TFI Follow Up meeting

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TFI Follow Up meeting
COMMUNICATION FOR EPI/Polio Dakar, Senegal, 5 7
April 2008
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Flow of data and information

• National
• State
• LGA
• Ward

Information for action / feedback
Data
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Process

• Collect/receive IPDs data for the LGAs/states
  from WHO (exported Excel files include all the
  data from the different forms used during the
  IPDs).
• The data are then converted into specific charts
  as required and compared with identical charts
  from previous IPDs
• IPDs data for states or LGAs is mapped to allow
  for visual interpretation of the geographical
  patterns over time.
• Feedback thru Consultants and review meetings
• Analysis by states sent to national data FP who
  gives feedback

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Actors Involved

• Socmob data officer at UNICEF
• Nat Socmob working Group (NSMWG)
• ME working Group (Chair is WHO)
• Health Education officers (LGA/State)
• State Consultants (WHO/UNICEF)
• WHO data FPs
• Other partners (COMPASS, RED Cross)

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2008 Monitoring Indicators

• Major
• reduction in NC Households (trends analysis)
• reduction in missed children (trend analysis)
• reduction in Zero dose children
• Trend analysis of sources of information
• Trend analysis of knowledge of campaign
• Other
• Trend analysis of data from Koranic schools
• Trend analysis of data for children immunised on
  the streets

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Priority Zones Trend in Non-compliance
NCHH by LGA, Sept 07
NCHH by LGA, Jan 08
NCHH by LGA, Feb 08
Trend in NCHH in 6 VHR States
Tally Data
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Strategic Result Sources of Information
JANUARY 2008
JANUARY 2007
FEBRUARY 2008
Independent Monitoring Data
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Strategic result Missed Children in the 6 VHR
States
10.6 reduction in children missed due to
non-compliance in the 6 Very High Risk States
from Nov 07 to Feb 08
Monitoring Data
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Reasons for Child Absent, Feb 08
Monitoring Data
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Jigawa State Trend in NCHH
September 2007
November 2007
February 2008
January 2008
Sule Tankankar
Tally Data
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Missed Children () by Ward Sule Tankakar LGA,
Jigawa State January 08 IPDs
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Sources of information, Danadi Ward, Sule
Tankakar LGA , Jigawa
IPDs JAN-08
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Key Communication Issues for HR Danadi Ward in
S/Tankankar

• Very high level of missed children.
• SECT (Digawa) does not believe in western
  medication
• Non-compliance, overt and passive
• Significant levels of zero-dose children
• No correlation between influence of traditional
  institutions and compliance
• Inadequate implementation by teams/health workers
  to counsel HH for acceptance.
• Responses
• Line listing of Quranic schools and population
  of children
• Additional teams provided by Jigawa
• Use of TBAs in every team as vaccinators.
• Use of Quranic schools teachers as vaccinators
  in HR.
• Engagement of Emir of Gumel

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Indicators for Special Initiatives

• Koranic schools
• No of Schools sensitized
• No of schools that allowed immunisation
• No of Children reached in Koranic schools
• Child to child and Youth participation outreach
• No of youths involved/participating
• No of eligible children identified
• No of identified children that are immunized

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Indicators for Special Initiatives (2)

• Community Dialogues (CDs)
• No of CDs conducted
• No of participants in CDs
• Issues raised in CDs
• No of Non-compliant children immunised after CDs
• IPC improvement initiative
• No and categories trained (vaccinators, TBAs,
  CBOs WFPs, HEOs)
• Quality of training
• Basic skills (GATHER)

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Strategic Results Community Mobilization
Federation of Muslim Women Associations of
Nigeria (FOMWAN) resolved over 70 of
non-compliance cases identified
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Strategic Result Children Vaccinated in Koranic
Schools
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Impact of Community Dialogues
Children Immunised
Non-compliant Households
Tally Sheet Data for Settlements where dialogues
were monitored
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Follow Up Supervision Mechanisms

• Review of microplans
• Feedback and guidelines for next IPDs
• Deployment of national consultants to supervise
  states
• STOP teams focus on supportive supervision for
  data
• 2 annual retreats for SM personnel
• Monthly State reports (LGA and state)

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Key Challenges

• Weak Capacity of personnel at ward, LGA and state
  to analyse social mobilization data to guide
  planning of interventions
• Weak feedback from states on linkages between
  epidemiological and SIA data and targeted
  communication interventions
• Inconsistent data collection tools across states
  on different initiatives by partner agencies

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Key Challenges contd.

• Frequent gaps in the data received from the
  states and sometimes data are entirely
  unavailable
• Weak capacity of vaccination team personnel to
  collect social mobilization data at
  household/settlement level
• Weak capacity of NPHCDA monitoring and evaluation
  personnel to support SMWG in data analysis in the
  absence of UNICEF personnel
• Poor access to social data collected and analysed
  by partner agencies on various communication
  approaches

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Key Lessons Learned

• Profiling and disaggregated analysis of
  communities and households has now led to better
  understanding of reasons and therefore better
  response
• Data analysis and use helps to pin point problem
  areas requiring priority attention
• HR analysis is key to deployment of Human and
  Financial Resources

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Recommendations/Suggestions

• Retain position of EPI Social Mobilization Data
  Specialist in new UNICEF Country Programme
• NPHCDA to assign staff from the data department
  of the agency to NSMWG to help build capacity,
  share workload
• UNICEF or partners to field Consultants with
  basic data analysis skills at State level to
  facilitate the use of social data on immunization
  for communication
• NSMWG and MEWG to harmonise tools for
  state-specific and agency-specific initiatives
  and then ensure partners regularly share their
  data.

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Next Steps

• Guidelines on data collection, analysis and use
• Harmonize and share basic tools
• Orientation on use of current tools

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Routine Immunisation (RI)Reaching Every Ward
(REW)
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Process and Actors

• Not systematically planned for
• Data collected through annual KAP
• Partners collect periodic data (PRRIN)
• SMWG
• M and E Working group
• SM consultants
• Integration of indicators in supervisory
  checklists (3 critical messages)

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Priority Zones

• Polio HR States/LGAs
• Priority wards based on numbers of un-immunised
  children (some wards in Lagos, Oyo and Benue)

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Indicators

• of caretakers who can state benefits of
  immunisation
• of caretakers who can state Vaccine Preventable
  Diseases
• of caretakers who can state number of doses
  required before childs 1st birthday
• of caregivers who can state correct age for
  measles vaccination
• No of Community Dialogues that indicate
  discussion of routine immunisation
• No of Health talks on radio that
  discuss/integrate Routine immunisation

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Knowledge on Routine Immunisation KAP 2007
Age a child should be vaccinated against measles
Number of doses of DPT required by child in
first year
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REW Indicators

• No of Community Coordinating Groups functional in
  wards
• No of Health Facilities with a community link
  plan
• No of community mobilizers or Community Health
  Workers involved in defaulter tracking
• b. Reasons for defaulting
• No of community groups mobilized in support of
  immunization
• b. Type of support they provided as a result of
  the mobilization
• Caregivers knowledge of diseases prevented,
  immunization schedule and dates of clinic
  sessions/outreaches)
• Health educators monthly plans (facility based
  and outreach)
• Sources of information on immunization

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Follow up and Supervision Mechanism

• Ensuring that Village Development Committee (VDC)
  health FP reports on immunisation to community
  and Ward Development Committee (WDC)
• HEO follows up (LGA/State)
• Supervision from state and LGA

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Key Challenges

• Weak supervisory system especially for health
  education
• No FP for SM at community and ward level
• No agreement on indicators and tools
• System not in place for regular data collection
  for RI communication
• SM very centralised at LGA level

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Key Lessons Learnt

• Establishment of a system for planning and
  monitoring communication for RI is a necessary
  first step for regular data collection

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Suggestions and Way Forward

• Strategic communication planning for
  communication for RI
• indicators and tools
• training
• data collection, analysis and systematic use

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Targeted advocacy makes a difference in the lives
of children and brings a smile
First lady of the Federal Republic of Nigeria at
National flag off for IPD