SIA MICROPLAN FIELD VALIDATION FORM

(to be filled by UC & District level staff)

Province District Date of SIA Date of Validation
Validating Person Designation Agency Govt. WHO UNICEF
Union Council Number of AICs
MP Validated by Whom at UC level? UCMO UCPO UCCO TTM
EPI Coord. DPMT NSTOP IO
MP Validated by Whom at District level? DHCSO TPO Other_____________________
MP Field Validation Variables Matching with Ground AIC ____ AIC ____ AIC ____ AIC ____ AIC ____
Team ____ Team ____ Team ____ Team ____ Team ____ TOTAL
Realities Day ____ Day ____ Day ____ Day ____ Day ____ SCORE
(1-Yes; 0-No; NA-Not Applicable) Matching: Yes/No Matching: Yes/No Matching: Yes/No Matching: Yes/No Matching: Yes/No

Collect Team Route map from AIC.

Team Route map are not part of Microplan but AIC should keep it and hand it over to FLWs during campaign
Select the starting household from any day’s work for a team
1 from their map and verify the household details while in the
field
From the same starting point as the previous question, cross
2 verify the Day/Team/Area/UC boundaries against their maps.
Continuing with the same day’s work, verify landmarks from
3 the team’s route map as you move to the ending point of that
day (Mosques, Madrassas, schools, markets, etc.)
Team movement pattern as per guidelines (not zig zag except
4 in certain circumstances)
Cross-verify any High-Risk & Mobile Population settlements
5 found while in the field with the maps
If there is an HR&MP in the AIC area where you are doing the
6 field validation, select the first HR&MP group you come across
and verify its information in MP
Select one school/madrassa from micro plan and verify its
7 target from school/madrassa registration
Select one fixed site if mentioned in the micro plan and verify
8 the location and if it is spotted in the map
Select one transit point if mentioned in the micro plan and
9 verify the location and if it is spotted in the map
In CBV areas, 10 households will be verified from micro census registration. Priority of these
houses are NA, Locked, 0/0, Refusals, or missed. The 10 households should be a mix of all these
categories for one day’s work. If there are not 10 houses that match there criteria, houses
10 should be selected at random until 10 houses are verified against the micro census books. NA NA NA NA NA NA
The following question will be answered about those 10 houses:
What is the status of the above-mentioned houses compared with the micro census book?
Comment if houses do not match. (NA in case of Mobile Team Area)
Select the ending household from the same day’s work and
11 verify the household details while in the field
From same ending point as the previous question, cross verify
12 the Day/Team/Area/UC boundaries against their maps
13 Community vaccination sites mentioned in MP exist in field.
Select Newly added hamlets/street in MP-verify in Field or
14 verify from MP in field
Total Score (Matching = 1 and Not Matching = 0)
If any missed area found: Provide detailed address along with estimated number of children found missed
(Missed area mean 3 or more HH Missed in one locality = MP Failed)
Remarks:

Signature of Validating Person: ________________________ Submitted to: ________________________