School-Based Immunization Microplan

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Department of Health-Regional Office IX

School-Based Immunization Microplan


Polanco, Zamboanga del Norte

Prepared by: DR. JULIANA M. UY


Date: June 30, 2016
Objective/s:
ACTIVITIES
1. Orientation of
School Teachers
-Elementary(by
district)
-High School(by
school)
2. Advocacy of the
scheduled
immunization days to
parents during
homeroom PTA
meeting by school
a. High School (by
school)
2A) History of allergy
taking during
homeroom PTA
meeting by school
2B) Distribution of
consent forms by
school and grade
3. Master listing of all
targeted school
children by school
4. Collection of
Accomplished Master
list by school
5. Procurement of
medicines for

TIMEFRAME
2nd week of July

RESOURCE
REQUIREMENT
-DOH Dept. Memo
0146

SOURCE OF FUNDS
DOH

RESPONSIBLE
PERSON
-DepEd Nurses
-RHU(MHO,PHN)
-NDP

Whole month of July

-DOH Dept. Memo


0146
-TEV (Travel
Allowance)

DOH

-DepEd Nurses
-RHU (MHO, PHN)
-NDP

Whole month of July

-Recording Form for


Allergy

DOH

-DepEd Nurses
-MHO & PHN
-NDP

4th week of July

-Blank Consent Forms

DOH

-DepEd Nurses
-School Teachers

Whole month of July

-Blank Forms

DOH

-DepEd Nurses
-School Teachers

4th week of July

-Master list of
Targeted school
children
-Medicines

DOH

-DepEd Nurses

Last week of June

LGU-RHU

-MHO,PHN

possible adverse
reaction

Department of Health-Regional Office IX

School-Based Immunization

Polanco, Zamboanga del Norte

Microplan

Prepared by: DR. JULIANA M. UY


Date: June 30, 2016
Objective/s:
ACTIVITIES

TIMEFRAME

RESOURCE
REQUIREMENT

SOURCE OF
FUNDS

RESPONSIBLE
PERSON
-DepEd Nurses
-MHO & PHN
-NDP
-DepEd Nurses
-MHO & PHN
-NDP

6. Organize medical
team for AEFI

3rd to 4th week of July

7. Distribution of
anaphylaxis response
kit per medical team

4th week of July

-Emergency Kit box


-Medicines & Medical
Supplies
-DOH Forms for AEFI

-DOH
-RHU

Aug. 1-30, 2016

-Vaccines
-Medical Supplies

-DOH
-RHU

b. Reporting of
adverse reaction if
present

Aug. 1-30, 2016

-DOH forms for AEFI

-DOH

c. Referral of existing
adverse reactions to
MHO
d. Reporting and
submission of

Aug. 1-30, 2016

-DOH forms for AEFI

-DOH

-DepEd Nurses
-PHN
-NDP
-School Teachers
-DepEd Nurses
-PHN
-NDP
-School Teachers
-MHO

-DOH
-RHU

-DepEd Nurses
-PHN

-Implementation
Phasea. By Grade, By
School

RHU-PHO/RHO
(Daily/Weekly)

Reports

RHU-PHO/RHO (Official
Report after 1 week)

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