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SIAs Micro Plan Quality Evaluation

Name of the Reviewer District/Tehsil/UC


Date of Review Campaign Total No of AICs
Name of AICs 1:_____________ 2:_____________ 3:____________ 4:______________ 5:_______________
(Request Micro plans and Tally Sheets for previous SIA activity for comparison. Action points related to activity
planning from the previous activity round)

Team/Area In charge/Union Council plan

Indicators Assessed AIC


Sr Major
(Yes = 1 and No = 0 and NA for Not Applicable) 1 2 3 4 5 Total
# Component
Score
Team Wise/Day Wise data (i.e. targets, defined areas, etc.)
1 updated and aligns with previous campaign tally sheet (or
Form 2C in CBV areas) and/or potential population changes
Human Is the workload for each team updated, rationalized and dd
Resource appropriate for the area (G1, G2, G3) (i.e. one team is not
doing double what other teams are doing in similar areas
2
[CBV G1 =70-75 G2 = 50-60 G3= 30-40 children/day Non
CBV G1 = 200 G2 = 150 G3 = 100/ day and maximum of 135
houses daily]
Missed/Persis Does the MP have an updated list of missed children 11
tently missed including persistently missed children for each team for
3
Children each team during the last campaign?
coverage plan
4 High Risk Is there a plan to cover high-risk groups?
Population IF there is is a high risk or mobile group in the area, is there
5
coverage plan a team-wise, day-wise plan to cover this area?
Name of head master/mistress is written for each
6 Schools and
school/madrassa
Madrassa
Number of children less than 5 at each school is mentioned
7 Coverage plan
and updated in the micro plan?
Does the plan for vaccine to be given to each team match
8 Logistic Plan the target for the current campaign and is this plan
updated? (i.e. 105 target children = 6 vials)
Does the training plan include updated Date, Time and
9 Teams/AICs
Venue for each training?
Training Plan
Does Training Plan include an updated plan for catchup
10
training?
11 Social Does the Social Mobilization Plan include updated details of
Mobilization Masajids (including Imam’s name and contact details)
plan where the Imam will talk about polio and RI during Juma
speech. In CBV areas, is there a social mobilization plan
created by RSPs?
Does the SM Plan include an updated strategy for coverage
12 of missed children through community influencers in
mobile team areas/ RSPs in CBV areas?
Is the supervision plan updated with reasons for selection
Supervision
13 of specific teams to be visited by AIC/AS (i.e. poor
plan
performing, routine, new team, etc.)?
Is the area of this AIC/AS included and labeled in the UC
14 UC Map
level map?
Is each team and the distribution of their days work
15
included, updated, and labeled in the AIC/AS Map?
AIC Map
Does the AIC map clearly identify High Risk and Mobile
16
groups in their area?
Does the AIC have an updated team route map for each
17
team? Note: this question in NA In CBV areas
Team Route
Does each team route map indicate the movement pattern
Map
18 of the team and it is not zig zagging? Note: this question is
NA in CBV areas if route maps are in registration books
Micro-plan Self Assessments are completed for this
Self-
19 campaign and show a change in the difference column
Assessment
(either positive or negative). Note: this is NA in CBV areas
Do the number of households in previous campaign’s tally
sheet/Form 2B for any selected day at random match the
20 Tally Sheet updated number of households in the current microplan
for the same day selected (pick ONLY one team PER area in
charge at random)?
Total Score (Yes=1 and No = 0)
Questions weighted
100 % Pass, 90-99% Needs improvement and < 90% fail
Any other comments (regarding any domains not mentioned above)

______________________________________________________________________________________

Signature of Reviewing Person:______________ Submitted To: ________________


Field Validation of Micro plan
Polio Eradication Initiative

Province: District/Town: Date of Campaign Date of validation:

Name of validating person: Designation: Agency (Gvt/WHO/UNICEF):


Union Council: Number of AICs:

Has this area been validated by the UC Level Supervisors for this campaign? Yes/ No,
By Whom: UCMO THO UCPO UCCO Any Other _________________________
AIC 1 AIC 2 AIC 3 AIC 4 AIC 5
Team #__ Team #__ Team #__ Team #__ Team #__
Day:___ Day:___ Day:___ Day:___ Day:___
Field Validation Variables (Tick appropriate)
(Tick "Not Matching" if field is different from the micro Score
plan or map) Matching Matching Matching Matching Matching

Yes / No Yes / No Yes / No Yes / No Yes / No

Select the starting household from any day’s work for


1 a team from their map and verify the household details
while in the field
From the same starting point as the previous question,
2 cross verify the Day/Team/Area/UC boundaries
against their maps.
Continuing with the same days’ work, verify landmarks
from the team’s route map as you move to the ending
3
point of that day (Mosques, Madrassas, schools,
markets, etc)
Team movement pattern as per guidelines (not zig zag
4
except in certain circumstances)
Cross verify any High-Risk and Mobile Population
4
settlements found while in the field with the maps.
Select one school/madrassa from micro plan and
5
verify its target from school/madrassa registration
Select one fixed site if mentioned in the micro plan and
6
verify the location and if it is spotted in the map
Select one transit point if mentioned in the micro plan
7
and verify the location and if it is spotted in the map
In CBV areas, 10 households will be verified from
micro census registration. Priority of these houses are
NA, Locked, 0/0, Refusals, or missed. The 10
households should be a mix of all these categories for
one day’s work. If there are not 10 houses that match
there criteria, houses should be selected at random
8 until 10 houses are verified against the micro census
books.
The following question will be answered about those
10 houses:
What is the status of the above mentioned houses
compared with the micro census book? Comment if
houses do not match.
Select the ending household from the same days’ work
9
and verify the household details while in the field
Total Score (Matching = 1 and Not Matching = 0)

100 % Pass 90-99% Needs improvement < 90% fail


If any missed area found: Provide detailed address along with estimated number of children found missed
(Missed area mean 3 or more HH Missed in one locality = MP Failed)

Signature of Reviewing Person: _______________________Submitted To:___________________________________

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