Transcript English pptx, 978kb

Independent Monitoring of the
Switch
A training module for Independent Monitors for
the switch from trivalent OPV to bivalent OPV
Version: 2 February 2016
For adaptation and use by regions and countries
What is covered in this Presentation?
At the end of this presentation, switch monitors will understand:
1
What is the switch?
2
What is the purpose of monitoring?
3
What do monitors do?
4
How do I complete monitoring tools?
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Polio eradication and the switch from trivalent
OPV to bivalent OPV
What is the switch?
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We are close to the
eradication of polio
• Immunization efforts have reduced the number of polio
cases globally by more than 99% over the last two decades.
• There are three types of polio viruses: 1, 2, and 3.
• Type 2 wild poliovirus has been eradicated. The last type 2
wild poliovirus was detected in 1999.
Together, we can finish the job of
eradicating all types of polio.
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Oral Polio Vaccine (OPV) and
Inactivated Polio vaccine (IPV)
 Both oral (OPV) and injectable (IPV) vaccines are used to
fight against polio today.
 Trivalent OPV (tOPV) provides protection against types 1,2,
and 3 poliovirus while bivalent OPV (bOPV) protects against
types 1 and 3 poliovirus.
 bOPV provides stronger protection against types 1 and 3
poliovirus than tOPV and is safer.
 Because type 2 poliovirus has been eradicated, the world
can now stop tOPV use and begin bOPV use (i.e., Switch)
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The switch from tOPV to bOPV must occur at the
same time across the country and the world
Switch in April
2016
 Switching from tOPV to bOPV at the same time across the
country and the world is the safest strategy
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[INSERT COUNTRY] Information
 Switch day: [INSERT SWITCH DAY(S)]
 IPV introduced: [INSERT PAST OR FUTURE DATE]
 bOPV distribution: [EXAMPLE: TO DISTRICT LEVEL STORES]
 *Adapt this slide to provide country context
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Independent Monitoring Overview
What is the purpose of
monitoring?
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Monitoring should prevent ongoing use of
tOPV after the switch
 Objectives of Switch Monitoring
– Ensure withdrawal of tOPV (Primary)
– Assess introduction of bOPV and IPV (Secondary)
– Provide national authorities with data to Validate the Switch
 Switch monitoring ideally should prevent:
1. Storage of large stocks of tOPV at district level and subsequent
distribution to service points after switch
2. Ongoing use of tOPV at service delivery level
3. Use of scavenged tOPV after the switch
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Independent monitors contribute to the
first of three Steps to National Validation
National Switch Date
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1
Government conducts independent monitoring and takes
corrective action
2
National Validation Committee (or equivalent) reviews and
provides validation recommendation
3
Government takes corrective action as necessary and submits
validation report to WHO
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Strive to complete monitoring within the
first week of the Switch Date
National Switch Date
Independent monitoring completed
Government takes
immediate
corrective action if
tOPV is identified
Typically within 3-5 days
Data available at National level (for review by Validation
Committee)
Typically within 7-10 days
Government submits Validation report submitted to WHO
Within 14 days
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Monitors are an important part of the switch!
Independent monitors are responsible for key
activities reduce risk of polio. These activities
include:
 Providing an unbiased, credible assessment of how well the switch
has been performed
 Ensuring that no tOPV is being administered after switch day
 Correcting problems that may arise during implementation of the
switch
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Independent Monitoring Strategy and
Implementation
What do monitors do?
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Overview of sites with tOPV storage or use
Primary
(National) stores:
Sub-national
(Regional or Provincial)
stores:
Lowest distribution
level
(District) stores:
Service points
(health facilities)
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Overview of Recommended Monitoring
Strategy
The strategy is to rapidly identify facilities with large stocks of
tOPV post-switch and implement immediate corrective action

National stores down to District level:
 Verify tOPV is removed from cold chain in ALL vaccine cold
chain stores down to the district level
 Service delivery points:
 Due to large number of service points, higher risk facilities
will be selected for independent monitoring by the
Monitoring Coordinator/Supervisor
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Summary of the Monitoring Process
Primary (National) stores:
Independent monitors
Visit 100% of
the vaccine
stores
Sub-national (Regional or
Provincial) stores:
Lowest distribution
level (District) stores:
Service points
(health facilities):
Monitor only
delivery points
selected by the
Supervising Official
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Preparation
Prior to facility visits, independent monitors will…
1.
Receive list of cold chain stores and service points from
coordinator/supervisor
2.
Review and finalize micro-plan for visit schedule to sites
1.
3.
Receive and review protocols for:
1.
2.
4.
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Instructions, transportation, cell phone, data collection instruments
Follow-up of sites that cannot be visited on schedule
Corrective action if tOPV is found
Retrieve Independent Monitoring Data Collection Tool (Form 1)
to record each site visited
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[INSERT COUNTRY] Protocols
 Protocol for follow up of sites that cannot be visited on
schedule:
– [INSERT INFORMATION ON PROTOCOL]
 Protocol for corrective action if tOPV is found :
– [INSERT INFORMATION ON PROTOCOL]
 *Adapt this slide(s) to reflect country protocols
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Visit Places that Store Vaccines
1.
Complete separate form for each administrative level assigned to you by the Official
(national, subnational, district or service delivery points with fixed vaccination services)
2.
Fill out date of monitoring, name of monitor, select level of cold chain, name of
administrative level
3.
List store name or location
4.
Ask staff at site to show you the vaccine storage equipment
5.
Examine contents and complete line listing for facility
1.
2.
Don’t forget to check for bOPV and IPV
Obtain information on number of vials disposed (stock ledger or other record), disposal method and
corrective actions
6.
Determine if a follow-up visit is needed for the site
7.
Tally the totals for columns B-F
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Report Findings
1. Send SMS or call Monitoring Coordinator/Supervisor on a
daily basis or more frequently if concerns are identified
2. Submit forms daily to monitoring coordinator/supervisor
3. Complete any follow-up visits as requested
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Site Visits and Corrective Action by Independent
Monitor
No
Visit and monitor
all cold chain
stores down to
the district level
tOPV vial
(opened or
unopened)
Yes
Stop and Report to
Supervisor
Dispose of tOPV
according to
instructions and
report to Supervisor
for follow-up activities
Visit and monitor
the selected 10%
of Service Points
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Practical Session
How do I compete
forms?
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1 form: Independent Monitoring Data Collection
Tool
 Completed by: Independent Monitor
 Reported to: Monitoring coordinator/supervisor
 Reporting frequency: Daily during monitoring
 Number of forms: Separate table for each administrative
level being monitored (primary, subnational, district and
service delivery points with fixed vaccination services)
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Independent Monitoring
Data Collection Tool
Date of Monitoring: ____________________ Name of Monitor: _____________________________
Level of cold chain: Primary: _____ Sub-National (Regional/Provincial): _______ Lowest distribution level (District): ______ Service Delivery Point (Fixed site): ________
Name of administrative level: ____________________________
Store Location or
Name
tOPV in
cold chain
(Yes = 1
No = 0)
tOPV
out of
cold
chain
without
label
“Do not
use”
(Yes = 1
No = 0)
A
B
C
bOPV in
cold
chain
(Yes = 1
No = 0)
IPV in
cold
chain
(Yes = 1
No = 0)
# vials
disposed or
pending
disposal at
time of
monitoring
# vials
destroyed
at service
point by
report
date
Disposal
method
(Multiple
codes okay)*
D
E
F
F
G
Corrective
actions**
(Multiple
codes okay)
Status
(ongoing
or
completed
Due
date, if
ongoing
H
I
J
1
2
3
4
5
6
7
8
9
10
TOTAL # stores
*Codes for disposal method: (1): Autoclave (2): Boiling (3): Incineration (4): Encapsulation (5): Burial (6): Burning (7): Other
**Codes for corrective action: (1): tOPV withdrawn (2): Onsite re-training (3): Officials at higher administrative level notified (4): Other
(please specify)
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Contact Details for Daily Feedback
 Monitoring coordinator: [INSERT CONTACT NUMBER]
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The End
Thank you !
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