Emergency Preparedness Status in Maharashtra (IEAG July11)

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Emergency Preparedness Status in
Maharashtra(IEAG July11)

• Dr D S Dakhure
• Director(HFW-MH)

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Maharashtra

• Part I
• Epidemiological risk in Maharashtra
• Part II
• Emergency Preparedness response Plan (EPRP)

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Part I
WPV importation and Transmission risk in
Maharashtra
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Source Census 2011
Maharashtra Profile 2011 Maharashtra Profile 2011
Population 112.6 Million
No. of Districts 34
No. of Corporations 22
No. of Blocks 396
MH
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Maharashtra is the second most populous state
after Uttar Pradesh and third largest state by
area after Rajasthan Madhya Pradesh in India.
It is the richest state in India- MIGRATION
RISK- PULL MIGRATION
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Risk factors-Maharashtra

• High urbanization
• High migration (inter/intra state)
• Booming construction industry
• Slums
• Seasonal migrants (sugar cane cutters-Beed)
• Past history of WPV importations/ transmission

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Risk factors-Maharashtra Risk factors-Maharashtra
Mumbai Thane High migration, Construction workforce Slums. Past h/o importations/ transmission
Bhiwandi Malegaon Refusals/Vaccine avoidance. Large underserved population
Rest of MH High urbanization. Seasonal migration (sugarcane cutters)
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MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA MAHARASHTRA
No. District 2003 2004 2005 2006 2007 2008 2009 2010 2011
1 NASIK 0 1 0 0 0 0 0 4  
2 BEED 0 0 0 1 0 0 0 1  
3 THANE 1 1 0 1 1 1 0 0  
4 GR. MUMBAI 0 1 0 3 0 1 0 0  
5 AMRAVATI 0 0 0 0 1 0 0 0  
6 SANGLI 1 0 0 0 0 0 0 0  
7 NANDED 1 0 0 0 0 0 0 0  
Maharashtra Total Maharashtra Total 3 3 0 5 2 2 0 5  
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MAHARASHTRA WPV Cases 2010 2011
P1 Wild Case - 5 Idcode Donset 1)
MH-NSK-10-201 10/01/2010 Mohd. Kasim Asrar
Ahmad 12 months 2) MH-NSK-10-217
21/07/2010 Sultan Shaikh Akil 24 months 3)
MH-NSK-10-220 24/08/2010 Altmish Anjum Siraj
Ahmad 10 months 4) MH-NSK-10-221
10/08/2010 Fareeha Mohd. Ibrahim 22 months 5)
INDMHOBD10017 16/09/2010 Raj Kiran Ade 10
months
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Mumbai
WPV Cases 2006-2010 MH WPV Cases 2006-2010 MH
Mumbai Thane 7
Nasik (Malegaon Corp) 4
Beed 2
Amravati 1
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WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards WPV Cases Mumbai 1999 onwards
Year H-E G-N K-W M-E B P-N R-N
1999 2 1          
2000   1 1 1      
2001         1    
2002       2      
2003              
2004           1  
2005              
2006       2     1
2007              
2008       1      
2009              
2010              
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High Risk Wards in Mumbai
9 High Risk wards in Mumbai on highest priority
for SIA Surveillance
High Risk Wards-Mumbai High Risk Wards-Mumbai High Risk Wards-Mumbai
  P/N,L,S Slums with migration
  H/W, K/E,K/W Highest construction sites (70)
  G/N, F/N,M/E Environmental Surveillance Sample wards
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Additionally ..

• Industrialized areas of Thane (Bhiwandi) Raigad
  are at high risk of WPV transmission due to
• 1) High MIGRATION
• 2) Construction workforce from endemic states of
  UP, Bihar West Bengal)
• 3) Slums with migration

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Areas at risk WPV transmission in Maharashtra
Risk in MH Area Risk Factors
  Mumbai Thane Past h/o WPV transmission, Migration and Slums Sewage sample results
  Malegaon Corp( other urban areas) Vaccine avoidance/Refusals/ Low Routine Immunization
  Beed and other migratory pop. Districts Seasonal migration
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Part II
Emergency Preparedness response Plan (EPRP)-MH
status
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State Emergency Preparedness Response Group
Maharashtra formed

• Preparatory meeting was held in 3rd week of
  Apr.11 in Pune with Addl Director and SEPIO to
  finalize names of RRT team members for high risk
  areas.
• EPRP meeting was held on 7th May 11 at Arogya
  Bhavan Mumbai under chairmanship of Director
  (HFW)

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EPRP-Maharashtra

• EPRP meeting was conducted under chairmanship of
  Director-HFW,MH with officials from all high
  risk areas Mumbai, Malegaon Bhiwandi, Thane
  Nasik districts.
• All members of core team were explained in detail
  about EPRP
• Senior experienced officials from state are
  identified as RRT members

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EPRP-Maharashtra

• They are assigned all pre-identified high risk
  areas.
• Senior state officials from HQ are designated as
  state supervisors for RRT members.

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EPRP ACTIVITIES-Maharashtra EPRP ACTIVITIES-Maharashtra EPRP ACTIVITIES-Maharashtra
Task  Actions  Status
Areas with high risk of importation spread of poliovirus Mumbai Metropolitan Region (MMR), all Corporations (24) and high migratory districts-Beed Completed
Districts/blocks with low RI coverage  Identified Completed
Communication Risk Analysis Bhiwandi Malegaon Corporation 69 Fast Track Field Volunteers (FTFVs) and 13 Field Volunteers in place coordinating with UNICEF
Media response plan Addl. Director chairman of media response Completed
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EPRP ACTIVITIES-MH   EPRP ACTIVITIES-MH   EPRP ACTIVITIES-MH  
Task  Action  Status
Rapid Response Team (RRT) members Identified by name for all high risk areas Completed
Surveillance Review Reviewed on monthly basis and letter issued from state to defaulting districts Completed/ Ongoing activity
Assigning senior state officials to high risk districts/blocks Followed in all SIAs and reports submitted for corrective actions Completed/ Ongoing
Migratory area mapping Completed in Mumbai-Thane-Raigad and Malegaon Rest of the state will be completed in next three months
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State Senior Supervisors State Senior Supervisors State Senior Supervisors
Sr. No. Name High Risk area assigned
1 AHO EPI Mumbai Corporation Mumbai
2 Deputy Director of Health Services Mumbai Circle Thane district and all 6 Corporations
3 Deputy Director of Health Services Nasik Circle Malegaon Corporation and Nasik district
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Special Plan for strengthening Routine
Immunization in Malegaon Corporation

• Deployment of PHNs and ANMs to Malegaon
  Corporation to manage RI
• Has shown good results
• Out of 2790 RI sessions planned 2730 (98)
  conducted

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Improvement in Malegaon RI due to deployment
PHN/ANMs
Month PHN ANM Total Staff Deputed No. of Immunization Sessions planned Actual no. of Immunization Sessions held
Oct.10 10 27 37 359 351
Nov.10 5 25 30 312 296
Dec.10 4 23 27 277 281
Jan.11 2 19 21 277 275
Feb.11 0 6 6 280 275
Mar.11 1 9 10 283 287
Apr.11 0 9 9 328 323
May.11 0 6 6 339 316
June.11 0 3 3 335 326
Total 22 127 149 2790 2730
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Summary

• Mumbai/ Thane followed by Malegaon are highest
  risk areas for WPV transmission
• Maharashtra is fully committed to implement
  Emergency Preparedness Response Plan
• SIA preparedness meetings of all key officials
  from high risk areas are conducted before each
  SIA
• Regular reviews at highest level for all HIGH
  RISK area during/after ALL SIAs for corrective
  actions.

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With all good wishes from Maharashtra
THANK YOU