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DR.I.SELVARAJ I.R.M.S B.Sc.,M.B.B.S.,D.P.H.,D.I.H.,PGH&FW/NIHFW/NEW DELHI/Trained Epidemiologist/C.M.C,VELLORE,S.INDIA. Senior Divisional Medical Officer, Railway Hospital, Chennai Division, Southern Railway, India . VISION. HEALTH FOR ALL. GOAL. ERADICATION OF POLIO BY 2000AD. OBJECTIVE.
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DR.I.SELVARAJ I.R.M.SB.Sc.,M.B.B.S.,D.P.H.,D.I.H.,PGH&FW/NIHFW/NEW DELHI/Trained Epidemiologist/C.M.C,VELLORE,S.INDIA • Senior Divisional Medical Officer, Railway Hospital, Chennai Division, Southern Railway, India
VISION HEALTH FOR ALL
GOAL ERADICATION OF POLIO BY 2000AD
OBJECTIVE REPLACEMENT OF HARMFUL WILD POLIO VIRUS IN THE COMMUNITY
STRATEGY INTENSIFIED PULSE POLIO IMMUNIZATION PROGRAMME
PROGRAMME • THE INTENSIFIED PULSE POLIO IMMUNIZATION
PULSE POLIO IMMUNIZATION SIMULTANEOUS MASS IMMUNIZATION SUDDEN TO ALL CHILDREN OF 0-59 MONTHS OF AGE ON FIXED DATE THROUGHT THE COUNTRY
Strategic Planning • Developing a plan of action • Publicity and mass awareness • Management of vaccination day • Managing the immunization post
The action plan • Training and orientation of various categories of workers/volunteers • Motivation of volunteers and masses • Publicity and mass awareness • Identification of vaccination centres • Management of vaccination centres and control room • Program finances • Transportation and communication
The function of control room • Storage of vaccine • Preparation of frozen ice packs • Preparing vaccine carrier with frozen ice packs • Vaccine supply • Delivery of vaccine by vehicles to various centres • Replacement of manpower from reserve list • Collection of statistics
Management of vaccination day • Identification of a place as vaccination centre • Deployment of manpower in centres • Supply of vaccines • Maintenance of cold chain equipment by end of the day • Collection of records at the end of the day
Management of Vaccination centre-1 • Number of children should be restricted to 250 to each centre • Each centre has to be managed by 4 categories of people • 1) team leader • 2) paramedical worker to administer vaccines • 3) paramedical worker for record keeping • 4) paramedical worker/volunteers for mobilization of people to bring children
Management of vaccination centre-2 • To ensure that the centre is open in time • To guide the volunteers to make house-to-house visit for finding eligible infants and children • A mid day assessment • To monitor the paramedical workers while immunizing the children • The vaccines are administered by vaccinator only • Only one vial to be used at a time from the vaccine carrier • Simply maintain record of total vaccines given rather than writing unnecessary details • To remind the parents about the next date of PPI
Vaccine carrier Place some packing material between DPT vaccine and the ice to prevent them from touching the ice packs Close the lid tightly Clean and dry after every use Clean and dry inner side of carrier after use Keep the carrier away from direct sunlight The carriers with four ice packs can keep the vaccine cold for 2 days Do not sit or place anything heavy on a vaccine carrier
Vaccine carrier-2 A carrier for small quantities of vaccines (16-20 vials) The ice packs for lining the sides of the carrier should be fully frozen The lid of carrier should be closed tightly The vials of DPT, DT, and TT vaccines should not be in direct contact with the frozen packs Place fully frozen ice packs in the carrier and wait for few minutes for temperature to fall to less than 8 degree Celsius Put vaccine vials and ampoules in a polythene bag and close it
Guidelines for optimal storing of vaccines at HU/SDH/DH-1 BCG and MEASLES vaccine to be stored in either the freezer or the shelf nearest to the freezer Check the temperature twice a day and maintain a record Follow First- in –First – out Rule Do not keep vaccines which are expired Keep the vaccines neatly with space between the stacks for circulation of air
Guideline-2 • Minimum stock(not more than 1 month requirement)of vaccines should be kept in the fridge at a time • Do not keep any vaccine in door panel • You should never keep DPT,DT,Typhoid vaccine in the freezer chamber of the refrigerator • These should be kept in lower compartments • To keep the OPV which is in current use in central compartment of the refrigerator to avoid repeated freezingand thawing
Common problems associated with PPI • Preparations begin too late • Vaccines ordered too late • Inadequate awareness about PPI in masses • Inadequate distribution of vaccines and manpower to the centres • Inadequate transport facility to supply vaccines • Long lines at vaccination centres • Recording too much information for each child • Posts open late or not open during lunch hours for working parents • Inadequate feed back
Publicity and mass awareness • Opinion makers • Extensive use of media • Organizing various events • A)rally of school children • B)sports events • C)human chain formation • D)and run for polio
Conclusion • Basic concept of PPI • Value of cold chain maintenance • 100% mass media coverage