dispensing of medicines for treatment of childhood diarrhoea.

d) Facilitation of Districts by providing IEC material prototypes shared by GoI

e) Facilitation of Districts by providing other printed material- orientation material, FAQs, IDCF guidelines, monitoring formats

f) State level monitors to be sent to each District for observation of activities

MD(NRHM)

District Level

a) Launch of IDCF to be organised jointly by CMO office and Indian Academy of Paediatrics in a general hospital

b) Launch of IDCF by MP/MLA in presence of media c) Daily miking for key messages d) TV advertisements e) Placing Banners/Posters at strategic locations f) Celebrating ORS – Zinc Day which falls on 29th July

CMO

Schools /Colleges

School: a) Organise WASH IDCF in which soap, clean water is provided

and hand washing is observed before Mid-Day Meal; Banners/posters on Hand washing to be displayed in hand washing area

b) Organise essay writing/speech/painting competition among Sec/Senior Secondary School students on diarrhoea prevention and control followed by a lecture by BMO/MO on diarrhoea and ORS/Zinc use

c) Rally by primary/middle school children as ambassadors of ORS and Zinc and hand washing in community

Colleges: d) Organise speech competition on hand washing and use of

toilets in preventing diarrhoea, use of ORS and Zinc followed by a lecture by BMO/MO on diarrhoea and ORS + Zinc use

BMO/Active MO of CHC, PHC

Block Level

a) Special session on childhood diarrhoea- ORS + Zinc, and other key messages as on page 11- in meeting of Block PRI members (Funds from PRI system)

b) Similar session in BDC (Block Development Committee) meeting

BMO/BHO

Village level

ANM counselling for IYCF related activities in mother meetings ANM

Home visit by ASHAs for ORS distribution to families with under-five children

ASHA

Goshthi/village level discussion at VHNSC meetings on diarrhoea management

ANM/ MO

KEY MESSAGES FOR AWARENESS GENERATION TO BE USED

DURING WEEK 1

-to be used by

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KEY MESSAGES FOR AWARENESS GENERATION TO BE USED

DURING WEEK 2

-to be used by

DDO/CMO/BMO/BHO/MO/Managers/ANM/ASHA/AWW:

Under-nutrition in children is a major Public Health problem in our

country. Under-nutrition increases the risk of illness and death associated

with the illnesses. It also leads to compromised growth, impaired

psychosocial and intellectual development in children, thus preventing

children from attaining their fullest potential. For prevention of onset of

under-nutrition in children, following key practices are to be ensured:

a. Early initiation of breastfeeding; immediately after birth, preferably within one

hour.

b. Exclusive breastfeeding for the first six months of life i. e 180 days (no other

foods or fluids, not even water; but allows infant to receive ORS, drops, syrups of

vitamins, minerals and medicines when required)

c. Timely introduction of complementary feeding (solid, semisolid or soft foods)

after the age of six months i. e 180 days.

d. Continued breastfeeding for 2 years or beyond

e. Age appropriate complementary feeding for children 6-23 months, while

continuing breastfeeding. Children should receive food from 4 or more food

groups [(1) Grains, roots and tubers, legumes and nuts; (2) dairy products ; (3)

flesh foods (meat fish, poultry);(4) eggs, (5) vitamin A rich fruits and vegetables

(e. g carrot, orange, maize, mango etc) ;(6) other fruits and vegetables] and fed for

a minimum number of times (2 times for breasted infants 6-8 months; 3 times for

breastfed children 9-23 months; 5 times for non-breastfed children 6-23 months)

f. Continuous feeding for children during and after illness

g. Active feeding for Children during and after illness.

(For detailed information- refer to IDCF toolkit)

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10. Monitoring and supervision plan for IDCF 2014

National level teams will be carrying out monitoring visits to oversee the implementation of

IDCF. Similarly from the state level would monitor IDCF activities by sending dedicated

personnel to monitor activity at District level

The district IDCF committee will act as a nodal committee for all the monitoring and

supervision activities at Sub District level. They will plan for their own supervisory visit

during the Fortnight and also guide Block PHCs for developing supervisory plan and its

proper implementation

The block supervisors include BMO/BHO, BHM, BCM, AYUSH, MOIC and others. They

will visit at least 10% of the AWW ORS-zinc sites and 10% of households provided with

ORS for confirmation during the Fortnight period.

The overall community mobilisation and the IEC activities are monitored

Under RMNCH+A intensification, the lead agency will monitor its implementation through

District Coordinators placed in 184 HPDs

Involve of IAP, Development Partners and NGOs in monitoring the implementation.

Involvement of IAP, Development partners and NGOs and reaching for poor

performing districts: Special focus should be provided to High Priority Districts, other poor

performing areas, remote and tribal blocks, slums, areas prone to Diarrhoeal outbreaks based

on previous year‘s data. Development partners and other NGOs working in field of

Diarrhoea management should also be roped in for better coverage and quality of IDCF.

Technical expertise available with major development partners can be used to orient State

and District Health Officials to conduct the programme. Involve NGOs (eg Rotary) for

reaching out in marginalised communities.

11. Reporting

Each ASHA shall provide the filled monitoring formats at the end of the IDCF to the ANM

(Within first two days of post Fortnight)

ANM will submit the compiled report to the Block within the next two days of receiving

from ASHA

The Block DEO will collate the reports and submit it to the district M and E in another 2

days

The district M&E will submit the compiled duly signed copy to the State level in another 2

days after receiving from the Block

State IDCF reports would be sent to National level by 14th August 2014.

(Monitoring formats are placed in Annexures)

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12. Financial Guidelines for IDCF

States/District may utilise the unspent amount in their ROPs for 2013-14 and adjust the same

amount in PIP 2014-15. Following is a suggestive structure for expenditure for one District.

S. No.

Activity Estimated expenditure per District (Rs.)

1. ASHA incentive: a. Week 1: for prophylactic distribution of ORS @ Rs. 1

per ORS packet delivered to family with under-five children.

[For 100 under-five children per village and approximate 2000 ASHA funds are Rs. 2 lakhs]

b) Week 2: Facilitating growth monitoring of all children in village; screening of undernourished children to Health centre; IYCF counselling to under-five children household- for completing at least 80% of household @ Rs. 100 per ASHA

[For a district with approximate 2000 ASHA @ Rs. 100 per ASHA: funds are Rs. 2 lakhs]

4,00,000

2. Printing Costs: - monitoring formats (Rs. 1 per page x 3000 formats) - printing of training material (in Annexure I) @ Rs. 10 per 13 page booklet. [For 3000 providers x Rs. 10= Rs. 30,000]

30,300

3. Procurement of ORS- for prophylactic distribution [For a district with 20 lakhs population—around 2 lakh under-five children requiring 1 packet@ Rs. 2 per packet)

2,00,000

5. Daily Mobility Support for field level monitoring- 2 hired vehicles from 26 July -8August 2 Vehicle (Rent per day Rs. 1000/vehicle Fuel Rs.1000/day/vehicle) =Rs. 2000*10 days

20,000

6 WASH activities in Schools (Rs. 1000 per School)

Rs. 50,000

7 IEC material printing: Banners/Posters/Pamphlets for ASHA, Munadi, Nukkad Nataks

2,00,000

8 One day orientation meeting at PHC/Block levels @Rs. 50/ participants for around 3000 health care providers (apart from printing of training material.

1,50,000

Total Rs10,00,000 (approx.)

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Annexure I: IEC materials for IDCF

List of IEC materials

Sr. No

Material Soft file

1 TV Spots Dono Zaroori – 40 sec TV Spot_DONO ZAROORI.mp4

2 Radio spots ORS & Zinc spot 30 sec.wav (30 sec)

3 Radio spots ―Dono ki Wajah Se‖ Radio_DiarrheaMIL.mp3 (40 sec)

4 Poster IEC_prototype_Set B.pdf

5 Poster Poster_1-Diarrhea.jpg

6 Poster Poster_7_VHND_Breastfeeding_VHND ‗Pehle cheh maah sirf stanpan karayein‘

7 Press advertisement Early initiation of Breast Feeding_Hindi_PRess_Ad

8 Hoarding IEC_prototype_Set B.pdf

9 Sticker IEC_prototype_Set B.pdf

10 IPC Leaflet ORS ZINC ‗Jab Bachche ko Dast ne Kamzor kiya…” 10 12 10.pdf

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MASS MEDIA

PRESS ADVERTISEMENTS

SUGGESTED CHANNEL

SOFT FILE MESSAGES INTENDED AUDIENCE

WEEK

TV ads/ Video streaming

through national, local channels

Dono Zaroori – 40 sec TV Spot_DONO ZAROORI.mp4

Combination of ORS and Zinc is necessary for treatment and building immunity against Diarrhoea

General public and care-givers of under-five children

WEEK 1

Handwashing WEEK 1

Amir Khan Nutrition Stage 3: Mariyal Singh, 60 sec

Exclusive breastfeeding for six months, giving water to child before six months can cause Diarrohea, Complimentary feeding after six months.

General public and care-givers children less than six months age

WEEK 2

Radio spots and miking

ORS & Zinc spot 30 sec.wav (30 sec)

General public and care-givers of under-five children

WEEK 1

―Dono ki Wajah Se‖ Radio_DiarrheaMIL.mp3 (40 sec)

Benefits of using ORS and Zinc

Care givers and Health care providers, opinion leaders

WEEK 1

SUGGESTED CHANNEL

SOFT FILE MESSAGES INTENDED AUDIENCE

WEEK

Newspapers / magazines / other print

media

Early initiation of Breast Feeding_Hindi_PRess_Ad

Early initiation of breast feeding protects child from diseases

Primary Care givers, mothers…

WEEK 2

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LOCATIONS

Suggested location

Material Soft file Messages Intended audience Week

Prominent location viz: Bus

stop, railway

station etc

Hoarding IEC_prototype_Set B.pdf Hoarding 20X10 feet

Combination of ORS and Zinc is necessary for treatment.

General public and care-givers of under-five children

WEEK 1

ORS - Zinc

corners

Poster (MI)

IEC_prototype_Set B.pdf

WEEK 1

Poster Poster_1-Diarrhea.jpg

Highlight the benefits and importance the new regime or combination ORS and Zinc.

Care-givers of under-five children

Video Dono Zaroori – 40 sec TV Spot_DONO ZAROORI.mp4

Combination of ORS and Zinc is necessary for treatment and building immunity against Diarrhoea

General public and care-givers of under-five children

WEEK 1

Leaflet Leaflet ORS ZINC ‗Jab Bachche ko Dast ne Kamzor kiya…” 10 12 10.pdf IPC tool

Benefits and correct dosage and ways to administer ORSand Zinc

School children and teachers

WEEK 1

School (for

distribution)

Sticker IEC_prototype_Set B.pdf

Combination of ORS and Zinc is necessary for treatment.

School children and teachers

WEEK 1

Leaflet Leaflet ORS ZINC ‗Jab Bachche ko Dast ne Kamzor kiya…” 10 12 10.pdf IPC tool

Benefits and correct dosage and ways to administer ORS and Zinc

School children and teachers

WEEK 1

All health facilities

Poster Poster_1-Diarrhea.jpg

Highlight the benefits and importance the new regime or combination ORS and Zinc.

Care-givers of under-five children

Poster Poster_7_VHND_Breastfeeding_VHND ‗Pehle cheh maah sirf stanpan karayein‘

Practice exclusive breastfeeding for 6 months. After six months start giving complementary food to child. Explains benefit of colostrum, balanced diet and its

17

Annexure II:

ORS – ZINC CORNER

ORS - Zinc Corners are usually meant for childhood diarrhoea with some dehydration to be

administered ORS under supervision for 4 hours. Also no-dehydration cases that come directly to

facilities could be treated at the ORS – Zinc corners.

Location:

ORS – Zinc corners should be at health facilities like Medical Colleges, District Hospitals, Block

health facilities, sub-centres, private paediatrics facilities etc. Earmark a suitable area in the health

facility for the corner. A small corner in the OPD or ward or any other suitable area in the health

facility is generally enough for this purpose. The space required would depend on the case load.

While earmarking such an area it should be ensured that:

In case of hospital, the area is close to the workplace of the Doctor so that assessment of the

child can be carried out frequently.

The area is near a toilet or a washing facility, where mothers can clean the child and wash

their hands before feeding them.

Mothers can sit comfortably while administering ORS to their child.

Timings:

The ORS – Zinc corners should be functional during OPD timings and 24 hours in paediatrics

ward. A health worker who is trained in preparation of ORS solution and Zinc solution, should be

posted to manage the corner. The corner should be prominently labelled as “ORS – Zinc Corner for

treatment of diarrhoea”

Materials required for management of ORS – Zinc corner

One table and two chairs / one bench should constitute the corner

Sufficient ORS and Zinc tablets with potable drinking water in a clean container, five glasses

(200 ml), bowl / cup, one litre vessel, clean spoons and leaflets should be on the table.

IEC activities at the ORS – Zinc corners:

Banner and poster on ORS – Zinc and hand washing should be displayed at the corner.

Activities:

At least one litter of ORS solution should be prepared daily after washing hands with soap

and water. The solution should be kept at the ORS – Zinc corner. It should be readily

available to the mother when required. Replenish the solution whenever required. More than

24 hours prepared solution should be discarded and not be used.

After the mother has washed her hands thoroughly with soap and water, provide the ORS

solution in bowl / cup or glass with spoon to enable her to administer the solution.

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In case of a diarrheal episode during ORS administration, the child and mother and the area

should be thoroughly cleaned. After washing hands again with soap and water the mother

should administer ORS.

If the child vomits, the child and mother and the area should be thoroughly cleaned. After

washing hands again with soap and water the mother should administer ORS more slowly.

In case of no-dehydration diarrhoea,

o Administer ORS solution at the corner for some time till the child is comfortable.

o Explain the mother on how to prepare the ORS solution, if possible demonstrate.

o Demonstrate on how to prepare age appropriate Zinc tablet solution in a spoon.

Administer the first dose of Zinc tablet solution.

o Explain when to administer ORS and Zinc.

o Provide at least one ORS sachet and 13 tablets of Zinc to take home.

o Advice on age appropriate feeding during diarrhoea

o Advice when to return

In case of some-dehydration diarrhoea,

o Administer ORS solution at the corner for 4 hours

o Re-asses the child for status of dehydration.

o In case of no dehydration, follow the above steps for no-dehydration diarrhoea.

o In case of severe-dehydration, the child needs to be admitted for Plan C treatment.

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Annexure III: MONITORING FORMATS

NATIONAL REPORTING FORMAT

Part A: FOR IDCF Week 1

Reporting for the period of …………………. To …………………..

1 Name of State:

2 Name of Nodal Officer Implementing IDCF Email: Phone:

…………. …………. …………...

3 No. of Districts conducted IDCF 2014/Total No. of Districts …../…….

4 State launch undertaken as per guidelines

5 No. of Districts where District launch was undertaken

6 No. of ASHAs oriented on IDCF/ No. of ASHA .…../……..

7 No. of ANMs oriented on IDCF/ No. of ANMs ……/……

8 No. of Staff Nurses oriented on Diarrhoea management/ No. of Staff Nurses ……/……

9 Dates of IDCF week 1 observation:

10 No. of vehicles hired for field monitoring

11 No. of HPDs where intensive monitoring was undertaken by DPs/Total no. of HPDs …../…….

12 No. of blocks where supervisory activities during fortnight was undertaken

13 No. of ORS – Zinc Corners established

14 No. of under five children visited by ASHA

15 No. of children given prophylactic ORS packets during IDCF

16 No. of childhood diarrhoeal cases reported in the State during IDCF

17 No. of cases of dehydration (some / severe) reported in the State during IDCF

18 No. of children treated with ORS and Zinc

19 No. of childhood deaths reported due to diarrhoea during IDCF

20 No. of ORS Packets distributed

21 No. of Zinc tablets used during IDCF

Part B: For IDCF Week 2

Reporting for the period of …………………. To …………………..

1 Name of State:

2 Name of Nodal Officer Implementing IDCF Week 2 Email: Phone:

…………. …………. …………...

3 No. of Districts conducted IDCF 2014 Week 2/Total No. of Districts …../…….

4 No. of ASHAs oriented on IDCF IYCF component/ No. of ASHA .…../……..

5 No. of ANMs oriented on IDCF- IYCF component/ No. of ANMs ……/……

6 No. of Staff Nurses oriented on IYCF component/ No. of Staff Nurses ……/……

7 Dates of IDCF week 2 observation:

8 No. of vehicles hired for field monitoring

9 No. of HPDs where intensive monitoring was undertaken by DPs/Total no. of HPDs …../…….

10 No. of blocks where supervisory activities during fortnight was undertaken

11 No. of institutional delivery (birth facilities) in the State

12 No. of births during IDCF Week 2

13 No. of new borns initiated breastfeeding within one hour of birth during IDCF Week 2

14 No. of IYCF demonstration and counselling sites established

15 No. of Families with under five children provided IYCF counselling

16 No. of children for which growth monitoring was undertaken

17 No. of under five children screened for referral by ASHA

18 No. of children with under-nutrition referred

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1. ASHA reporting Format

FORMAT FOR WEEK 1

Name of ASHA: Village: Block District ASHA to tick (√) the boxes as she distributes 1 ORS packet to each household with under-five children

1 21 41 51 61 71 81 91 101 121 141 161 181

2 22 42 52 62 72 82 92 102 122 142 162 182

3 23 43 53 63 73 83 93 103 123 143 163 183

4 24 44 54 64 74 84 94 104 124 144 164 184

5 25 45 55 65 75 85 95 105 125 145 165 185

6 26 46 56 66 76 86 96 106 126 146 166 186

7 27 47 57 67 77 87 97 107 127 147 167 187

8 28 48 58 68 78 88 98 108 128 148 168 188

9 29 49 59 69 79 89 99 109 129 149 169 189

10 30 50 60 70 80 90 100 110 130 150 170 190

11 31 51 61 71 81 91 101 111 131 151 171 191

12 32 52 62 72 82 92 102 112 132 152 172 192

13 33 53 63 73 83 93 103 113 133 153 173 193

14 34 54 64 74 84 94 104 114 134 154 174 194

15 35 55 65 75 85 95 105 115 135 155 175 195

16 36 56 66 76 86 96 106 116 136 156 176 196

17 37 57 67 77 87 97 107 117 137 157 177 197

18 38 58 68 78 88 98 108 118 138 158 178 198

19 39 59 69 79 89 99 109 119 139 159 179 199

20 40 60 70 80 90 100 110 120 140 160 180 200

Part B: ASHA Reporting format

S. No.

1 No. of Under five children in the village

2 No. of Families provided prophylactic ORS packets

3 No. of children reported with diarrhoea during IDCF

4 No. of children with diarrhoea getting ORS

5 No. of children with diarrhoea getting zinc for 14 days

6 No. of children with diarrhoea provided counselling on feeding practices

7 No. of children with diarrhoea provided counselling for WASH components

8 No. of children detected with danger signs during diarrhoea

9 No. of children with danger signs referred to facility

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FORMAT FOR Week 2 Name of ASHA: Block District ASHA to tick (√) the boxes provides IYCF counselling to each household with under-five children

1 21 41 51 61 71 81 91 101 121 141 161 181

2 22 42 52 62 72 82 92 102 122 142 162 182

3 23 43 53 63 73 83 93 103 123 143 163 183

4 24 44 54 64 74 84 94 104 124 144 164 184

5 25 45 55 65 75 85 95 105 125 145 165 185

6 26 46 56 66 76 86 96 106 126 146 166 186

7 27 47 57 67 77 87 97 107 127 147 167 187

8 28 48 58 68 78 88 98 108 128 148 168 188

9 29 49 59 69 79 89 99 109 129 149 169 189

10 30 50 60 70 80 90 100 110 130 150 170 190

11 31 51 61 71 81 91 101 111 131 151 171 191

12 32 52 62 72 82 92 102 112 132 152 172 192

13 33 53 63 73 83 93 103 113 133 153 173 193

14 34 54 64 74 84 94 104 114 134 154 174 194

15 35 55 65 75 85 95 105 115 135 155 175 195

16 36 56 66 76 86 96 106 116 136 156 176 196

17 37 57 67 77 87 97 107 117 137 157 177 197

18 38 58 68 78 88 98 108 118 138 158 178 198

19 39 59 69 79 89 99 109 119 139 159 179 199

20 40 60 70 80 90 100 110 120 140 160 180 200

Part B: ASHA Reporting format

S. No.

1 No. of Under five children in the village

2 No. of Families with under five children provided IYCF counselling

3 No. of children for which growth monitoring was undertaken

4 No. of under-five children screened for referral

5 No. of children with under-nutrition referred to ANM

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IDCF Secretariat

In case of any further information may contact:

1. Dr. Rakesh Kumar, Joint Secretary (RCH)

Email: rkumar92@hotmail.com

Telefax: 011-23061723

2. Dr. Ajay Khera, Deputy Commissioner (Child Health & Immunization)

Email: ajaykheramch@gmail.com

Telefax: 011-23061281

3. Dr. Sila Deb, Deputy Commissioner (Child Health) Email: drsiladeb@gmail.com

Telefax: 01123061218

4. Dr. Ruchika Arora

Email: ch.mohfw.trainings@gmail.com

Telefax: 01123061218

5. Dr. Manjunatha R

Email: manjunathar@micronutrient.org

Telephone: 08004938567

IDCF Toolkit

Contents:

1. Orientation module cum FAQs (Frequently Asked Questions) on Diarrhoea

management

2. Orientation module cum FAQs (Frequently Asked Questions) on Infant &

Young Child Feeding Practices

3. Communication Kit for Awareness campaign

(IDCF toolkit is a separate document provided with these guidelines)