UNICEF, NPSP-WHO, Rotary International & CORE

Underserved Strategy for Polio Eradication

Uttar Pradesh

Technical Advisory Group Meet

28 – 29 March 2007

New Delhi, INDIA.

 Caste distribution of low season (Feb-May) WPV cases
Uttar Pradesh 2006

Chaudhary, 2 Qureshi, 2 Saifi, 2

Ansari, 2
Balmiki, 1
Brahman, 1
Khan, 4 Ghosi, 1
Gujjar, 1
Jatav, 1
Kanjar, 1
Kashyap, 1
Kharaswanshi, 1
Kumhar, 1
Turk, 6 Lodhe, 1
Manihar, 1
Mansoori, 1
Maurya, 1
Mewati, 1
Nai, 1
Prajapati, 1
Rajput, 1
Saini, 1
Alvi(Fakir), 7
Salmani, 1
Unknown, 1
Sakki, 1

Seikh, 7

61% of Low season N=53

cases were Muslims
Source: Linelist of WPV cases, NPSP
 Networking with over 300 key Muslim
Institutions
institutions as of Feb 2007.
in Delhi
National level institutes
State level institutes
District level institutes
Block level institutes
Local level institutes
Key Mosque/Mazar

Source: SM Net
Key strategies to engage networks, broaden the base & sustain
the same
Leveraging the influence of 3 Muslim universities (AMU,JMI & JH)

• In-house volunteers
• Alumni
• Technical support for neutralizing impact of negative materials/rumours
• Technical support for local IEC.
Leveraging influence of other key Muslim institutions

All India Milli Council

All India Muslim Personal Law Board
Islamic Fiqh Academy
Darul Uloom Deoband
Jamait Ulama-i-Hind
All India Hajj Committee
 Key sufi shrines & Khankas

• Bahraich Dargah (Bahraich) . Kichhocha Sharif (Ambedakar Nagar)

• Mahrehra Sharif (Etah) . Chote-Bare Sarkar (Badaun)
• Saqlaini Mian (Bareilly) . Urs-e-Rizvi (Bareilly)
• Khanka Niyazia (Bareilly) . Kaliyar Sharif (Utrakhannd)
• Nizamuddin Auliya (Delhi) . Moinuddin Chishti (Ajmer, Rajasthan)
 Vaccination during ‘Urs’ (Religious Festival) at different Mazars

2005 children vaccinated = 265163 2006 children vaccinated = 240174

Badaun, 25455
Ghaziabad, 29261

Bareilly, 23480

Badaun, 19480

Bahraich, 136923
Bahraich, 161821 Saharanpur, 16536
Bijnor, 11264

Meerut, 9018
Moradabad, 9585
Etah, 7896
Moradabad, 7247 Bareilly, 6150
Etah, 4426
Sultanpur, 6000 Bulandshahar,
Bulandshahar, Muzaffarnagar,
4366
Ghaziabad,
3627637 Rampur,
J.P Nagar, 3881
1781
Bijnor, 2883 4051

Source: Tally sheet

 Field activities ensuring ownership & accountability

• Influencers orientation
• Supervisors/influencers interface meetings
• Ijtema / milaads
• Local IEC endorsed by local leaders
• Appeals on TV and newspapers, CDs of the same on local TV channels
 Rotary support for strategic advocacy
Negative fatwa & advocacy, Consultation meetings with religious leaders on
18 July & 10 August 2006
Logistic support for religious congregations.
Advocacy at Social & cultural events ensuring ownership
& accountability

• Shab- e-Barat .Ramazan

• Idul Fitr .Hajj travelers
• Idul Azha .Pedal Jhanda Qafila
• Id-e-Miladal Nabi .Rabews-sani
• Urs & Mazars .Marriage functions
Caste-wise vaccination at underserved Muslim marriage functions
2006 total children
vaccinated = 3398

Banjare, 172

i, 170
Saifi, 194

7
16
Machera, 55

Ga d d

l i,
Te

2
16
Idrisi, 43

,
vi
Sheikh, 280

Al
15
t, 1 2
a jpu k, 11 Salmani, 37
R T ur
Rangarh, 35 Jhoja, 20
Qureshi, 404 Mansuri, 20
Sayyed, 34
Other, 450 Abbasi, 29 Gaur, 18
Shia, 25 Mirasi, 18
Rangrez, 22
Pathan, 736 Mansoori, 17

Ansari, 1036 Siddiqui, 15

Manihar, 13
Naai, 12
Malik, 8
Sunaar, 8
Mewati, 7
Machiyare, 5
manihar, 5
Dhobi, 4
Ownership & accountability by mosques & madrasas

• Announcements on SIA from mosque

• Polio appeal in sermons
• Madrasa students polio rally
• Madarsa teachers supporting booth & H-t-H
• Mosque, madrasa & local community leaders moving with
vaccination teams during bi-phasic
 Non-polio AFP cases (age >=6 months and age < 5 years) by
OPV, Western UP
Hindu
2004 2005 2006*
1 - 3 doses 1 - 3 doses 1 - 3 doses
0 dose 4 - 6 doses 0 dose
0 dose 1% 4 - 6 doses 1% 1% 4 - 6 doses
0% 7% 0%
0% 10% 5%
7 - 9 doses 7 - 9 doses
7 - 9 doses 13% 10%
18%

>=10 doses
71% >=10 doses
>=10 doses
84%
(N=848) 79%
(N=2607) (N=3274)

Muslim2004 2005 2006*

1 - 3 doses 1 - 3 doses 1 - 3 doses
0 dose 0 dose 1%
2% 0 dose 1%
0% 4 - 6 doses 4 - 6 doses 4 - 6 doses
0%
17% 11% 0%
8%

7 - 9 doses
15% 7 - 9 doses
14%

>=10 doses
54% 7 - 9 doses
27% >=10 doses >=10 doses
73% 77%
(N=487) (N=1407) (N=1709)
* data as on 17th March 2007 Source: NPSP
UNDERSERVED
MONITORING DATA
 USS: MONITORING OBJECTIVES
• To monitor critical Operational components of team
working in H.R.As
1- Same a community female in team working
2- Identify reasons for Muslim female replacement (If
any) and take appropriate actions accordingly.
3- Interpersonal skills of HRA teams.
• To meet influencers, heads of religious institutions, Local
doctors
1- To know their involvement in progamme.
2- Thanks/ motivate them for their support.
3- To identify opportunities (Community Gatherings
etc.) that can be used for advocacy/ vaccination.
 MONITORING - PROCESS
• High Risk Areas monitored exclusively by
monitors specially trained for Underserved
Strategy
• USS Monitors:
– NPSP: Special SMOs, Field Volunteers, External
Monitors
– UNICEF: Dist Underserved Coordinators
• Monitoring extent:
– 1075 Teams / 856 Influencers/ 2173 Local
practitioners/ Religious institutions (2822 Mosque, 837
Madarsas, 424 Mazars).
• Result of monitoring shared with all partners at
block, district & sub regional levels
MONITORED AREA (CMC/ NON CMC), MAR 07

CMC AREA NON CMC AREA

 % HRA Team days with same community
female (MAR 07 Round)
120

100

100

100

100
99

99

99

99

99
98

98

98

98

97
100

96
95

95
95

95
93

93

93

93
90
89

87

79
80
77

60

40

20

0
MRT MZN BGPT SHP BLS GZA ALIG BIJ RMP MBD JPN BLY BAD TOTAL

Microplan Analysis Monitoring Data

Reasons for identified same community
female not working
MARCH 07

61 SAME COMMUNITY FEMALE

IDENTIFIED DURING MONITORING
TO WORK AS VACCINATOR

Not willing to work Sickness other temporary

Not informed/replaced Other

 % Mosque announcement/ appeal by agency
area (March 2007)

100

80

60

40

20

0
MRT BGPT MZN SHP ALIG ETAH BLS GZA MBD BIJ JPN RMP BAD BLY TOTAL

CORE UNICEF TOTAL

 Reasons for no announcement
(January-March 2007)

NO P.A SYSTEM OTHERS

NOT CONTACTED REFUSED
 Mosque announcement after monitor’s
interventions

50.00%
46.15%
42.07% 42.90%

0.00%
JAN (474/1027) FEB (451/1072) MAR (386/900)
 Madarsa involvement in rally/ bulawa tolly
(January-March2007)

100

80

60

40

20

0
MRT BGPT MZN SHP ALIG ETAH BLS GZA MBD BIJ JPN RMP BAD BLY TOTAL

JAN FEB MAR

REASONS FOR NO RALLY/ BULAWA TOLLY
FROM MADARSA (JAN 07– MAR 07)

NOT CONTACTED
REFUSED
OTHERS
 % CMC HRA covered with supervisor influencer
interface meeting in last 3 rounds
USS PARTNERSHIP DECISION: ALL CMC HRA SHOULD BE COVERED WITH
INTERFACE MEETING IN 3 ROUNDS
100

80

60

40

20

GZA
ALG

TOTAL
BLY

BAD

MZN
BGPT

MRT
RMP

BLS

SHP
MBD

JPN

BJN

INCLUDE MAR 07 PLANNING

 Supervisor influencer interface meetings

800

700
616
600 92 %
550
93% 514
500 94%

400

300
Jan Feb Mar
Meetings Monitored Meetings Held
 % Supervisor’s presence in interface meeting

100

80

60

40

20

0
ALG MBD JPN BJN RMP BRL BAD MRT BLS MZN SHP GZA TOTAL
JAN FEB MAR
 % Influencer’s presence in interface meeting

100

80

60

40

20

0
ALG RMP BRL MBD JPN BJN BAD MRT BLS MZN SHP GZA TOTAL

JAN FEB MAR

% Influencers participation in interface meetings

100

80

60

40

20

0
IMAM MADARSA SAJJADA PRADHAN/ WD RATION DEALER LOCAL
REPRESENT NASHEEN MEMBER PRACTITIONER

JAN FEB MAR

Underserved Strategy needs TAG’s advice on:

• Suggest a strategy to close the gap between

influencers who commit to helping the
programme and those who actually do so during
booth day and house-to-house activities.

• Suggest process indicators to strengthen the

level of commitment and drive by Muslim
influencers/networks to support the programme
THANKS