An Update

India’s Immunization
Programme

Immunization Division, MOHFW, Govt. of India

Overview of Universal
Immunization Programme
(UIP)
 One of the largest, ongoing public
health interventions in the country
 Centrally sponsored programme
under National Rural health Mission
- NRHM (2005-12)
 Programme targeted ~ 26 million
infants and 30 million pregnant
women in 2009-10
 All the vaccines are procured by
central government with 100%
domestic funding
Immunization Division, MOHFW, Govt. of India
 Full Immunization Coverage
(DLHS-3)
Coverage States/UT

Low Uttar Pradesh , Meghalaya , Madhya Pradesh ,

(<50%) Tripura , Arunachal Pradesh , Bihar , Manipur and
Rajasthan

Medium Mizoram , Assam , Jharkhand , Gujarat ,

(50-70%) Chhattisgarh , Haryana , Orissa , Jammu &
Kashmir , Uttarakhand , Andhra Pradesh , Delhi ,
D & NH and Maharashtra

High Chandigarh, West Bengal, Karnataka, Sikkim, Kerala,

(>70%) Punjab, Pondicherry, Himachal Pradesh, Tamil Nadu,
Lakshadweep, A & N Islands, Daman & Diu and Goa

Immunization Division, MOHFW, Govt. of India

Measles Second
Opportunity
 Applying the 80% MCV1 coverage cut-off and
applying DLHS-3 survey data there are
▪ 14 states qualify for catch-up campaign in 9
mo-10 yrs age group
▪ 21 states qualify for MCV2 through routine
immunization
 4 states viz. Delhi, Goa, Poducherry & Sikkim already
introduced 2nd dose
 Operational guidelines for Measles catch-up
campaign developed
 State planning for second opportunity of Measles
started
Immunization Division, MOHFW, Govt. of India
Measles Coverage
(DLHS-3)
India : 69.6%
2nd Dose of RI

Immunization Division, MOHFW, Govt. of India

 Polio cases, India
Most recent virus
28 May 2010
Birbhum, WB

WPVs
State P1 P3 Total
Jamm u & Kashmir 1 0 1
Maharashtra 1 0 1
West Bengal 3 0 3
Uttar Pradesh 0 10 10
Bihar 0 6 6
Haryana 0 1 1
Total 5 17 22

* data as on 25 June 2010

Why is Polio Transmission
Persisting?
 Remaining gaps in SIA quality in
high-risk areas
 High-risk populations missed during
SIAs, especially migrant
populations
 Low routine OPV3 immunization
coverage
 Poor sanitation and Hygiene
 Convergence of these risk factors in
high-risk blocks
Cold Chain:
Status of Preparedness of WIC/WIF sites for
installation
State WIC WIF Status as per record
Chhattisgarh 2 1 Site Not Identified;
1 WIC lying for 3 yrs
H.P 1 1 Site NOT Identified
Manipur 1 - Site NOT Identified
West Bengal 4 1 Sites Identified, Civil work NOT
started

•All the states were informed of these installation in Nov’09

•Other states need to expedite the civil work so that WIC/WIF
installation can be completed by end of July’10
Cold Chain: Key issues
 High sickness rate, response time and break
down period of cold chain equipments.
 Temperature monitoring of vaccines requires
strengthening
Ø Cold chain management is poor in some places
(including private practices), particularly for
temperature recording and risk of freezing the
freeze-sensitive vaccines.
 There is need to assess adequacy of trained
manpower with essential qualifications at
every level.
 Disposal of condemn equipments – occupying
un-necessary space. Needs to be dispose off
 Immunization training of
Health workers
< 30%
State / UT s Annual Trained in 30% - 50 %
Target 2009 - 10
Andhra Pr 6728 19413 JAMMU & KAS HMIR 50 % - 80 %
Arunachal Pr 319 0 > 80 %
HIMACHAL PRADESH
Assam 1567 0 PUNJAB Completed
UTTARANCHAL
Bihar 5558 0 HARYANA
ARUNACHAL PR.
Chattisgarh 2266 5638 SIKKIM
RAJ ASTHAN UTTAR PRADE SH ASSAM NAG ALAND
Haryana 1211 0 BIHAR MEG HALAYA
MANIPUR

J & K 574 483 GUJARAT MADHYA PRADESH

JHARKHAND
WEST BENGAL
TRIPURA
MIZORAM

Kerala 3297 2687 CHHATTISGARH

ORIS SA
Madhya Pr 7077 5937 D&N HAVELI
MAHARASHTRA

Maharashtra 13057 8131

Orissa 4587 2408 ANDHRA PRADESH

GOA

Punjab 933 150 KARNATAKA

Rajasthan 4758 0 PONDICHERRY

A&N ISLANDS

Sikkim 200 0 TAMIL NADU

LAK SHADW EEPKERALA

Uttar Pradesh 6700 0

West Bengal 7855 13795
Total 69397 41763
 Rest of the states have completed the training or achieved 90%
of Total training load (As on 1 June 10)
 HW Trainings startedDivision,
Immunization in 2007-08;
MOHFW,~175,000 out of 220,000
Govt. of India
Immunization Training of
Medical Officers
Not Started
 TOTs conducted < 30%
30 % - 50%
for 1500 trainers JAMMU & KAS HMIR 50 % -80%

from all states

> 80%
HIMACHAL PRADESH
PUNJAB

during 2009-10.
UTTARANCHAL
HARYANA
ARUNACHAL PR.

 MO-Training
SIKKIM
RAJ ASTHAN UTTAR PRADE SH ASSAM NAG ALAND
BIHAR MEG HALAYA
MANIPUR

started and GUJARAT MADHYA PRADESH

JHARKHAND
WEST BENGAL
TRIPURA
MIZORAM

~11500 out of
CHHATTISGARH
ORIS SA
D&N HAVELI
MAHARASHTRA

62000 (18%) ANDHRA PRADESH

MOs trained so
GOA
KARNATAKA

far.
A&N ISLANDS
PONDICHERRY
TAMIL NADU
LAK SHADW EEPKERALA

 Slow / No progress
in 22 states. As on 1 June10

 Monitoring needs
Immunization Division, MOHFW, Govt. of India
New Vaccine
Introduction
 Hepatitis B Hepatitis B States

Ø Already in 10 states and Hepatitis B Pilot Districts

selected cities and districts Hepatitis B Pilot Cities

of the country
Ø Expansion of Hepatitis B
vaccine in the remaining
states of country in phased
manner is under
consideration
Ø Service delivery issues -Birth
dose of Hep B not being
given within 24 hours
ØReluctance to use due
to concerns about
AEFI and vaccine
wastage (Punjab &
Tamil Nadu)
Immunization Division, MOHFW, Govt. of India
Reported Coverage 2009-
10-Issues

Immunization Division, MOHFW, Govt. of India

Reported Coverage 2009-
10-Issues

Immunization Division, MOHFW, Govt. of India

Name Based Tracking
of Pregnant Mothers &
Children – ANCs &
Immunisation

Ministry of Health &

Family Welfare
Objective
• Name-based tracking of
– pregnant women - for ANCs, Delivery &
PNCs
– children - for immunisation
–
• To facilitate
– Closer monitoring of regular check-ups of
pregnant women and reduce avoidable
complications
– Complete immunisation of children
–
• For closer monitoring of mortality
indicators (IMR and MMR)
Coverage
• Pregnant Women
– All pregnant women since 1st April, 2009
– In the first instance from 1st
December, 2009
– Emphasis on ALL pregnancies
• Irrespective of whether ANCs are done by
public or private health provider
–
• Children
– All Births since 1st April, 2009
– In the first instance from 1st
December, 2009
– Emphasis on all births – public or private
Data to be captured

• Pregnant Women • INFANTS

 Location Details
Ø State, District, Block,
Address
 Identification details
Ø Name, DOB, Phone No,
JSY, caste
 Health Provider details
Ø HSC, ANM, ASHA, Linked
facility for delivery
 ANC details
Ø LMP, ANC dates, TT, IFA,
Anemia, complications
 Pregnancy Outcome
Ø Place, delivery date, JSY
benefits
 PNC Details - dates
 Infant details
•
 Location Details
Ø State, District, Block,
Address
 Identification details
Ø Name, DOB, Phone
No, JSY, caste
 Health Provider
details
Ø HSC, ANM, ASHA
 Immunization details
Ø Dates for BCG, OPV,
DPT, Hepatitis,
Measles, Vit A
 16 digit Identity Code
1 2 3 4 5 6 7 8 9
10 11 12 13 14 15 16
2 3 2 2 1 1 3 1 6 1 1 0 0 0 0 1
Digits (Nos) Item Description /Remarks
01-02 (2) State Code As per Census codes
03-04 (2) District Code As per Census codes
05-07 (3) Block PHC/CHC Code As per Census codes given to Block HQ

08-09 (2) Health Sub-Centre Code To be serially given by Block HQ.

10-10 (1) Pregnant Woman – Code 1;

Child – Code 2
11-12 (2) Year Code Last 2 digits for the year is to be given, for
example, for the year 2009, “09” will be
entered and so on
13-16 (4) To be given serially to each From 1st April each year, the codes will be
mother / child from 1st December, given afresh starting from 0001.
2009 starting from 5000
 Progress made so far…
Based on recent observations during field tours
Ø
States Status
Ø
Chhattisgarh •Mother & Child tracking registers printed;
•Data entry in registers started,
Ø •Computerization to be done

Orissa •Standardized Formats for data collection

•Data entry at blocks in standardized excel sheets developed by

state

West Bengal •Standardized formats for data collection

•Data entry started at block levels in excel sheets designed at

blocks; lack of uniformity

Uttarakhand •Standardized formats for data collection

•Data entry started at block levels in excel sheets designed at

blocks
Issues in the field
 Specialsoftware required for this
process
Ø To generate beneficiary list
Ø To maintain uniformity
Ø To avoid duplication of beneficiaries
Ø To access data for
supervision/monitoring
Ø To calculate coverage
 Data entry at block level being done
by Block Accounts Assistant; no
data entry operator
Ø Huge volume of data coming monthly
Name Based Information
Tracking System -NHSRC
 Name Based Information Tracking
System (NBITS) being developed
by NHSRC and piloted in MP
 This would address some of the
issues raised
•

Ø
Ø
Ø
Ø
Ø
Thank you

Immunization Division, MOHFW, Govt. of India