MISSION INDRADHANUSH.pptx

Data obtained from NFHS 3 and 4

1. MISSION INDRADHANUSH Presented By: Dr.Amrutha K P Junior Resident

2. What is Mission Indradhanush ? Initiative of Ministry of Health and Family Welfare, Government of India Immunization of all children below 2 years of age and pregnant women against vaccine preventable diseases.

3. Why the mission is IN DR A DH A NU SH ? Seven colours of rainbow = Immunity against seven vaccine preventable childhood diseases Diphtheria Tetanus Pertusis ( Wooping cough) Tuberculosis Polio Measles Hepatitis B

4. 5 more diseases

5. Rationale for Mission Indradhanush HISTORY Immunization programme (Expanded programme of Immunization) Universal Immunization programme 1978 1985

6. Evaluation surveys NFHS I NFHS II NFHS III CES (1992-93) (1998-99) (2005-06) (2009) 35.4 % 42% 43.5% 61% HISTORY Full Immunization Coverage - 12-23 months

7. Rationale for Mission Indradhanush UIP, Despite being operational for more than 30 years , only 65.3% of 12-23 months old children are fully immunized. National-level measles coverage in India was 79% More than 70 lakh (7 million) children in the country did not receive all vaccines that are available under the UIP Drop-out rates for DPT 2 to 3 and OPV 2 to 3 were 11.1% and 11.9%, respectively. (Reference: Integrated Child health and Immunization Survey (ICHIS-2016), (Rapid Survey On Children , 2013-14) HISTORY

8. UIP- Programmatic Challenges Accessibility Acceptance Slow Progress Equity Issues Rapid Urbanization Migrant Populations

9. To strengthen and reenergize the programme 25 th December 2014 MISSION INDRADHANUSH Jagat Prakash Nadda To accelerate and increase the Immunization coverage by >5% per year and achieve >90% coverage by 2020 .

10. Aims and Objectives To fully immunize more than 90% of newborns by 2020 through special drives to reach all children who are partially vaccinated or unvaccinated. UIP Provide free vaccines against 12 life threatening diseases  26 million children annually. Also focuses on strengthening health systems for addressing equity issues in access to immunization.

11. Implementation Focused and systematic immunization drive which was through a “catch-up” campaign mode A ll the children who have been left out or missed out Pregnant women are administered the tetanus vaccine ORS packets and zinc tablets are distributed for use in the event of severe diarrhoea or dehydration Vitamin A doses are administered to boost child immunity.

12. Areas Under Focus… Areas with low RI coverage (pockets with Measles/vaccine preventable disease outbreaks). Areas with vacant sub-centers: No ANM posted for more than three months. Areas with missed Routine Immunization sessions :  Eg : ANMs on long leave Small villages and hamlets, clubbed with another village for RI sessions and not having independent RI sessions.

13. Areas Under Focus Areas which are at high risk for polio Urban slums with migration Nomads Brick kilns Construction sites Other migrants (fisherman villages, riverine areas with shifting populations etc.) Underserved and hard to reach populations (forested and tribal populations etc.)

14. Journey of Mission Indradhanush The country was categorized into high, medium and low focus districts A total of 528 districts covered during the various 4 phases of Mission Indradhanush from 2015- 2017 PHASE I PHASE II PHASE III PHASE IV April- July 2015 201 districts October 2015- January 2016 352 districts 73 districts repeated from Phase-1 279 districts April – July 2016 4 intensified immunization rounds 216 districts 199 districts repeated from Phase-1/2 Feb- May 2017 in NE states , 68 districts, 60 districts repeated from Phase-1, 2 & 3 April to July 2017 in 19 other states: 186 districts, 163 districts repeated from phase1/2/3

15. Phase I Phase III

16. Reference: Annual report 2021-22, Table No;4.7, Page No;92, Mission Indradhanush (All Phases) Coverage Report (As on March, 2021 )

17. Strategy for Mission Indradhanush 4 Basic elements, Meticulous planning of campaigns/sessions at all levels Effective communication and social mobilization efforts Intensive training of the health officials and frontline workers Establish accountability framework through task forces

18. Period and programme approach Four phases, each consisting of four monthly rounds, with each round lasting for 1 week  Did not include the routine immunization days planned in that week Improved microplanning, monitoring, social mobilization and strengthened vaccination systems (especially in areas with inadequate staff numbers) This Photo by Unknown Author is licensed under CC BY

19. Mission Indradhanush sessions in district Reach out all identified areas which have no/infrequent routine immunization sessions Deploying of ANMs Coordination between District immunization officer, urban nodal officer with block medical officers Planning process Prepare roster Implementation

20. Head count survey House to house visits Conducted by ASHA/AWW/mobilizer Utilized for preparation of name‐based due lists for tracking and mobilization of beneficiaries Due lists for subsequent Mission Indradhanush rounds were updated Mission Indradhanush sessions in district

21. Components of Mission Indradhanush National Communication plan State communication plan District communication plan Block communication plan Community –level communication plan Role of local influenzer

22. Fixed and outreach sessions Sites for vaccination Availability of human resources Timings: 9:00 am to 4:00 pm. Team: One vaccinator and two mobilizers

23. Mobile sessions Peri‐urban areas Scattered slums Brick kilns Construction sites etc.

24. Communication planning A need‐based communication and social mobilization activities were planned to achieve the following objectives: Demand generation through increased visibility Advocacy through media Professional bodies and political leadership

25. Communication planning Capacity building of immunization workforce on communication Social mobilization through interpersonal communication, school and youth networks and corporates Concurrent monitoring of communication interventions

26. Results Full Immunization coverage of Children aged 12-23months NFHS I NFHS II NFHS III CES NFHS IV (1992-93) (1998-99) (2005-06) (2009) (2015-16) 35.4 % 42% 43.5% 61% 62% MI

27. Results NFHS4 (2015-16) Figure shows the coverage for each of the basic vaccinations among children age 12-23 months

28. Coverage with All Basic vaccinations by State/ UT

29. Data from five states (Bihar, Madhya Pradesh, Rajasthan, Telangana and Uttar Pradesh), included in both rounds of INCHIS, was used to assess the impact of MI. Results

30. As per the National Family Health Survey-4 (NFHS 4) trends increase in full immunization in urban areas has been 6% (57.6 to 63.9) as compared to NFHS-3, whereas the same is 22% (38.6 to 61.3) in rural areas Results

31. Conclusion In spite of repeated phases of Mission Indradhanush Full Immunization coverage in selected districts/ cities showed slow progress Sluggish increase in urban areas as compared to rural areas There was a need of acceleration of full Immunization coverage

32. PRAGATI platform: Need of supplemental aggressive action plan Left outs And Drop outs December 2018

33. References Mission Indradhanush , Operational guidelines 2016; MoHFW Intensified Mission Indradhanush , operational gui delines, MoHFW National Family health survey( NFHS) 3 & 4 Integrated Child Health and Immunization Survey (ICHIS) Report 1 & 2, 2016 Gurnani V, Haldar P, Aggarwal MK, Das MK, Chauhan A, Murray J, Arora NK, Jhalani M, Sudan P. Improving vaccination coverage in India: lessons from Intensified Mission Indradhanush , a cross-sectoral systems strengthening strategy. Bmj . 2018 Dec 7;363. Rapid Survey On Children (RSOC) 2013-14 National Report, UNISEF Annual Report 2021-22, Department of health and family welfare, MoHFW ,G OI Website : mohfw.nic.in Website: https://nhm.gov.in