Since the launch of Expanded Programme of Immunization (EPI) in 1978, India is consistently trying to attain and sustain high vaccination coverage both qualitatively and quantitatively through UIP, CSSM, RCH I & II, NHM actively involving multiple development partners and stake holders.
CES 2009 revealed that, in India 2 of every 5th child are either unimmunized or partially immunized. It was 1 in every 5th child in Karnataka. [National coverage was 61% and that of Karnataka was 78%]. DLHS3 of 2007-08 revealed coverage of 71.5% & 84.8% of DPT3, in India & Karnataka respectively.
200 districts in 14 states were below the National average of 71.5% of DPT3 coverage. For rapidly achieving >90% Fully Immunized Children (FIC), GOI declared 2012-13 as year of Intensified Routine Immunization (IRI) through 4 intensified Immunization Weeks (IWs) as the key strategy.
Rapid Survey of Children (RSOC) 2013-14 revealed 65% FIC, 1 of every 3rd child either unimmunized or partially immunized. For closing this gap GOI launched an ambitious special drive – “Mission Indradhanush (MI)” on 25th Dec 2014 setting the target of achieving >90% FIC by 2020 @ 5% increase yearly.
Operating the key strategy of 4 intensified Immunization Weeks (IWs) successively at monthly interval is common to both IRI and MI.
Paradoxically, In Karnataka, with promotive efforts, MI in operation, NFHS4 (2015-16) revealed a drastic decline in FIC to 62.6% from 78% of CES 2009 & 79.4% of RSOC 2013-14. DPT3 coverage also showed significant decline to 72.7% from 88.2% of CES 2009 & 89.2% of RSOC 2013-14.
It is learnt that in the recent regular monthly review meeting, state superiors expressed their uncertainty and loss of confidence with regard to the Operationalization and effectiveness of the special drive. They have evidences of rapid rise and sustenance of high vaccination coverage (>95%) using the simplest tool and supportive supervision approach of learning by doing and working together in Karnataka since Jan 2013. International independent observer also observed the same in Chikkaballapur district and admired as to why it was discontinued!! Expanding / replicating the same to 8 RMNCH+A districts with effect from Jan 2014 somehow did not materialize, otherwise these 8 low performing districts would have attained and sustained >90% coverage like Chikkaballapur.
And now, the superiors asked the district managers in the review meeting to replicate Chikkaballapur model to support “INTENSIFIED MISSION INDRADHANUSH (IMI)” as they are very skeptical about the outcome of IMI.
Medical Colleges are the authorized stake holders to strengthen the Government in the effective implementation of all National Health Programmes including immunization. They proactively came forward to support the programme managers. In the recent state level Continued Medical Education (C.M.E) programme, supporting the IMI through the proven tool and approach was a topic for sharing and capacity building – especially the post graduates of Community Medicine who will be the future technical consultants / assistants. Through local innovations we wish to attain and sustain the achievements – the 6th and the 5th strategies of Global Vaccination Action Plan (GVAP).
We have attached the highlights of C.M.E for sharing with the viewers.
Holla and the team