Refresher Training for Frontline Health Workers in Expanded ... - RHO

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Understand the Problem — Never-Reached or Drop-Outs? 100 90 Never-reached Percent DPT DTP coverage Coverage 80 70 60 50 40 30 Never-reached Drop-outs Drop-outs 20 DPT 1 DPT 3 DPT 1 DPT 3 10 0 District A District B Never reached = 100% minus DPT1 % coverage Drop-out = DPT1 coverage – DPT 3 coverage x 100 DPT 1 coverage District A. 50% of children have access to immunization services using DPT1 coverage as an indicator. 42% complete the three-dose series of DPT. The drop-out rate therefore is 16%: ( 50% – 42% ) x 100 = 16% 50% In District A, planners should give priority to raising DPT1 coverage by reaching the 50% of children who have never been reached. Reducing drop-outs would, at best, result only in a gain in DPT3 coverage from 42 to 50%. District B. 85% of children have received DPT1. 58% complete the three-dose DPT series. The drop-out rate is 32%: ( 85% – 58% ) x 100 = 32% 85% In District B, reaching the last 15% of the population that has never been reached is likely to be labor-intensive and expensive. On the other hand, following up on dropouts and persuading them to complete the series could raise coverage of DPT3 from 58% to 85%. Unless additional information indicates otherwise, District B should give priority to reducing drop-outs. 81
“Who are the unreached?” (some possible responses) - peri-urban populations who do not utilize accessible services - rural and urban populations with access, but who drop out - remote rural populations with poor access Some local causes of drop out Service delivery - vaccine shortage - cold chain breakdown - long waits - infrequent outreach sessions - improper contraindications practices - missed opportunities Communication - not told to return - not provided with information on vaccination schedule - not told about normal side effects - health staff perceived as unfriendly Community - not informed in advance of outreach dates - not informed outreach team has arrived - session times conflict with farming/family duties - no active follow-up of defaulters 82
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Refresher Training for Frontline He
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EPI Refresher & Training of Trainer
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Module 2: The Cold Chain...........
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- Facilitators should be well verse
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Course Syllabus Session/Objectives
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Session/Objectives immunization cum
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Session 1 Module 0: Facilitating Ad
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facilitator: read and understand Se
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Flip Chart 2 A. Difference between
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0.3 Additional Handouts How to impr
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0.4 Exercises (with answers) in Mod
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Session 2 Module 1: EPI Target Dise
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Step 2: 30 minutes Re-convene into
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Exercise 2 (found on Page 25 of the
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5. What is the immunization schedul
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Exercise 5 (found on Page 32 of the
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Module 2: The Cold Chain 2.1 Lesson
Page 35 and 36: ideas, the facilitator can refer to
Page 37 and 38: Sample job aid 1. Vaccine over or u
Page 39: 2.3 Additional Handouts How to main
Page 44 and 45: 3. In the picture below of a refrig
Page 46 and 47: Exercise 3 (found in Section 9, Pag
Page 48 and 49: Course Syllabus Session 4 Module 3:
Page 50 and 51: Step 3: 15 minutes Request the part
Page 52 and 53: 3.4 Exercises (with answers) in Mod
Page 54 and 55: 3. How do you keep the following va
Page 56 and 57: Module 4: Communication with careta
Page 58 and 59: Show the participants the immunizat
Page 60 and 61: Situation Cards #1 Group #1 Selam h
Page 62 and 63: Role play #2 HW: Almaz: HW: Almaz:
Page 64 and 65: Role play #3 The Story of Wubalem a
Page 66 and 67: 4.3 Additional Handouts Communicati
Page 68 and 69: Case Study: Earn the diploma! Four
Page 70 and 71: Module 5: Monitoring Immunization C
Page 72 and 73: Step 7: 15 minutes In plenary, expl
Page 74 and 75: FLIPCHART #1 Immunization Coverage
Page 76 and 77: “Funny Numbers” Exercise (with
Page 78 and 79: Monthly Woreda EPI Vaccination Repo
Page 80 and 81: Training held during the month No.
Page 82 and 83: TT Vaccination Monthly Health Facil
Page 84 and 85: Example of data used to calculate a
Page 88 and 89: Diagnosis/Planning Action Supply qu
Page 90 and 91: 5.3 Additional Hand-outs Immunizati
Page 92 and 93: Note for the reader: please use fil
Page 94: Annex 1 Immunization Coverage and D
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