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In this page you can get Forms and Formats About Polio Campaign in Pakistan
UPEC Meeting
Meeting Must be started with the recitation of Holy Quran
In UPEC Meeting the Chairman must give briefings to the community elders, Imam Masajid, School Teachers and other influencers. The Representative of Health Department must share Globally Current Situation of Polio Virus and Polio Cases. UPEC Members have very important role in coverage of Refusals and NAs. It is Necessary to make attendance of the participants to
Download Attendance Sheet Click Here
Team Training
Are you ready? to Get for a comprehensive overview of the Polio Team Training Agenda 2025! Download our easily accessible Excel file to streamline your planning and ensure you don’t miss any important sessions or topics. Perfect for team collaboration and preparation. For better achievement Stall Method of Training included im agenda Dive in and make the most of your training fruitful
House Hold Cluster
What is house hold cluster in polio campaign?
House hold cluster is a very important monitoring form to access the polio campaign in community. It is necessary specially for area in charges to take at least six house hold cluster from different areas of polio teams. If he found gaps in vaccination of missed children or missed house than community in this area is on risk to effect with polio virus, In this situation area incharge must sweep this area again and take more HH Cluster to vaccinate every child and save the community from polio virus to Download HH Cluster form click here
House Hold Cluster Urdu
پولیو مہم میں گھرانے کا کلسٹر کیا ہے؟
گھرانے کا کلسٹر پولیو مہم کی نگرانی کا ایک بہت اہم فارم ہے تاکہ کمیونٹی میں پولیو مہم تک رسائی حاصل کی جا سکے۔ یہ خاص طور پر علاقائی انچارج کے لیے ضروری ہے کہ وہ پولیو ٹیموں کے مختلف علاقوں سے کم از کم چھ گھرانے کے کلسٹر حاصل کریں۔ اگر انہیں بچوں کی ویکسینیشن میں کوئی کمی یا چھوٹے گھرانوں میں کوئی کمی نظر آتی ہے تو اس علاقے کی کمیونٹی پولیو وائرس کے اثر میں آ سکتی ہے۔ اس صورت میں علاقائی انچارج کو اس علاقے کا دوبارہ معائنہ کرنا چاہیے اور مزید گھرانے کے کلسٹر حاصل کرنا چاہیے تاکہ ہر بچے کو ویکسین فراہم کی جاسکے اور کمیونٹی کو پولیو وائرس سے بچایا جا سکے۔
House Hold Cluster and Team Monitoring Urdu
پولیو مہم میں گھرانے کا کلسٹراورٹیم کی نگرانی کیا ہے؟
گھرانے کا کلسٹر پولیو مہم کی نگرانی کا ایک بہت اہم فارم ہے تاکہ کمیونٹی میں پولیو مہم تک رسائی حاصل کی جا سکے۔ یہ خاص طور پر علاقائی انچارج کے لیے ضروری ہے کہ وہ پولیو ٹیموں کے مختلف علاقوں سے کم از کم چھ گھرانے کے کلسٹر حاصل کریں۔ اگر انہیں بچوں کی ویکسینیشن میں کوئی کمی یا چھوٹے گھرانوں میں کوئی کمی نظر آتی ہے تو اس علاقے کی کمیونٹی پولیو وائرس کے اثر میں آ سکتی ہے۔ اس صورت میں علاقائی انچارج کو پولیو ٹیم کے ذریعے دوبارہ ویکسینیشن کروا کر اس علاقے کا دوبارہ معائنہ کرنا چاہیے اور مزید گھرانے کے کلسٹر حاصل کرنا چاہیے تاکہ ہر بچے کو ویکسین فراہم کی جاسکے اور کمیونٹی کو پولیو وائرس سے بچایا جا سکے۔
گھرانے کے کلسٹراور ٹیم مانیٹرنگ کا فارم ڈاؤن لوڈ کرنے کے لیے یہاں کلک کریں۔
Complete Guide on Filling Polio Campaign Supervisor Monitoring Form
Polio eradication campaigns require strict monitoring to ensure quality, accountability, and accuracy in vaccination activities. Supervisors play a key role by checking field performance, identifying gaps, and documenting them through the Supervisor Monitoring Form (SMF). This guide explains step-by-step how to fill the form correctly.
click here to download Supervisor Monitoring Form
1. Introduction to the Supervisor Monitoring Form
The Supervisor Monitoring Form is used by polio campaign supervisors like UCMO or TSP to:
Monitor Polio Teams performance.
Verify vaccination coverage of polio team in assigned areas.
Identify missed and refusal children with reasons.
Ensure proper campaign implementation.
Correctly filling this form helps health authorities take immediate corrective actions.
2. General Information Section
At the top of the form, supervisors must record basic campaign details:
Date of Visit – Mention the exact date of supervision.
District / Tehsil / UC – Write the name of the district, tehsil, and union council.
Area / Village / Mohalla – Specify the exact area where monitoring is done.
Name of AIC/Supervisor Monitored – Record the names or codes of the AIC/Supervisor
Supervisor’s/Monitor Name & Designation – Clearly write your full name and role (e.g., TSP, DHMT, UC Supervisor etc.).
Supervisor/Monitor Must Check That AIC Have Verification Documents of the Following Points.
click here to download Supervisor Monitoring Form
1. Vaccination Team Monitoring
This section assesses the vaccination team’s field performance. Supervisors should check and record:
Team Presence – Are both team members present?
Vaccinator Kit – Do they have vaccine carrier, tally sheet, finger marker, chalk, and marker?
Cold Chain Maintenance – Is the vaccine properly stored with adequate icepacks?
Vaccination Technique – Is OPV administered correctly? (2 drops in the mouth).
Marking – Is the child’s left little finger marked after vaccination?
House Marking – Are houses marked properly after team visit?
Behavior with Community – Is the team polite and cooperative with families?
2. Child Finger Marking Verification
Supervisors must check children (especially under 5 years) in the monitored houses:
Number of Children Checked – Count and write how many children under 5 were verified.
Proper Finger Marking – Note how many had visible finger marking.
Missed Children – Record unvaccinated children found and reasons (e.g., child not at home, refusal, newborn, sick child).
3. House-to-House Monitoring
While accompanying or checking the team, verify household coverage:
House Visited by Team – Confirm if the house was actually visited by the vaccination team.
House Marking Accuracy – Ensure marking shows number of children under 5 and vaccination status.
Unvisited Houses – Note if any house was skipped.
Locked Houses – Record locked houses and whether they were re-visited later.
4. Community Feedback Section
Supervisors should ask families about:
Team Behavior – Was the team respectful and cooperative?
Awareness – Did the family know about the campaign in advance?
Concerns – Any complaints or reasons for refusal (fear of side effects, lack of trust, religious beliefs, etc.).
Documenting this feedback helps in community engagement strategies.
5. Tallies and Documentation Check
Review the vaccinator’s paperwork and compare with field reality:
Tally Sheet Accuracy – Cross-check if numbers match with vaccinated children.
Daily Record Updates – Ensure tally sheet is filled in real-time.
Consistency – Verify that tally sheets, house markings, and finger markings are consistent.
6. Summary of Findings
At the end of the form, supervisors must provide a summary:
Strengths – Note good practices observed (e.g., punctuality, good community behavior).
Weaknesses / Gaps – Highlight major issues (e.g., missed children, poor marking, inaccurate tallies).
Immediate Action Taken – Mention corrective measures (e.g., re-vaccination of missed children, retraining).
7. Signatures and Verification
The final step is to sign and authenticate the form:
Supervisor’s Signature – Required for validity.
Team Leader Signature (if applicable) – To acknowledge monitoring.
Date & Time – Record when supervision was completed.
8. Best Practices While Filling the Form
Always use clear handwriting (preferably block letters).
Fill the form on the spot, not later from memory.
Be honest and accurate—avoid filling just for formality.
Carry extra forms in case one gets damaged.
Submit forms to higher authorities daily.
click here to download Supervisor Monitoring Form
Complete Guide on Filling Polio Campaign Fixed Site Monitoring Form
To Download Form Click here
Polio campaigns often set up fixed vaccination sites (hospitals, health centers, schools, bus stands, etc.) in addition to house-to-house teams. To ensure quality service and proper coverage, supervisors must monitor these sites using the Fixed Site Monitoring Form (FSMF). This guide explains how to fill the form accurately and effectively.
1. Introduction to Fixed Site Monitoring Form
The Fixed Site Monitoring Form is used by supervisors to:
Assess the performance of vaccinators at fixed sites.
Verify vaccine handling, recording, and child coverage.
Ensure proper interaction with the community.
Identify problems and report for corrective action.
2. General Information Section
At the top of the form, fill in basic details:
Date of Visit – Exact day of supervision.
District / Tehsil / UC – Name of administrative area.
Name of Fixed Site – e.g., Basic Health Unit, Rural Health Centre, Bus Terminal, School, or Market.
Name of Supervisor – Your full name and designation.
Fixed Site Team Name / Code – If available, note the team code or staff names.
3. Vaccination Site Setup Verification
Supervisors should first check whether the site is properly set up:
Visibility – Is the site visible and identifiable for the community? (Banner, flag, or poster).
Accessibility – Is the location easy to access for families with children?
Vaccinator Presence – Are all team members present and active at the site?
Working Hours – Is the site open during campaign hours?
4. Vaccine and Logistics Check
Supervisors must confirm proper handling of vaccines and supplies:
Vaccine Carrier – Is the carrier present and in good condition?
Ice Packs – Are ice packs properly conditioned and keeping vaccine cold?
Vial Status – Are OPV vials properly opened/handled (VVM checked, no expired vials)?
Finger Markers & Chalk – Available and being used correctly?
Tally Sheets & Forms – Vaccinators have and are using correct documentation.
5. Vaccination Technique
Observe and document:
Child Handling – Are vaccinators gentle and safe in administering drops?
Correct Dosing – 2 drops of OPV given properly in the mouth.
Finger Marking – Left little finger marked after vaccination.
Recording – Each vaccinated child immediately recorded on tally sheet.
6. Site Functionality and Community Engagement
Check how well the fixed site is operating:
Crowd Management – Is there an organized way to manage families?
Awareness – Are families aware of the fixed site in advance?
Refusals – Are refusals recorded and addressed (counseling done)?
Newborns & Travelers – Are newborns, sick children, and travelers being vaccinated?
7. Child Verification
Supervisors should randomly check children at/around the site:
Number of Children Checked – Record how many under-5 children were verified.
Finger Marking Seen – How many had correct finger marking.
Missed Children – Note children who were not vaccinated at the site and why (refusal, absent, sick, or newborn not yet reached).
8. Documentation and Tally Sheet Review
Ensure proper paperwork:
Tally Sheet Completion – Numbers recorded clearly and updated in real-time.
Consistency – Cross-check vaccinated children with finger markings.
Refusal Tracking – Are refusals noted on tally sheets for follow-up?
9. Summary of Findings
At the bottom of the form, supervisors must provide a summary:
Strengths – e.g., punctual team, good crowd management, proper vaccine storage.
Weaknesses – e.g., no banner, poor tally sheet updates, improper marking.
Immediate Action Taken – e.g., re-training vaccinator on technique, calling for new ice packs, reporting a refusal.
10. Signatures and Verification
Finalize the form with:
Supervisor’s Signature & Date – To authenticate monitoring.
Fixed Site Team Leader Signature (if applicable) – For acknowledgment.
Time of Visit – Record when monitoring was conducted.
11. Best Practices for Supervisors
Always carry extra blank forms.
Write in clear, legible handwriting (preferably block letters).
Fill the form on site while observing, not afterwards.
Be objective – report strengths and weaknesses honestly.
Submit completed forms daily to the UC/Tehsil Coordinator.
✅ Filling the Fixed Site Monitoring Form correctly ensures transparency, strengthens accountability, and helps improve vaccination quality—moving one step closer to a Polio-Free World.
To Download Fixed Site Monitoring Form Click here
