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    Readiness-Assessment-Tool - All-Levels - COVID-19 - 25 New 2020

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    Novie Fenecios
    This document contains a monitoring form to assess the readiness of a city/municipality for an outbreak response immunization campaign at the local government unit level. It includes sections to evaluate planning, coordination and financing; vaccines, cold chain and monitoring/supervision; logistics; social mobilization and communication; and the campaign readiness at the health center level. Officials are asked to indicate if critical activities are achieved or still need action, and provide remarks. The form will help identify areas that require further work to ensure the campaign is fully prepared and can be safely and effectively conducted.

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    Readiness-Assessment-Tool - All-Levels - COVID-19 - 25 New 2020

    Uploaded by

    Novie Fenecios
    51 views10 pages
    This document contains a monitoring form to assess the readiness of a city/municipality for an outbreak response immunization campaign at the local government unit level. It includes sections to evaluate planning, coordination and financing; vaccines, cold chain and monitoring/supervision; logistics; social mobilization and communication; and the campaign readiness at the health center level. Officials are asked to indicate if critical activities are achieved or still need action, and provide remarks. The form will help identify areas that require further work to ensure the campaign is fully prepared and can be safely and effectively conducted.

    Original Title

    Readiness-Assessment-Tool_all-levels_COVID-19_25 new 2020 (1)

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    This document contains a monitoring form to assess the readiness of a city/municipality for an outbreak response immunization campaign at the local government unit level. It includes sections to evaluate planning, coordination and financing; vaccines, cold chain and monitoring/supervision; logistics; social mobilization and communication; and the campaign readiness at the health center level. Officials are asked to indicate if critical activities are achieved or still need action, and provide remarks. The form will help identify areas that require further work to ensure the campaign is fully prepared and can be safely and effectively conducted.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    51 views10 pages

    Readiness-Assessment-Tool - All-Levels - COVID-19 - 25 New 2020

    Uploaded by

    Novie Fenecios
    This document contains a monitoring form to assess the readiness of a city/municipality for an outbreak response immunization campaign at the local government unit level. It includes sections to evaluate planning, coordination and financing; vaccines, cold chain and monitoring/supervision; logistics; social mobilization and communication; and the campaign readiness at the health center level. Officials are asked to indicate if critical activities are achieved or still need action, and provide remarks. The form will help identify areas that require further work to ensure the campaign is fully prepared and can be safely and effectively conducted.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 10

    FORM 2: CITY/MUNICIPALITY LEVEL MONITORING AND ASSESSMENT OF READINESS FOR OUTBREAK RESPONSE IMMUNIZATION

    City / Muncipality : ________________________ Target Population (0-59 months): ____________


    LGU zoning (ECQ/MECQ/GCQ/New Normal) _________________ Effective Dates of COVID-19 zoning: ________________ Strategy (H2H/Fixed Posts/Mixed): _________________
    Name of Monitor: _____________________ Agency: ___________ Respondent (Position): ____________________ Date of Visit/Assessment: ___________

    6 wks 4 wks 2 wks 1 wk

    If not
    accomplished
    Area Critical activities plan achieved (Y/N) Action required
    describe
    Mark "X" planned activity deadline. deficiency

    1. Budgeted microplans developed for


    resource mobilization purposes

    2. Campaign budget allocation done at


    city/municipal level

    3. Political commitment of the Local Chief


    Executives

    4. Discussions with LGU COVID-19 Task Force


    to support campaign and mobilise resources

    5. Local Polio Emergency Operations Center


    established and meeting daily
    PLANNING, COORDINATION & FINANCING

    6. Local Polio Incident Management Team


    (Emergency Operations Center) established
    with clearly defined roles:
    a. Technical including monitoring (EPI
    Manager)
    b. Vaccine, Cold Chain & Logistics (Logistics)

    c. Advocacy, Social Mobilization &


    Communication/ Media Relations (HEPO)

    d. Risk Management/AEFI/AFP/COVID-19
    Surveillance (C/MESU)
    PLANNING, COOR

    e. Patient pathway and referral system (for


    COVID-19 suspects)

    7. Adequate number of human resources for


    campaign (specify # of vaccination teams)

    8. Funds available to the city/municipal level


    for operational costs (e.g., transport)
    9. Microplans available at all RHUs/ health
    centers

    10. OPV guidelines, supervisory checklists,


    tally sheets, summary report forms, AEFI
    forms, etc. printed and distributed

    11. Plan and budget for campaign


    VACCINES, COLD CHAIN AND MONITORING/
    SUPERVISION

    supervision, monitoring, and RCA available

    12. Pre-campaign monitoring visits to


    RHU/Health Center to assess preparedness
    planned and budgeted
    13. A budgeted logistics plan developed
    14. Received required vaccines, safety boxes,
    PPE and additional commodities
    LOGISTICS

    16. Cold chain assessment completed and


    action taken
    16.Immunization Waste management plan
    available
    17. Bundled vaccine and other ancillary
    supplies distributed to all RHU/HCs

    18. A budgeted plan for advocacy, social


    mobilization and communication developed
    SOCIAL MOBILIZATION AND

    19. Advocacy & community engagement


    COMMUNICATION

    meetings held with partners and


    stakeholders - e.g., other departments
    (DSWD, DILG), church groups, NGOs,
    professional/medical societies, civil society
    groups (e.g., Red Cross, Rotary, Lions) and
    others
    SOCIAL MOBILIZA
    COMMUNIC

    20. Advocacy, social mobilization and


    communication materials developed and
    distributed with special focus on
    immunization during covid
    Total score: No. items with "Yes" 0% General Remarks:
    Circle time of assessment: 6w 4w 2w 1w
    Is the regional level on track to conduct the ORI?
    Person
    Deadline Remarks
    Responsible
    CAMPAIGN READINESS ASSESMENT AT HEALTH CENTER LEVEL

    Name of Health Center: ____CHO MATI____ Strategy (H2H/Fixed Posts/Mixed): _________MIXED_____


    Name of Respondent / Position: _____MARIO P. LUTOG JR. ,RN/ NIP COORDINATOR Date of Visit: ______________
    Microplan
    All puroks/areas are included in the barangay microplan
    List of all transit points, markets, congregation points, religious gathering places, day care centers, evacuation centers, isolation fa
    catchment area available
    Plan to reach high risk populations included: high risk areas identified, vaccination strategy identified, details about any special arr
    available, areas are included in the monitoring and supervision plan
    Daily activity plans for the teams are available: indicating assigned areas, strategy used, estimated target population
    Special strategies clearly planned: transit posts for population on move, special sessions in gated communities, hard to reach area
    populations, etc
    Maps show catchment areas for house to house teams; and location of fixed and special sessions (e.g transit) posts
    Logistics and other resource estimations are complete; distribution plans are ready
    List of local influencers/ leaders/ stakeholders along with their contact details, including potential support expected from them
    Plan for bOPV/mOPV2 management and waste mangement in place
    Logistics supply
    Sufficient functional cold chain capacity and/or contingency plans for vaccine storage available
    Adequate quantity of vaccine available
    Adequate quantity of vaccine carriers, ice packs, zip lock bags available
    Other logistics received: Finger markers, data tools and templates (tally sheets and reporting formats), banners
    Logistics transport plan available to supply all areas
    Contingency plan in place for replenishment of stocks run low
    Social Mobilization
    Barangay officials and other local leaders engaged for campaign announcements, conducted meetings, and support confirmed
    Banners and other promotion material displayed
    Community aware about the assigned date and venue of vaccination session in their area (survey 5 randomly selected eligible par
    awareness)
    Immunization safety
    All supervisors know how to report AEFI
    AEFI Investigation forms and SOPs available with supervisors
    Supervision and monitoring
    Monitoring and supervision plan available: details about areas selected, reason for selection, and monitors assigned
    All supervisors and monitors are trained for conducting team monitoring, and RCAs
    Required checklists and templates available
    System to do mop ups in areas of failed RCAs in place
    System for daily monitoring of coverage data and feedback from monitors; and using it for corrective actions
    Reporting system
    System for daily collection and consolidation of tally sheets, and monitoring feedback into reports
    Mechanism in place for submission of reports (manual or electronic)
    Mopv2/bOPV management
    Logistics focal point assigned, and trained on mOPV2/bOPV management
    Separate allocation of space for mOPV2/bOPV vaccine with clear labeling in refrigerators
    All required recording and reporting templates available
    System for vaccine recall, accountability, collection, handover and reporting to district/city level health office in place
    Human resources
    Adequate number of vaccinators, recorders (specify number for each)
    All teams trained on specific infection prevention and control for COVID-19
    All teams aware of recent guidelines on Polio campaign during COVID-19 pandemic response
    Fully Achieved
    Remarks
    (Y/N)

    Y
    Y

    Y
    Y
    N WALA PA ANG MASK, FACE SHIELD & ETC FROM REGION
    Y
    Y

    Y
    N WALA PA MI NATAGAAN OG ADD ON
    N WALAY ZIPLOCKS
    N ADDITIONAL TALLY SHEETS AND REPORTING FORMS
    Y
    N WALA PAKO KABALO KNG NAA BAI EXTRA ANG PHO

    N WALA PA NA INFORM
    N WALA PA MI KADAWAT OG TAGA-I

    N WALA PA NA INFORM

    Y
    Y

    Y
    Y
    N
    Y
    Y

    Y
    Y

    Y
    Y
    Y
    Y

    N
    Y
    N

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