How India is aiming for full immunisation

Bhupendra Tripathi
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With an annual birth cohort of 27 million, India has the largest commitment to keep in its national routine immunization program. Based on the latest national coverage evaluations, fully immunization coverage is around 65%. The critical reasons for low coverage are awareness gaps, as well as operational issues that are most prevalent in the large states of Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan. Of 270 lakh (27 million) children born annually, who must be reached under the current Universal Immunization Program, 72 lakh (7.2 million) are partially vaccinated for seven life-threatening diseases and 17 lakh (1.7 million) are totally unreached. In all, 89 lakh (8.9 million) newborns get either partial or no vaccination.

On the other hand, supported by a rapidly growing supply of indigenous vaccines, India has adopted a policy to introduce three new vaccines Inactivated Polio Vaccine (IPV), Measles-Rubella (MR) and a vaccine against rotavirus in the current routine immunization program. Pentavalent vaccine introduction is already in progress and scheduled to be completed in all the states by the end of this year. To ensure the full impact of both current and new vaccines, there has to be very high full immunization coverage in the country.

Against the backdrop of a successful polio eradication program, India rightly believes in the age old saying that “where there is a will, there is a way”, when it comes toreaching new heights in the field of immunization. The national government has targeted to achieve more that 90% full immunization coverage by year 2020 through a renewed push by Mission Indradhanush (Indradhanush meaning rainbow)). The seven colors of the rainbow symbolize the seven vaccine antigens being provided by the government free of cost to all the beneficiaries in the country. In the initial phase, intensive campaigns will be organized for four consecutive months in 201 high-focus districts with suboptimal coverage, with a goal to reach every last child. The plan is to revitalize the government’s communication strategy and focus on all the available channels for an effective dissemination of immunization related messages. New posters have been designed and multiple media materials have been developed for this mission.

There is a strong thrust from the highest political level for Mission Indradhanush. The Prime Minister of India, Shri Narendra Modi has provided his support and commitment for the program. During the launch of the initiative’s national media workshop, Union Health Minister, Shri JP Nadda, urged all members of parliament and the members of state legislatures to take ownership in their respective areas and strengthen the program. “Around 40 per cent of the cause for partial or no immunization can be attributed to lack of parental awareness about vaccinations and around 32 per cent to myths about side effects of vaccines. The creation of awareness among parents is clearly the biggest challenge for immunization program,” Shri Nadda said. Similarly, bureaucrats and technocrats have also communicated the message to their counterparts. A special letter has been drafted for each and every health worker (ANM & ASHA) who will be engaged in this endeavor.

The first month for this Mission Indradhanush will be from 7-14th April, 2015, followed by the same dates for subsequent three months. The state workshops and district workshops have also been completed and now the block level planning is in progress. The program is planned for the next 5 years.

Key partners supporting the program are WHO, UNICEF, UNDP, Immunization Technical Support Unit (ITSU), Rotary, CORE-Polio, Global Health Strategies, USAID, Bill & Melinda Gates Foundation, State Governments and various local non-governmental organizations. GAVI has already provided Health System Strengthening grant for improving the immunization program in the country. There will be a strong monitoring component for this duration with a fast communication channel between the field level observations and the highest level action taken for improvements.

With a joint collaboration between the government and partner agencies, India hopes to reach the target of more than 90% full immunization coverage by the end of this ‘Decade of Vaccines’.

This article is published in collaboration with the Bill & Melinda Gates Foundation. Publication does not imply endorsement of views by the World Economic Forum.

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Author: Dr. Bhupendra Tripathi is a public health professional with over 14 years of experience.

Image: A health worker displays bottles of vaccine ‘Pneumovax’ during a vaccination programme organised by non-government organisation ‘Sngobadho’. REUTERS/Rupak De Chowdhuri. 

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