Mission Indradhanush: A mission by the GOI.pptx

Mission Indradhanush

1. Presented by: Dr. Aneesh K Mathew Mentor: Dr. Shubham Arora Mission Indradhanush

2. Background India’s immunization programme, launched in 1985, is one of the largest health programmes of its kind in the world, catering to a birth cohort of 2.7 crore (27 million) children annually. The programme provides vaccination against eight life‐threatening diseases (diphtheria, whooping cough, Haemophilus influenzae type B (Hib) causing pneumonia and meningitis, tetanus, polio, tuberculosis, measles and hepatitis B) in the entire country. In spite of all positive changes, there are ongoing challenges and shortcomings in the national immunization programme. Despite being operational for the past more than 30 years, only 65% of children in India receive all vaccines duringtheir first year of life, thus contributing to continued high burden of morbidity and mortality in children from vaccine preventable diseases (VPDs).

3. Based on full immunization estimated from routine immunization monitoring and Mission Indradhanush data, it is estimated that annually, more than 70 lakh (7 million) children in the country do not receive all vaccines that are available under the UIP. The Ministry of Health and Family Welfare, Government of India (MoHFW‐GoI) is committed to rapidly address the inequity in immunization coverage and consolidate the health systems strengthening efforts. To strengthen routine immunization planning and delivery mechanism, the MoHFW, GoI, launched its flagship programme “Mission Indradhanush” in December 2014 to achieve more than 90% full immunization coverage in the country.

4. Mission Indradhanush Mission Indradhanush launched by MoHFW, GoI in December 2014. Objective: Increase child immunization coverage from 65% (2014) to at least 90% by 2020. Special catch-up drives implemented to reach unvaccinated and partially vaccinated children. Identified 216 high-focus districts, with Uttar Pradesh and Bihar contributing 38% and 10% of total missed children. Maharashtra, Rajasthan, Gujarat, Madhya Pradesh, and Assam, with 61 high-focus districts, account for 30% of total missed children.

5. Vaccines Given

6. Strategy A total of four rounds will be conducted under each phase of Mission Indradhanush. Upon completion of each phase, districts must ensure that these sessions are included in regular routine immunization plans. Mission Indradhanush is a special immunization drive spread over 7 days. These 7 days do not include the routine immunization days planned in that week. Such routine immunization sessions should be held as already planned. Targeted beneficiaries will be pregnant women and children up to 2 years of age; however, children up to 5 years need to be focussed upon to improve booster dose coverage and if required school campaigns may be conducted.

7. The priority for conducting Mission Indradhanush sessions should be areas with weak routine immunization coverage in the district. This will require deployment of ANM to areas outside of her own sub‐centre and block. All ANMs should be engaged for 7 working days over and above the regular routine immunization days excluding Sundays and holidays for conducting session during Mission Indradhanush. Sub centres having delivery facilities need to plan ANM deployment accordingly. Head count survey is a mandatory activity to be conducted through house to house visits before the first round of Mission Indradhanush. The head count survey will be utilized for preparation of name‐based due lists for tracking and mobilization of beneficiaries.

8. Steps Microplanning Microplanning at the district and block level was essential for stopping polio transmission in India, with vaccinators tracking activities and district task forces identifying unvaccinated children. High-risk areas posed challenges for immunization due to factors like geography, poverty, migration, education, language diversity, cultural differences, and government distrust. Mission Indradhanush targeted communities with limited access to Routine Immunization (RI) services, focusing on increasing coverage and equitable access to immunization. The initiative aimed to integrate additional immunization sites into the government’s RI microplans, enhancing the reach of routine immunization services. Support from the WHO & UNICEF polio network was instrumental in ensuring the inclusion of these additional sites into the RI microplans for comprehensive service delivery.

9. Steps Head count survey and due list preparation Head count process to develop session specific due‐list based on head count should be initiated well in advance, and pre‐round validation of head survey should be done for improving coverage. There is a need of regular orientation and supervision of frontline workers for doing head count survey, due list updation and mobilization of children.

10. Steps Capacity building of frontline workers Frontline workers were trained prior to Mission Indradhanush with brief orientation during subsequent campaign. These trainings will improve technical and communication skills of frontline workers. Reorientation of frontline workers on IPC skills should also be conducted on a regular basis.

11. Supervision Of Activities Steps Strengthening Supervision: The STFI and DTFI are crucial, and there’s a need for robust supervision at all levels, with national and state officials overseeing Mission Indradhanush rounds to ensure improved quality of work. Leadership and Ownership: Active review by high-level officials like MD-NHM, Secretary, or PS is vital for strong ownership and effective implementation of Mission Indradhanush at the state, district, and block levels. Effective Communication: Utilizing technology such as video conferencing and mobile SMS for feedback has proven to be an effective method of communication and monitoring within the program

12. Vaccine and Cold Chain Management Steps Urgent attention is needed to improve vaccine upkeep to ensure conditioning of ice packs, maintenance of distribution register, implementation of open vials policy and its records, and adherence to AVD plan. Focus on cold chain management training.

13. Social Mobilization Steps Social Mobilization & Information, Education and Communication Materials: Initial phases faced challenges with social mobilization due to unprepared IEC materials, but national oversight led to improvements. Community Awareness: Information, Education and Communication activities are vital for community awareness on immunization; thus, involvement from PRI members, ration dealers, and local influencers is essential. Standardization and Engagement: There’s a need for standardizing information, education and communication materials and enhancing community engagement through mothers’ meetings, Nukkad Natak, and community videos.

14. Timing Steps Special catch up rounds should be planned in a way to ensure better coverage of migratory populations and HRG sites. In Mission Indradhanush, day should be fixed and not the date. We should plan from a day in the week rather than date in the month.

15. Financial Issues Steps Communication of financial guidelines for IEC activities should be shared well in advance. The financial guidelines have to be released well on time for replication. Ensure timely payments of incentives to motivate ASHAs/mobilizers.

16. Data Mnagement Steps Newly designed tally sheet will help in reporting as well as tracking beneficiaries during all rounds. Ensure completeness and quality of data transmission an issue.

17. Intensified Mission Indradhanush 5.0 Special focus on improvement of Measles and Rubella vaccination coverage, will conclude all three rounds on 14 October 2023. IMI 5.0 is being conducted across all the districts in the country and includes children up to 5 years of age. Over 34 lakh children and 6 lakh pregnant women were administered vaccine doses during the first 2 rounds of IMI 5.0 campaign across the country.

18. IMI 5.0 campaign aims to enhance immunization coverage for all vaccines provided under the Universal Immunization Programme (UIP) as per the National Immunization Schedule (NIS). Special focus is on improvement of Measles and Rubella vaccination coverage with the aim of Measles & Rubella elimination by 2023 and use of U-WIN digital platform for Routine Immunization in pilot mode across all districts in the country. IMI 5.0 was conducted in three rounds i.e., 7 -12 August, 11-16 September, and 9-14 October 2023 i.e., 6 days in a month with the inclusion of a Routine Immunization Day. All States/UTs except Bihar, Chhattisgarh, Odisha and Punjab would conclude all the three rounds of IMI 5.0 campaign by 14th October 2023.

19. Thank You