Spotlight on Campaign Microplanning

Microplanning, defined as the process of creating detailed, delivery-level operational plans for reaching target populations with health interventions, is a critical component of effective and efficient health campaigns. Microplanning can include both regional- and state-level operational planning as well as granular implementation plans at the district and local levels.

Below are several key resources on microplanning, including models, best practices guides, and qualitative studies. The full archive of microplanning resources can be found here.

 

Promising Practices in Health Campaign Microplanning

 

While microplanning can significantly improve campaign performance, many organizations, governments, and programs are not positioned to undertake effective microplanning because of lack of resources, poor quality data for population targeting and progress tracking, and knowledge gaps around efficient microplanning practices. Despite these challenges, some programs have successfully developed and deployed innovative microplanning approaches that may be adaptable to other programs and geographies.

Findings: Microplanning approaches and innovations often focus on individual diseases, with proportionally more research on vaccine-preventable diseases such as measles and polio that have wellestablished and well-resourced programs in many countries (2,3). Overall, both the discussion at the 2020 Microplanning Meeting and findings from the literature review suggest that microplanning can be a valuable strategy for improving campaign effectiveness. This report outlines four key areas where promising practices may exist for further exploration as means of improving microplanning across different campaign programs: 1. Cross-campaign sharing and synergies 2. Data quality and access 3. Community engagement 4. Efficient planning, implementation, and management.

 

The Power of Microplanning: Insights from Polio Eradication (The STRIPE Project)

The STRIPE (Synthesis and Translation of Research and Innovations from Polio Eradication) project is a collaboration of academic and research partners in 8 countries. They are collecting and disseminating lessons learned from the global polio eradication effort.

The group surveyed 3,955 people and interviewed and 194 people, getting insight from people around the world about their experiences with polio eradication. In their research, health professionals across the world expressed consistent and strong enthusiasm for a surprising topic—microplanning.

This document covers best practices for microplanning.

 

GRID3 data as a building block for COVAX interventions: spotlight on Nigeria microplanning

Ninety million doses of COVID-19 vaccines are to be distributed within the African continent in the first quarter of 2021, with another 600 million by the end of the year. In Nigeria, about four million doses were shipped in March, marking a key milestone in the COVAX roadmap to enable equitable worldwide access to COVID-19 vaccines.

To plan and implement efficient COVID-19 immunisation campaigns, Nigeria’s National Primary Health Care Development Agency (NPHCDA) and National Space Research and Development Agency (NASRDA) joined forces with GRID3 Nigeria to support COVID-19 vaccine delivery and access strategies across the country. This work is one example of how GRID3, one of the COVAX technical partners, aims to support sub-Saharan African governments’ efforts to end the pandemic.

 

Best Practices in Microplanning for Polio Eradication, from the Global Polio Eradication Initiative

This document describes best practices in microplanning for polio eradication campaigns, also known as supplementary immunization activities (SIAs) with oral polio vaccine (OPV). A microplan must aim to reach 100% of the target population, usually children aged under 5 years. Experience over the years has
shown that the poliovirus can continue to circulate in quite small populations of unvaccinated children, thus requiring that the microplan be sufficiently detailed to reach every child with OPV. The elements for making a microplan are described, along with the relevant best practices learnt over time. This document is a practical guide with working examples that can be adapted as needed. The best practices can serve as a guide for other public health programmes.

 

A microplanning model to improve door-to-door health service delivery: The case of Seasonal Malaria Chemoprevention in Sub-Saharan African villages, from BMC Health Services

Malaria incidence has plateaued in Sub-Saharan Africa despite Seasonal Malaria Chemoprevention’s (SMC) introduction. Community health workers (CHW) use a door-to-door delivery strategy to treat children with SMC drugs, but for SMC to be as effective as in clinical trials, coverage must be high over successive seasons.

Results: Estimates showed that microplanning significantly reduces CHWs’ walking distance by 25%, increases the number of visited households by 36% (p < 0.001) and increases SMC coverage by 21% from 37.3% under current SMC deployment mode up to 58.3% under microplanning (p < 0.001).

 

A Qualitative Study of the Development and Utilization of Health Facility-based Immunization Microplans in Uganda

In 2006, Uganda adopted the Reaching Every District strategy with the goal of attaining at least 80% coverage for routine immunizations in every district. The development and utilization of health facility/district immunization microplans is the key to the strategy. A number of reports have shown suboptimal development and use of microplans in Uganda. This study explores factors associated with suboptimal development and use of microplans in two districts in Uganda to pinpoint challenges encountered during the microplanning process.

Results: Three key findings emerged from this study. First, there are significant knowledge gaps about the microplanning process among health workers at all levels (community and district health facility and nationally). Limited knowledge about communities and program catchment areas greatly hinders the planning process by limiting the ability to identify hard-to-reach areas as well as prioritize areas according to need. Secondly, the microplanning tool is bulky and complex. Finally, microplanning is being implemented in the context of already over-tasked health personnel who have to conduct several other activities as part of their daily routines.

 

Microplanning verification and 2017/2018 measles vaccination campaign in Nigeria: Lessons Learnt

This 2021 article covers microplan verification in two stages.The measles supplemental immunisation activity is an effective strategy that improves vaccination coverage and reduces measles-related morbidity and mortality. However, the lack of compliance with microplanning processes, contributes to improper estimation of resources needed for a good SIA in Nigeria. We described the microplanning verification process for 2017/2018 measles vaccination campaign and highlighted the contribution of selected variables to the output of the microplan.

Results: All states in Nigeria verified their wards’ microplans, 21 states (57%) verified more than 30% ,16 states (43%) verified less than 30%, Kebbi State verified the lowest (5.3%). Over 90% of microplans verified complied with the microplanning processes. We observed that overall, there was no significant difference in the number of target population, vaccination teams and qualified vaccinators after the verification process.

 

A cost-effectiveness analysis of traditional and geographic information system-supported microplanning approaches for routine immunization program management in northern Nigeria

Effective RI microplanning requires accurate population estimates and maps showing health facilities and locations of villages and target populations. Traditional microplanning relies on census figures to project target populations and on community estimates of distances, while GIS microplanning uses satellite imagery to estimate target populations and spatial analyses to estimate distances. This paper estimates the cost-effectiveness of geographical information systems (GIS)-based microplanning for routine immunization (RI) programming in two states in northern Nigeria.

Results: The study compares the total number of vaccinations that would take place (or projected) applying either administrative or the 2018 NNHS coverage for traditional microplanning vs. GIS-driven microplanning in three LGAs in each state. We show two scenarios: (1) using the administrative coverage (85% for traditional microplanning and 87% coverage for GIS) and (2) using the NNHS 2018 coverage for Bauchi and Sokoto States. We estimated the total number of vaccines required for all antigens in the RI schedule. For vaccines other than pentavalent and measles, we made the following assumptions: (1) penta3 coverage for pneumococcal conjugate vaccines and oral and injectable polio vaccines, (2) antenatal care prevalence for tetanus toxoid, (3) measles coverage for yellow fever, and 4) delivery with a trained attendant coverage for BCG and hepatitis B birth dose.

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