WEBVTT 00:00:00.000 --> 00:00:02.400 align:middle line:90% [MUSIC PLAYING] 00:00:02.400 --> 00:00:07.680 align:middle line:90% 00:00:07.680 --> 00:00:12.330 align:middle line:84% ERIC MAFUTA: So the last concept we will try to explore today 00:00:12.330 --> 00:00:15.380 align:middle line:90% is about the monitoring. 00:00:15.380 --> 00:00:19.810 align:middle line:90% Here we have a team of monitor. 00:00:19.810 --> 00:00:22.460 align:middle line:84% The monitoring is an activity that 00:00:22.460 --> 00:00:28.580 align:middle line:84% consists of learning about experience, 00:00:28.580 --> 00:00:33.380 align:middle line:84% a process of collecting data, analyzing it, 00:00:33.380 --> 00:00:36.350 align:middle line:84% and use this information to assess 00:00:36.350 --> 00:00:40.700 align:middle line:84% effectiveness, relevance, and impact of program-- 00:00:40.700 --> 00:00:44.810 align:middle line:84% is a structured way of improving program implementation 00:00:44.810 --> 00:00:47.330 align:middle line:90% and decision-making. 00:00:47.330 --> 00:00:51.840 align:middle line:84% The monitoring can be used in the fifth phase 00:00:51.840 --> 00:00:56.340 align:middle line:84% of the immunization activities, as we see. 00:00:56.340 --> 00:01:01.560 align:middle line:84% During the pre-campaign, we can assess the preparedness. 00:01:01.560 --> 00:01:06.930 align:middle line:84% During the campaign, we have to assess the ongoing operation 00:01:06.930 --> 00:01:10.960 align:middle line:84% and activity-- for example, unvaccinated children 00:01:10.960 --> 00:01:13.800 align:middle line:90% [? non-remote ?] area. 00:01:13.800 --> 00:01:16.350 align:middle line:84% And this can be used to correct-- 00:01:16.350 --> 00:01:18.750 align:middle line:90% to take corrective measure. 00:01:18.750 --> 00:01:25.200 align:middle line:84% At the post-phase, we can also do this monitoring to assess 00:01:25.200 --> 00:01:29.490 align:middle line:84% unvaccinated children and the [? not-met ?] area. 00:01:29.490 --> 00:01:34.140 align:middle line:84% So we can use it for setting mop-up campaign 00:01:34.140 --> 00:01:36.680 align:middle line:90% and other activity. 00:01:36.680 --> 00:01:39.350 align:middle line:84% Sometimes during a polio program, 00:01:39.350 --> 00:01:42.530 align:middle line:84% we are using independent monitoring. 00:01:42.530 --> 00:01:45.500 align:middle line:84% In addition to the routine monitoring, 00:01:45.500 --> 00:01:51.590 align:middle line:84% we can have these independently monitored by other people. 00:01:51.590 --> 00:01:57.290 align:middle line:84% What is important is that they provide their insights 00:01:57.290 --> 00:02:01.940 align:middle line:84% in activity what are done and the independent monitoring 00:02:01.940 --> 00:02:06.760 align:middle line:84% is done by people who are not in the same supervisory structure 00:02:06.760 --> 00:02:09.470 align:middle line:84% as those who implement the campaign. 00:02:09.470 --> 00:02:15.590 align:middle line:84% So this is used to contribute to an unbiased perspective 00:02:15.590 --> 00:02:19.730 align:middle line:84% for the quality of the immunization activity. 00:02:19.730 --> 00:02:22.970 align:middle line:84% We would like you to figure out, what 00:02:22.970 --> 00:02:28.700 align:middle line:84% are the benefits of monitoring by those inside the government 00:02:28.700 --> 00:02:31.130 align:middle line:90% or outside the government? 00:02:31.130 --> 00:02:35.960 align:middle line:84% And I invite you to discuss about what 00:02:35.960 --> 00:02:40.410 align:middle line:84% you think be the advantage and the disadvantage of these two 00:02:40.410 --> 00:02:43.020 align:middle line:90% type of monitoring. 00:02:43.020 --> 00:02:45.870 align:middle line:84% We can come back now to talk about 00:02:45.870 --> 00:02:48.660 align:middle line:90% the independent monitoring. 00:02:48.660 --> 00:02:52.380 align:middle line:84% As we see, for the monitoring, the normal monitoring, 00:02:52.380 --> 00:02:54.060 align:middle line:84% the independent monitoring can be 00:02:54.060 --> 00:02:58.140 align:middle line:84% used in the different phase of the campaign. 00:02:58.140 --> 00:03:04.200 align:middle line:84% Here we provide you some example in process monitoring and post 00:03:04.200 --> 00:03:05.430 align:middle line:90% monitoring. 00:03:05.430 --> 00:03:11.010 align:middle line:84% So they can also assess the operation about vaccination 00:03:11.010 --> 00:03:15.240 align:middle line:84% team, their training, how the vaccine are conserved, 00:03:15.240 --> 00:03:19.740 align:middle line:84% the house marking, how the daily meeting are carried out, 00:03:19.740 --> 00:03:23.610 align:middle line:84% and to check about, also, immunization. 00:03:23.610 --> 00:03:28.350 align:middle line:84% So they can see what finger is marked, 00:03:28.350 --> 00:03:33.990 align:middle line:84% is all house have a number, such information. 00:03:33.990 --> 00:03:35.280 align:middle line:90% And at the end of-- 00:03:35.280 --> 00:03:40.750 align:middle line:84% after the immunization activity, they can assess the coverage-- 00:03:40.750 --> 00:03:45.180 align:middle line:84% for example, to check if each children in this area 00:03:45.180 --> 00:03:50.490 align:middle line:84% have his finger marked and the reason for no vaccination, 00:03:50.490 --> 00:03:51.800 align:middle line:90% for example. 00:03:51.800 --> 00:03:55.980 align:middle line:84% And this information can be used for mop-up campaign 00:03:55.980 --> 00:04:00.140 align:middle line:84% and future immunization activities. 00:04:00.140 --> 00:04:04.550 align:middle line:84% Here we have some results for the monitoring. 00:04:04.550 --> 00:04:06.860 align:middle line:84% For example, they can provide information 00:04:06.860 --> 00:04:12.470 align:middle line:84% about how many children missed during the immunization 00:04:12.470 --> 00:04:15.800 align:middle line:84% or how many children was missed-- 00:04:15.800 --> 00:04:20.750 align:middle line:84% how tough house during the immunization activity. 00:04:20.750 --> 00:04:24.860 align:middle line:84% We can have, also, the reason for the no vaccination, 00:04:24.860 --> 00:04:28.670 align:middle line:84% and they can check the awareness of parents 00:04:28.670 --> 00:04:33.150 align:middle line:84% prior to the team visit and so on. 00:04:33.150 --> 00:04:38.090 align:middle line:84% Here we have also another slide, which show information 00:04:38.090 --> 00:04:41.840 align:middle line:84% about the missed children during immunization 00:04:41.840 --> 00:04:44.790 align:middle line:90% activity in the DRC. 00:04:44.790 --> 00:04:49.290 align:middle line:84% And the different map is for different supplementary 00:04:49.290 --> 00:04:53.370 align:middle line:90% immunization activity in 2012. 00:04:53.370 --> 00:05:00.240 align:middle line:84% For example, here you can see the middle one in October 2012. 00:05:00.240 --> 00:05:02.400 align:middle line:90% We have a lot of color. 00:05:02.400 --> 00:05:07.530 align:middle line:84% So you can see, it's green mostly. 00:05:07.530 --> 00:05:11.430 align:middle line:84% So if it's green, it show that you have less than 5% 00:05:11.430 --> 00:05:15.690 align:middle line:84% of children we've missed during the immunization. 00:05:15.690 --> 00:05:19.920 align:middle line:84% For example, for me, I know the DRC 00:05:19.920 --> 00:05:25.570 align:middle line:84% in the equator in the north, it's almost green. 00:05:25.570 --> 00:05:28.260 align:middle line:84% But you can see, for example, in the south-- 00:05:28.260 --> 00:05:35.230 align:middle line:84% so this red place, it show that we have more than 15% of childs 00:05:35.230 --> 00:05:39.240 align:middle line:84% were missed during the immunization activity. 00:05:39.240 --> 00:05:42.840 align:middle line:84% And this represents most of the time 00:05:42.840 --> 00:05:49.030 align:middle line:84% where you can have the following outbreak of polio viruses. 00:05:49.030 --> 00:05:54.270 align:middle line:84% So this type of information provided by the monitoring 00:05:54.270 --> 00:05:57.840 align:middle line:84% can help us to plan other activity 00:05:57.840 --> 00:06:00.990 align:middle line:90% as we see mop-up campaign. 00:06:00.990 --> 00:06:05.040 align:middle line:84% And what we have also to note is that this monitoring activity 00:06:05.040 --> 00:06:08.790 align:middle line:84% is carried out for in-house children. 00:06:08.790 --> 00:06:13.200 align:middle line:84% So they are pass house to house to check 00:06:13.200 --> 00:06:18.770 align:middle line:84% how many children you have and how many are immunized-- 00:06:18.770 --> 00:06:19.980 align:middle line:90% vaccinate. 00:06:19.980 --> 00:06:22.740 align:middle line:84% And in the second activity, they have also 00:06:22.740 --> 00:06:27.240 align:middle line:84% to go in the open, the community place where 00:06:27.240 --> 00:06:30.550 align:middle line:84% you can find children who are playing together, 00:06:30.550 --> 00:06:32.040 align:middle line:90% and they can also check. 00:06:32.040 --> 00:06:36.090 align:middle line:84% So the bottom graphs show the information 00:06:36.090 --> 00:06:40.740 align:middle line:84% about community place where children are out of their house 00:06:40.740 --> 00:06:43.110 align:middle line:84% playing, and they have to check, also, 00:06:43.110 --> 00:06:47.400 align:middle line:90% how many of them are immunized. 00:06:47.400 --> 00:06:53.050 align:middle line:84% Sometime currently they are using a new methodology. 00:06:53.050 --> 00:06:57.920 align:middle line:84% This methodology is called the cluster-lot quality assessment 00:06:57.920 --> 00:07:00.010 align:middle line:90% assurance sampling. 00:07:00.010 --> 00:07:06.640 align:middle line:84% So if just draw on manufacturer strategy, you have a lot. 00:07:06.640 --> 00:07:09.700 align:middle line:84% A lot is a group of products which 00:07:09.700 --> 00:07:13.040 align:middle line:90% are produced in the same time. 00:07:13.040 --> 00:07:18.100 align:middle line:84% So when they try to select this group of product, 00:07:18.100 --> 00:07:23.110 align:middle line:84% you can just check if one of this group is in good quality. 00:07:23.110 --> 00:07:27.250 align:middle line:84% So you conclude that others is also in the good quality. 00:07:27.250 --> 00:07:32.500 align:middle line:84% So we use this strategy to try to sample in the community. 00:07:32.500 --> 00:07:36.400 align:middle line:84% We have a big community or a big satellite area. 00:07:36.400 --> 00:07:39.450 align:middle line:84% You choose only some lots, some community, 00:07:39.450 --> 00:07:44.990 align:middle line:84% and in this community chosen at random, you can choose house. 00:07:44.990 --> 00:07:47.890 align:middle line:84% And in this house, you have to check 00:07:47.890 --> 00:07:51.760 align:middle line:84% how many children are vaccinated and how many are not 00:07:51.760 --> 00:07:53.420 align:middle line:90% vaccinated. 00:07:53.420 --> 00:07:56.260 align:middle line:84% So we are using this strategy to try 00:07:56.260 --> 00:08:03.250 align:middle line:84% to have very large samples of children in several communities 00:08:03.250 --> 00:08:08.620 align:middle line:84% to be sure that the immunization campaign or activity has 00:08:08.620 --> 00:08:13.600 align:middle line:84% a good quality during its conduction. 00:08:13.600 --> 00:08:17.350 align:middle line:84% The lot quality assurance sampling sometimes 00:08:17.350 --> 00:08:21.820 align:middle line:84% take place during the post campaign. 00:08:21.820 --> 00:08:25.150 align:middle line:84% So they are using this after the campaign, 00:08:25.150 --> 00:08:29.260 align:middle line:84% I think, in the two weeks so you can 00:08:29.260 --> 00:08:32.890 align:middle line:84% have all the children with their marked fingers 00:08:32.890 --> 00:08:36.549 align:middle line:84% and parent have their information in mind 00:08:36.549 --> 00:08:40.850 align:middle line:84% so you can have the real and the good information. 00:08:40.850 --> 00:08:44.270 align:middle line:84% Here we have, also, for the Democratic Republic 00:08:44.270 --> 00:08:50.150 align:middle line:84% of the Congo some results from the lot quality 00:08:50.150 --> 00:08:51.910 align:middle line:90% assurance sampling. 00:08:51.910 --> 00:08:57.110 align:middle line:84% And we use information on mapping, 00:08:57.110 --> 00:09:01.310 align:middle line:90% and we use color codes. 00:09:01.310 --> 00:09:05.780 align:middle line:84% So when you have less than three unvaccinated children 00:09:05.780 --> 00:09:08.510 align:middle line:84% in the lots, the small community, 00:09:08.510 --> 00:09:11.150 align:middle line:90% you can put it in green. 00:09:11.150 --> 00:09:15.470 align:middle line:84% When it's between four and eight, you have the yellow. 00:09:15.470 --> 00:09:19.160 align:middle line:84% And when you have more than nine in the lot-- 00:09:19.160 --> 00:09:21.590 align:middle line:90% so around 10 house-- 00:09:21.590 --> 00:09:24.870 align:middle line:84% you say that it's a failed activity. 00:09:24.870 --> 00:09:28.160 align:middle line:84% So for example, we took about the same region 00:09:28.160 --> 00:09:31.490 align:middle line:90% in the southeast of the DRC. 00:09:31.490 --> 00:09:36.470 align:middle line:84% As you can see, there is a lot of red community. 00:09:36.470 --> 00:09:41.120 align:middle line:84% And all this red community, for the monitor 00:09:41.120 --> 00:09:45.020 align:middle line:84% and for the health program, say that it's 00:09:45.020 --> 00:09:49.970 align:middle line:84% a failed campaign, that we have to plan mop-up campaign 00:09:49.970 --> 00:09:54.530 align:middle line:84% and to be sure that we will have an outbreak in the future. 00:09:54.530 --> 00:09:57.650 align:middle line:84% And in July, for example, when they are carrying out 00:09:57.650 --> 00:10:01.790 align:middle line:84% the monitoring, there was only very small part 00:10:01.790 --> 00:10:04.790 align:middle line:84% in the middle of the Katanga region. 00:10:04.790 --> 00:10:08.510 align:middle line:84% In the southwest, we have a yellow and we have a red. 00:10:08.510 --> 00:10:10.880 align:middle line:90% And in November, we have all-- 00:10:10.880 --> 00:10:12.290 align:middle line:90% it was spread. 00:10:12.290 --> 00:10:16.620 align:middle line:84% But the red remained almost in the same area. 00:10:16.620 --> 00:10:22.190 align:middle line:84% So this provide information for decision-maker and health 00:10:22.190 --> 00:10:26.300 align:middle line:84% professionals to plan other activity or to correct-- 00:10:26.300 --> 00:10:30.120 align:middle line:84% to try to know why there is this problem. 00:10:30.120 --> 00:10:35.550 align:middle line:84% Now I would like you just to try to figure it out 00:10:35.550 --> 00:10:38.490 align:middle line:90% or to answer this question. 00:10:38.490 --> 00:10:41.880 align:middle line:84% After following this session, what 00:10:41.880 --> 00:10:47.530 align:middle line:84% are key output about monitoring and evaluation? 00:10:47.530 --> 00:10:52.080 align:middle line:84% So for the possible answer can be 00:10:52.080 --> 00:10:54.600 align:middle line:90% the number of missed children-- 00:10:54.600 --> 00:10:57.240 align:middle line:84% the characteristic of these children, 00:10:57.240 --> 00:11:01.260 align:middle line:84% their age, their location, the main reason 00:11:01.260 --> 00:11:04.480 align:middle line:90% for this no vaccination. 00:11:04.480 --> 00:11:09.750 align:middle line:84% We can also have the number or the percentage of zone that 00:11:09.750 --> 00:11:14.370 align:middle line:84% are poorly covered, the parents who are not 00:11:14.370 --> 00:11:18.220 align:middle line:84% aware about the activities, and, in addition, 00:11:18.220 --> 00:11:21.420 align:middle line:84% we can also have a lot of information 00:11:21.420 --> 00:11:26.010 align:middle line:84% about the social aspect of the polio program. 00:11:26.010 --> 00:11:29.420 align:middle line:90% So we will end our session here. 00:11:29.420 --> 00:11:34.010 align:middle line:84% And we would like you also to try to figure out 00:11:34.010 --> 00:11:38.840 align:middle line:84% why so many way to monitor health program 00:11:38.840 --> 00:11:41.720 align:middle line:84% and to deal with what are the advantage 00:11:41.720 --> 00:11:46.490 align:middle line:84% and the disadvantage of having so many monitoring system. 00:11:46.490 --> 00:11:47.090 align:middle line:90% Thank you. 00:11:47.090 --> 00:11:51.290 align:middle line:90% 00:11:51.290 --> 00:11:54.040 align:middle line:90% [MUSIC PLAYING] 00:11:54.040 --> 00:11:58.000 align:middle line:90%