Region:

Province:
City/Municipality: RHU/HC: Total Population:
MANPOWER, VACCINES, AND ANCILLARY REQUIREMENTS

Finger # temprature
# of Vaccination Teams Required # Safety monitoring
# OF CHILDREN # of MR Markers = 1
MR TARGET OPV TARGET TOTAL # # OPV Vials # of Droppers # of MR # MR Diluent # of AD # of Mixing # of Collector # divices
DISTRICT/ TYPE (URBAN TO BE # OF DAYS # TEAM # OPV DOSES Vaccine Vials # MR DOSES Marker Per # Cold box # Vaccine # ICE PACKS
POPULATION POPULATION STAFF REQUIRED = 1 dropper Diluents = # of DOSES IN Syringes = # of Syringes = # AEFI/Epinephrine Boxes = # of Refrigerators
BARANGAY OR RURAL) VACCINATED REQUIRED SUPERVISORS IN LITERS Required IN LITERS 200 Children Required career REQUIRED
(9-59MO) (0-59MO) Mobile REQUIRED =EP/20 x 1.15 per OPV vial MR Vials LITERS EP x 1.11 MR Vials*1.11 Kits = 1 Kit Per VT ADS + Requiered
PER DAY = EP/10 x 1.20 (+50%
Fixed Post Fixed H2H MS/100
buffer)
Post
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
Total 0 0 0 0 0 0 0 0 0 0
 ADVOCACY, COMMUNICATION AND SOCIAL MOBILIZATION PLAN

Region: _____________________________ Province/ City: _____________________________ Municipality/ Barangay: _____________________________ Date: _______________

Activities Indicator Target Baseline Time frame Responsible person/ unit Budgetary requirement Funding source(s) Remarks

BEFORE THE MASS IMMUNIZATION CAMPAIGN

(Pre-Implementation Phase)
1. Briefing and feedback with mayor, city administrator, # of briefing sessions with city mayor, city
city public information officer, CSWD, city sanitation administrator, and other key local officials
officer, and other key local officials conducted
2. Briefing and dialogues with local partners and local
leaders
a. Barangay chairmen, kagawad for health and sanitation, # of barangay chairmen, kagawad for health
and other local officials and sanitation, and other local officials given
orientation on the polio mass immunization
campaign

- Prepare letter of invitiation/notice of meeting; send

invitation
- Conduct the meeting(s)
b. Representatives from community-based organizations # of representatives from community-based
(homeowners associations, senior citizens, women's organizations given orientation on the polio
groups, transport groups, youth groups, indigenous mass immunization campaign
peoples, etc.)

- Prepare letter of invitiation/notice of meeting; send

invitation
- Conduct the meeting(s)
c. Religious leaders # of religious leaders given orientation on the
polio mass immunization campaign
- Prepare letter of invitiation/notice of meeting; send
invitation
- Conduct the meeting(s)
d. Representatives from private organizations and business # of representative from private sector given
sector orientation on the polio mass immunization
campaign
- Prepare letter of invitiation/notice of meeting; send
invitation
- Conduct the meeting(s)

e. NGOs, CSOs, civic, and other organizations operating in # of representatives of NGOs, CSOs, and
the city other organizations given orientation on the
polio mass immunization campaign
- Prepare letter of invitiation/notice of meeting; send
invitation
- Conduct the meeting(s)

3. Orientation/training of barangay health workers and

volunteers on campaign guidelines and IPCC # of barangay health workers and volunteers
given orientation on the polio mass
immunization and key messages
# of BHWs and volunteers trained on IPCC to
address refusals
4. Development, production, and dissemination/posting
of communication materials
a. Development and/or printing of communication # of communication materials developed
materials
b. Distribution and posting/installation of streamers, # of streamers or posters installed
posters, and other communication materials (consider
public markets, transport terminals, ports, health facilities,
day care centers, commercial areas)

# of flyers distributed
5. Announcements via local public address system(s) - e.g. # of announcements made regarding the
mobile public address system, community megaphones polio mass immunization campaign
6. Facility-based awareness-raising activities for
parents/caregivers (group orientation; announcements;
barangay assemblies; day care center meetings)

7. Awareness raising and engagement via the city # of posts regarding the polio mass
government's social media platforms (e.g. Facebook, immunization campaign
Twitter, Instagram, Youtube)

8. Awareness-raising activities for hard-to-reach or special # of awareness-raising activities for 'special'

populations (e.g. areas with security issues, relocated populations conducted
populations, mobile and transient families, homeless)

- Identifying hard-to-reach or special populations

- Conduct of local strategies to reach hard-to-reach or
'special' populations

9. City-level launching or kick-off activity # of city-level kick-off activities conducted

- Form committee; assign tasks
- Prepare programme or activity plan, with budget;
speeches or talking points
- Send invitations; coordinate logistics support
- Conduct kick-off activity

10. Pre-campaign monitoring (check for visibility of # of pre-campaign monitoring activities

communication materials e.g. streamers; awareness of conducted
parents/caregivers about the campaign; activities
conducted by local officials and partners in support of the
campaign)

11. Documentation of pre-campaign activities (e.g. video, Type of documentation used (video, audio,
photo) photo, narrative)

12. Coordination meetings on advocacy and social # of coordination meetings conducted

mobilization

DURING THE MASS IMMUNIZATION CAMPAIGN

(Implementation Phase)
1. Monitor the progress of immunization activities; check # of monitoring activities conducted
for possible issues including refusals, rumours,
misinformation; apply corrective actions, if needed

2. Continuing social mobilization activities (add details

below; some awareness-raising activities during pre-
campaign period may be continued until end of the
campaign period and/or when all children have been
immunized)

3. Home visits to follow-up missed children # of home visits conducted

AFTER THE MASS IMMUNIZATION CAMPAIGN (Post-Implementation Phase)

1. Post-campaign assessment meetings and other # of post-campaign assessment meetings and
activities other related activities conducted
2. Meetings with local partners to report on campaign # of meetings conducted
accomplishment and to thank them for their support;
agreements to maintain/sustain the partnership

3. Preparation and submission of campaign # of reports submitted

documentation report(s)
4. Partner's Recognition # of Partner's attended & recognized
TOTAL AMOUNT REQUIRED
r
ACTIVITY PLAN

Region: _____________________________ City/ Province ____________________________Municipality: ____________________________

District: Barangay: _______Date: _______________

Activities Indicator Time frame Responsible person/ unit Budgetary requirement Funding source(s) Remarks

PRE-IMPLEMENTATION ACTIVITIES
2.Conduct City/Municipality SIA Orientation and
Microplanning Workshop (Synchronized
Orientation)

- Campaign Objectives, Strategies, Guidelines on

Vaccine Safety & Administration, Cold chain and
vaccine handling,etc
- Inter-personal Communication and Counselling
(Key Messages); COVID-19 IPC
- AEFI Surveillance and Management
- Planning/Microplanning
- Data Management (Apps, Recording and
Reporting)
- Immunization Waste Handling & Management

3. Conduct of Roll-out Orientations and

Microplanning for VTs in RHUs & HCs for Field
Health workers/Vaccination Teams/ Barangay
Health Workers/Bgys. Officials and Partners

4. Organize Campaign Operation Center

- Organize TWGs & Preparatory Meetings, etc
- Identify/designate data room & logistics

5. Conduct of Advocacy, Communications & SocMob

Activities (maybe in a separate sheet/Comms Plan)
-community awareness raising, IEC dissemination,
partner's meeting and mobilization, etc
6. Cold chain, vaccine carrier, Ice-packs and related
equipments inventory and preparation
7. Vaccine and Logistics Allocation, Distribution &
Transpost including IEC Materials

8. Identification & Meeting of Referral Hospitals and

Coordination for Emergency Transportation in Case
of AEFIs
- AEFI Kit & Medical Equipment repositioning
IMPLEMENTATION ACTIVITIES

1. Deployment of VTs & conduct of Actual

Vaccination in the Field with IPC Measures
2. Daily accomplishment data reporting and
management
3. Daily coordination meeting and feedback
4. Field Monitoring and Supervision
5. Rapid Convenience Monitoring/Assessment
- Deployment of Monitors and RCA Validators
6. AEFI Monitoring and Surveillance
- Standby ambulance or emergency transport
POST-IMPLEMENTATION ACTIVITIES

1. Post-Campaign Meetings and Evaluation

2. Partner's Recognition

3. Final Disposal of Immunization Wastes

4. Planning to Strengthen Routine Immunization

5. Continuation of AEFI Surveillance or Monitoring

TOTAL AMOUNT REQUIRED
VACCINATION SESSION PLANNING

City/Municipality: _____________________________ District: ___________________ Health Center: ________________________ Team Number: ______________

Strategy # of MR Vaccine # OPV Vials # of Mixing # of

Date of Target area MR EP (9- Vials Required # of MR Diluents OPV EP (0- REQUIRED # of AD Syringes = Syringes = # MR # Vaccine AEFI/Epinephrine Supervisor's Name Vaccinator Recorder
vaccination (Barangay) 59MO) = # of MR Vials 59MO) # of EP x 1.11 career
= EP/10 x 1.20 =EP/20 x 1.15 Vials*1.1 Kits = 1 Kit Per VT

0 0 0 0 0
 SUPERVISION SCHEDULE

Region: ________________________ Province: _______________________ Date Prepared: _______________________

City/Municipality: __________________________ District: ________________________

Health Center: _____________________________

Team Number and Name Catchment Areas to Be Please Indicate if

Name of Supervisor of VT Leader Visited temporary fixed post Mode of transport Date of Supervision
 Contact Numbers

VT Team Leader Supervisor

 MICROPLANNING FOR TRANSPORTATION/ HEALTH WORKER MOBILIZATION
Region: Province: CITY/MUNICIPALITY:
DEMOGRAPHIC DATA COMPUTING FOR TRANSPORTATION REQUIREMENT

Type (Urban or Total # of vehicles # transport

No. Barangays required for
Rural) available vaccination team
1 1 2 3 4
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
TOTAL 0 0
KER MOBILIZATION
MUNICIPALITY:
PORTATION REQUIREMENT
# of transport # of transport # transport # of additional
required for required for required for transport needed
supervisors monitors supplies for the SIA
5 6 7 8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0 0
 BUDGET REQUIREMENT

Logistical Requirements Est. unit cost (PhP)

# of recording forms required
# of finger markers required
# of transport needed
TOTAL (PhP)

Manpower Requirements Mobilization

allowance
Total # of vaccination staff required
# of team supervisors
TOTAL AMOUNT

Activity Plan and Budget Unit price

TOTAL AMOUNT
MENT

Quantity needed Total cost (PhP)

quantity Amount (PhP)

quantity Amount (PhP)