WEBVTT

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[MUSIC PLAYING]

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OLUWASEUN AKINYEMI: Hello.

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"Planning and Management,
Beyond the Basics."

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These are the themes
we'll be exploring

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in this module, the
power for engagement,

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reaching special populations,
the importance of politics,

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as well as the
power of incentives.

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We'll start with the first
theme, the power of engagement,

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"Best Practices
in Microplanning."

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Microplanning
fulfills its potential

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when it is more than
a paper exercise.

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Microplanning is
particularly a powerful tool

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when it is used as a
platform for community

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engagement, program
improvement, and health system

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strengthening.

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Some of the people
refer to microplanning

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as community action plan
or bottom-up planning.

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Best practices in
microplanning involve

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ensuring that there is
community participation.

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According to a Bangladeshi
health officer,

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he said, "We made microplanning
more participatory.

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The community was involved
in the microplanning.

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Political leaders would
participate as well.

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By this kind of
microplanning, when

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we were doing
things precisely, we

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could see the whole
of Bangladesh."

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So it is very important to
engage community members

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in microplanning,
particularly community leaders

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directly in the
microplanning process.

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Engaging community members,
particularly community leaders,

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directly in the microplanning
process has multiple benefits.

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It not only results
in better data.

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It also builds
stronger relationships

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and strengthens community
engagement and buy in.

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According to health official
from the Democratic Republic

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of Congo, "The
microplanning that

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was implemented from
the polio campaign

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extended to microplanning
routine immunization activities

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and integrated even with
maternal and child health

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intervention."

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So we see that detailed
microplans are powerful.

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They also take substantial work.

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Challenges [INAUDIBLE]
across health programs

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fulfill microplanning's
potential

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for broad
health-system benefits.

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From this slide, we see examples
of integrated microplanning

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from two countries, Nigeria
as well as DRC and Somalia.

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From Nigeria, polio
Geographic Information System,

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GIS, mapping was used to plan
for routine immunization.

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And also in DRC
and Somalia, we see

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microplanning included
in routine immunization,

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routine immunization
information.

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And this also shows
availability of supplies

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as well as capacity
of health worker.

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So we see that microplans
are very powerful.

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They could be used to
strengthen routine immunization,

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ensuring availability
of supplies,

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and in management of
human resource for health.

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From India, a health
official said,

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and I quote, "Polio brought that
microplanning, which was not

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that robust and real micro
in any other program,

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for bringing out those people.

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Polio brought out unserved
and left-out populations

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like the brick cleans, the
buses, or the construction

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workers, or slum migrant
workers into the program focus.

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So it has created a system
in the government itself

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which is still be used for
other public health programs.

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And it's helping a lot."

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So from this quote, we
see that microplans also

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help to promote equity
by putting the spotlight

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on populations that
might not easily

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be seen such as the poor,
the migrant population,

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other population that
are disadvantaged.

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So microplans, in that
sense, are very powerful.

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Again, another
quote from Pakistan

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from a global-level policy
maker, "To eradicate polio,

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you have to keep on vaccinating
children time and time again,

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both in these poor
villages in Pakistan,

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for example, there is some
resentment by parents saying,

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oh, you keep coming back
and vaccinating for polio,

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but we haven't got any water,
or we haven't got any food,

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or my children
just got measles."

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So this is true in many
developing countries.

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People are getting skeptical.

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And sometimes they're becoming
suspicious about the frequency

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of the polio vaccination.

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But what is the
solution to this?

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Again from Pakistan, from
that same global-level policy

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policymaker, they said,
"So we responded to that

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by rotary setting of what
we call health camps.

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We don't only do polio.

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They check for all
sorts of things.

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And they give measles and TB.

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And we've set up
permanent transit camps

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on the borders using whole
shipping containers which

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are being converted
into units that they

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can use to vaccinate children
through health camps,

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provide information, you
know, on all sorts of issues."

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So we see that in order to deal
with the issue of hesitancy

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as the result of the frequency
in polio vaccination,

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there are some other very
innovative methods are being

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developed in many countries.

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Some people call
it polio plus days,

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where they had other things
than the polio vaccine

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in terms of during the
campaign, like measles vaccine,

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like TB vaccine, like vitamin
A, and in some places,

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insecticide treatments.

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So the question is,
what would be involved

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in this sort of microplanning?

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I'd like you to take a
moment to reflect on this.

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How would it be different
than the usual microplanning?

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From India, again from a
health official from India,

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they said, "There were
shortages of health manpower.

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And the microplanning
was done in such a way

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that it could move people
around and make sure

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that the vacant positions
are not affecting the program

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delivery."

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So microplans can
be transformative

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when they are used
not only for making

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work plans for a campaign, but
for taking substantive action

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to improve health services.

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This is particularly
true in reaching

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mobile or otherwise
hard-to-reach populations which

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may show up on a health system
readout for the first time

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through the
microplanning process.

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Usually when we rely only
on administrative data

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our census figures, it might not
take into consideration migrant

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populations.

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But when we do microplan,
we are able to identify

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migrant population or
other population that

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are disadvantaged.

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And we can better plan for them
and make provision for them

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during campaigns or in the
health system planning.

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What steps does this kind
of engagements involve?

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I'd like us to discuss
the example of the Social

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Mobilization Network strategy
in Uttar Pradesh called

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SMNet from India.

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How is this relevant
for the engagement

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for microplanning and reaching
hard-to-reach populations?

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The SMNet's goal was to
improve access and reduce

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family and community
resistance to vaccination.

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The partners trained
thousands of mobilizers

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from high-risk communities
to visit households, promote

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government-run child
immunization services,

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track children's
immunization history,

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and encourage
vaccination of children

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missing scheduled vaccination,
and mobilize local opinion

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leaders.

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These social mobilizers
maintain detailed maps

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of their communities and
visited their assigned household

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at least once each month
to promote polio vaccine

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campaigns.

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Using specially
designed registers,

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CMCs tracked pregnancies and
routine and polio vaccination

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status of newborns, children
under five, and pregnant women,

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sending their register data
to their supervisors monthly.

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They also level data
that were aggregated

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at community and
district levels, provided

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critical inputs for
microplanning as well

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as for senior staff to
provide rapid feedback

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and provide regular supervisory
capacity building to staff.

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As the campaign
became more organized,

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campaign implementers
used real-time data

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in nightly government-led
debriefings

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to support rapid situation
analysis and problem solving,

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especially for
hard-to-reach areas.

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