Balanced scorecard slide 1

Divisional Task Force

Coordination Meeting
August 2021
Peshawar Division
Balanced scorecard
OUTLINE
slide 2
1. Follow-up of last DTF Decisions
2. Polio Updates: Global and Local
3. Environmental Sample Peshawar Div
4. Supplementary Immunization Activities: KPIs
5. Essential Immunization: First Line of Defense!
6. Surveillance for Eradication
7. Preparation for CR August 2021
8. Health Camps
9. Conclusion

07/27/2021
 Follow Up To Previous DTF Meeting
Decisions Responsibility Peshawar Khyber Charsadda Nowshera Mohmand

Balanced scorecard slide 3

Covid 19 vaccination of all the FLWs before the commencement
of June SNID.
DCs/DHOs Done Done Done Done Done

Recruitment of EPI technicians and LHWs in district Mohmand

DHO to take up with Case in court,
while recruitment of EPI technicians in Khyber Is still pending
Quarter Concern NA Stay order NA NA Done
Process to be expedited.

DHOs to ensure that all FLWs are vaccinated against COVID 19

before the commencement of June SNID.
DEOC Done Done Done Done Done

DHO
FLWs to be provided with all necessary PPEs (masks and Peshawar/Charsadda/Kh Done
sanitizers) and should be trained on following COVID SOPs. yber/Nowshera
Done Done Done Done
/Mohmand
Still missed children against target and recorded didn't meet the
benchmark. Targeted community engagement activities to be CE sessions/SM
conducted In order to convince refusal families. Similarly proper CE sessions/SM CE sessions/SM CE sessions/SM
ADC/DEOCs NA Activities done
2M Visit during campaign days to be I ensured in order achieve Activities done Activities done Activities done
same day coverage above the benchmark. Quality catch up
activities to be ensured

Coverage of EPI zero dose children Identified during | campaign

was below the benchmark of 80% in Charsadda, Nowshera,
Khyber and Peshawar. EPI Coordinator to direct concerned EPI
technicians to ensure coverage of all zero dose children identified
DHO/EPI Coordinator IN PROGRESS IN PROGRESS IN PROGRESS IN PROGRESS DONE
by FLWs during campaign

LQAS pass rate was below the benchmark in District 1 Mohmand

and Charsadda, DEOC to investigate failed LQAS and
improvement plan in light of that investigation to be shared with Concerned DEOCs NA NA Done NA Done
PEOC

07/27/2021 3
 Follow Up To Previous DTF Meeting
BalancedDecisions
scorecard Responsibility
slide 3Peshawar Khyber Charsadda Nowshera Mohmand
Action plan
Essential immunization status is not satisfactory In district Khyber made,
Action plan for improvement to be made and
1 recruitment process of EPI technicians to be taken up with
DHO/EPI
Coordinator NA recruitment NA NA NA
concerned quarter in order to expedite it Case in
court

Staff/ Team sitting at UC Haryana, Pajjagi. Hayatabad 1 and UC District Two

University town faces accommodation/ sitting space issue Administration NA NA NA NA
Pending

In Nowshera enhanced per diem to team after July 2021 Is still District
pending, list already shared with account officer. Process of payment Administration NA NA NA In Progress NA
to be expedited /DHO

District
Late deployment of teams in tehsil Safi,Baizai and Ambar due to late Administration
BD Clearance in Mohmand To take up with NA NA NA NA Pending
quarter concern

District
CMH Peshawar to facilitate early vaccine dispatch during campaign
days
Administration Done NA NA NA NA

07/27/2021 4
 KP: Epidemiology WPV1 – cVDPV2 cases 2019-2020-2021
2019 2020 2021
District
WPV cVDPV aVDPV WPV cVDPV aVDPV cVDPV aVDPV

BAJOUR 1 1     3
Upper
Chitral BANNU 26     1 2
CHARSADA 1 1      
Peshawar
KP/30/20/145 Lower
Chitral
DIKHAN 4        
Onset: 13-Jul-20 DIRLOWER         3
1Swat 1
Kolai DIRUPPER         1

Kohistan
1Palas2

Lower
Wazir-North 3Dir U 1 Upper
HANGU 2        
1 1 3 3 Kohistan
KP/64/20/032 KARAK       2  
Onset: 15-Dec-20 3 1 7
1 1 1 KHYBER 1 3     15
Kh 1
Pesh
1 1
yb
1 15 3 awar
6 4 KOHISTANLOWER   2 1    
er 1 1

Haripur
2
KOHISTANUPPER   1      
2 LAKKIMRWT 32 1   12 5
9 26
1 1 2 2019 aVDPV Case MARDAN         1
1
32 2019 WPV1 Case MOHMAND 1 3      
1 4 6 Kara
5 12
1 Bannu k NOWSHERA         4 1
1 1 2019 cVDPV2 Case
2 4 PESHAWAR   1   1  6
Lakki
Marwat
2020 WPV1 Case
SHANGLA 1         1
2020 cVDPV2 Cases SWABI 1        
2020 aVDPV Cases TANK 6     4 1 
2021 VDPV Cases TORGHAR 7 3      
WAZIR-N 9         1
2021 aVDPV Cases
WAZIR-S 1     2 1
Grand Total 93 16 1 22 42 1 1 1
 Polio Virus Isolates From Environnemental Surveillance Result 2018-2020-2021

Last case (globally) Eradication Certified

WPV1 Continue Not yet Trivalent to Bivalent
WPV2 1999, Aligarh India 20 Sep 2015 Switch:
April 2016
WPV3 2012, Khyber Pakistan 18 Oct 2019

2019 2020 2021

District Site Name

June
May

May

May
Mar

Mar

Mar
Nov

Nov
Aug

Aug

Dec
Dec
Apr

Apr

Apr
Sep

Sep
Feb

Feb

Feb
Oct

Oct
Jun

Jun
Jan

Jan

Jan
Jul

Jul

Jul
Larama                     S S                           u        
SMT (GRAB)                     S S S S S S                           u
Peshawar
SMT (BMFS) u u u u u u u u u u S S S u S u u u u u u u u u S u u u u u
Naray Khwar Palosi Pull                       S S                                  
Charsadda Shahjahan/Majoki                                                            
Nowshera Mill Colony                                                     u      
Mardan Chak/ParHoti                                      
    S                

WPV1 (GRAB) WPV 1(BMFS) aVDPV Negative Grab Negative (BMSF)  cVDPV2  cVDPV2+WPV Under Process
Data Source: Latest ES Results : 14-Jul-2021 WPV1 WPV1 (BMFS) Negative Under Process NC: Not Collected
 Supplementary Immunization Activities (Polio Campaigns)
Key Performance Indicators (SNID Jun 2021)
Balanced scorecard slide 5
District
Benchmark
CHARSADA KHYBER MOHMAND NOWSHERA PESHAWAR

Campaign SNID Jun 21 SNID Jun 21 SNID Jun 21 SNID Jun 21 SNID Jun 21

Household Target <5 (#)   292,050 210257 106,597 286,001 750456

Household coverage (%) > 95% 98% 99.53% 99% 97% 97.48%

Still missed (#)   3,244 6824 1,754 3,861 27116

Still missed (% of target <5 in households) < 0.75% 1.23% 3.25% 1.81% 1.52% 3.61

Still Missed (% of Recoded Missed) < 5% 8% 20.67% 12% 10% 17.17

Still Refusals (#)   587 4334 175 586 11667

Still Refusal (% of recorded refusal) < 5% 17.6% 75% 40% 23% 35%

NA Covered same day (% of recorded missed) >40% 47.5% 42% 45% 51.8% 50%

ICM by Recall (% Cumulative) >90% 87% 92% 90% 85% 86%

ICM by Finger Mark (% Cumulative) >95% 98% 98% 97% 96% 94%

Market Survey by Finger Mark (%) >95% 93% 98% 98% 96% 97%

E-LQAS Result (% of Lots passed) >90% 100% 100% 100% 100% 85%

Zero dose children Covered (%) >80% 74% 29% 86% 61% 22%

7
07/27/2021
 Essential Immunization
Balanced scorecard slide 6
At least 80% of INFANTS must receive 03 doses of OPV and 01 dose of IPV in “Essential Immunization”

Essential Immunization: January 2021 to June 2021

CHARSAD MOHMAN NOWSHER PESHAWA

District Benchmark
A
KHYBER
D A R

Access (% Penta-1 Coverage) >80% 86% 62 % 118% 97% 93%

% of UC's with <80% P-3 Coverage <20% 16% 90 % 18% 6% 12%

Utilization (Penta-1 to Penta-3 % Drop-out) <10% 1% 28 % 8% 3% 2%

% of UC's with >10% P-1 to P-3 Drop-out <10% 2% 86 % 43% 12% 9%

% of Category-4 Union Councils

(UC's with <80% P-1 Coverage & >10% P-1 to P-3 Drop- <10% 0% 74% 4% 0% 2%
out)

07/27/2021 8
 AFP Surveillance
Balanced scorecard slide 7
Zero Report timeliness& Completeness Monthly District Surveillance Review Meeting
Tracking
Week # 17 18 19 20 21
2021

Completeness

Completeness

Completeness
Completeness

Completeness
Timeliness

Timeliness

Timeliness
Timeliness

Timeliness
District
District
Jan Feb Mar April May Jun

Lorem ipsum dolor sit amet, consectetur

adipiscing100%
CHARSADA elit. 100%
Morbi100%
condimentum euismod
100% 100% 100% elit 100%
100% 100% 100% CHARSADA 1 1 1 1 1 1
eu viverra. Etiam cursus nec lacus nec rhoncus.
Pellentesque ac hendrerit enim. Fusce id odio et
KHYBER erat
97% tincidunt
97% 99%sodales at a elit.
99% 99% 99% 90% 90% 97% 97% KHYBER 1 1 1 1 1 1

MOHMAND 98% 98% 97% 97% 98% 98% 100% 100% 98% 98% MOHMAND 1 1 1 1 1 1

NOWSHEHRA 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% NOWSHEHRA 1 1 1 1 1 1

PESHAWAR 93% 93% 85% 85% 89% 89% 92% 92% 92% 92% PESHAWAR 1 1 1 1 1 1

07/27/2021
 Preparation for CR August(2nd Aug to 8th )
Balanced scorecard slide 8
S. No. Activity

Divisional Task Force (DTF) coordination meeting: To review previous

Charsada Khyber Mohmand Nowshehra Peshawar

1
campaign and plan for next campaign Being Conducted
DPEC meeting: review previous campaign, set calendar of activities, and
2 100% 100% 100% 100% 100%
assign responsibilities
3 Refresher Training of UPEC Chairpersons 100% 98% 100% 100% 94%

4 Refresher Training of UC Staff (UCPOs, UCOs, UCDOs) 100% 98% 100% 100% 97%

5 Refresher Training of TTMs 100% 100% 100% 100% In-Progress

6 Refresher Training of Area In-charges 100% 99% 100% 100% In-Progress

7 Refresher team trainings In progress In progress In progress In Progress In-Progress

8
AIC micro plan (MP) review and field validation by UC staff/Submission to 100% 100% 100% 100% 100%
DEOC
9 UC-level MP preparation 100% 100% 100% 100% 100%

10 UPEC meeting: 100% 100% 100% 100% 100%

11 Community engagement, refusal conversion and influencer mobilization In progress In progress In progress In Progress in progress

12 Desk & Field Validation at District Level 32% 31% 32% 46% 35%

13 District-level MP field validation 32% 31% 32% 46% 10 35%

Balanced scorecard slide
Health Camps Peshawar
2
• Total of 72 Camps in (15)SHRUCs and
(12)Peshawar
• 36 Camps daily
• Supported by NEOC through AKU
• Targeting PMC, Refusals, Zero dose and Sick
children

07/27/2021
 Health Camp Immunization Coverages

Ref/PMC Coverage Zero/IPV/OPV Coverage

668 2534

242

565
487

68
Still Refusals Vaccinated PMC Vaccinated
zero dose covered 4-23 months children recieved IPV
24-59 months children recieved IPV 0-59 months OPV received
 Challenges & Issues
Balanced
Peshawarscorecard slide 2

• 31 incidents of harassment of Polio workers reported during the June campaign by

refusal families ranging from threats for consequences to physical manhandling.
• Sitting Space Issue for Staff
• UC Hayatabad-1 – Staff stationed at HMC. No sitting space, Potential space of
TB Hall identified. Need support from DG Health

• UC University Town – Staff stationed at KTH. Staff sits in female OPD

occupying space of patients.
• Provision of mineral water and ORS by UNICEF to FLWs to minimize the
risk of heat stroke. 500 incidents were reported last August 2020

07/27/2021
Nowshera Issues/Challenges
• EPI Technicians involve in COVID-19 Vaccination Effecting Essential
immunization
• Provision of COMNet staff for Drainage UCs (Nawan kalay,Chowki
Town,Gandheri, and Kabul river

Mohmand Issues/Challenges

• 175 still refusals demanding recovery of their missing family members

• Late deployment of Teams in Tehsil Safi, Baizai and Pandiali d/t late BD
Clearance.
 Challenges & Issues
Balanced scorecard slide 2
Khyber
• Demand based refusals of UC Sra Cheena, 4205 in last
campaign.
• Compromised EPI coverages due to shortage of human resource.
• ILR for vaccines at PTP Torkham is still not provided by EOC.

07/27/2021
Balanced scorecard slide 10

THANK YOU
 Pakistan: WPV-1 & cVDPV-2 cases in 2015-21
Total in 2021 Total in 2020 Total in 2019
Countries cVDP
WPV WPV cVDPV WPV cVDPV
V
Afghanistan 1 18 56 308 29 0
Pakistan 1 6 84 135 147 22

Wild Polio Virus Type-1 Cases (WPV-1) Circulating Vaccine Derived Polio Virus (cVDPV2)

PROVINCE 2015 2016 2017 2018 2019 2020 2021 PROVINCE 2015 2016 2019 2020 2021

PUNJAB 2 0 1 0 12 14 PUNJAB 1 25 1

SINDH 12 8 2 1 30 22 SINDH 0 45 2
KHYBER KHYBER
33 10 1 8 93 22 2 16 42 1
PAKHTUNKHWA PAKHTUNKHWA
BALOCHISTAN 7 2 3 3 12 26 1 BALOCHISTAN 1 0 23 4

GILGIT-BALTISTAN 0 0 1 0 0 0 GILGIT-BALTISTAN 4 0
AZAD JAMMU & AZAD JAMMU &
0 0 0 0 0 0 0 0
KASHMIR KASHMIR
ICT 0 0 0 0 0 0 ICT 1 0

TOTAL POLIO CASES 54 20 8 12 147 84 1 TOTAL POLIO CASES 2 1 22 135 8

 AFP Surveillance
Key Performance Indicators

Investigated within 48
NPAFP Rate Notify within 7 Days Stool adequacy EV isolation (%) SL isolation (%)
Hrs

District 6 95% 80% 80% >10% NA

2019

2020

2021

2020

2021

2019
2019

2020

2021

2019

2020

2021

2019

2020

2021

2019

2020

2021
CHARSADA 23.3 18.5 15.7 99 99 98 77 77 80 84 84 87 13 17 14 6 6 6

KHYBER 19.9 19.4 49.8 97 96 99 84 85 93 91 88 94 13 15 11 3 5 14

MOHMAND 25.9 25.5 20.5 97 100 100 88 87 64 90 97 80 22 18 9 4 5 14

NOWSHERA 20.6 15.9 19.9 100 100 100 85 85 76 89 88 82 16 13 11 3 12 4

Peshawar 21.1 15.74 17 98 98 99 70 70 69 80 75 81 13 11 10 7 14 16