PPt_for_National_ToT_IMI_4.0.pptx

Intensified Mission Indradhanush

1. IMI- 4.0 1 Intensified Mission Indradhanush (IMI 4.0)

2. Immunization Coverage (FIC – NFHS 3, NFHS 4 & NFHS 5) ≥ 80% 70% to 80% 60% to 70% 50% to 60% < 50% India: 43.5% ranging from 21% to 81%, NFHS-3, 2005-06 India: 62% ranging from 36% to 91%, NFHS-4, 2015-16 India: 76.4% ranging from 58% to 95%, NFHS-5, 2019-21 Six States/UTs shows decrease in FIC (%) in NFHS-5 compared to NFHS-4 Punjab (12.9%), Puducherry (9.4%), Goa (6.5%), Kerala (4.3%), Lakshadweep (2.9%) Sikkim (2.4%). NA

3. Address the Partially vaccinated & Unvaccinated

4. Data source: NFHS-5 Address the Partially vaccinated & Unvaccinated

5. Migrant Populations Rapid Urbanization Programmatic Challenges Accessibility Acceptance Slow Progress Equity Issues

6. Programmatic Challenges- COVID-19 Due to COVID-19 containment many outreach sessions not being held, resulting in a fall in immunization coverages. Since Anganwadi centres & schools are closed RI sessions are being organized at alternate session sites affecting the uptake of services. Overlap of work due to engagement of ANM and frontline workers in COVID containment and COVID vaccination Large scale movement of migrant population Hesitancy among caregivers to take their children to healthcare facilities due to fear of exposure to COVID-19.

7. Drop in Immunization Coverage Globally 2.3 crore children <1 year old left unvaccinated even with basic vaccines India ranks first with most un/partially vaccinated children IMI- 4.0 7

8. Immunization strengthening during COVID-19 pandemic Health Services including Immunization deemed as essential services – MHA order issued Guidelines for delivering Immunization services during COVID-19 outbreak disseminated by MoHFW Routine Immunization Polio SIAs Surveillance for Vaccine Preventable Diseases Reviews held with States/ UTs to discuss challenges being faced during the pandemic and the necessary measures taken to ensure immunization services

9. 2019-20 2020-21 2021-22 *Data Source: HMIS Impact of COVID-19 on Immunization Coverage, India- No. of sessions

10. Full Immunization Coverage 2019-20 2020-21 2021-22 Impact of COVID-19 on Immunization Coverage, India- FIC(%) Percent *Data Source: HMIS

11. IMI- 4.0 11 Rural & Urban Variation

12. Districts Selected for IMI- 4.0 IMI- 4.0 12 No. Of Districts State/s 1 A&N Islands , Chhattisgarh, Daman & Diu, J&K, Mizoram 2 Haryana, Meghalaya, Pondicherry, Sikkim, Tripura, Goa 3 Uttarakhand 4 Punjab 5 Jharkhand , Madhya Pradesh, 7 Delhi 8 West Bengal 9 Karnataka, Kerala 10 Maharashtra, Odisha 12 Nagaland, Tamil Nadu 13 Andhra Pradesh 14 Arunachal Pradesh 15 Manipur 19 Rajasthan 27 Assam 29 Telangana 33 Gujarat 38 Bihar 75 Uttar Pradesh IMI 4.0 districts – 374 of 736

13. Timeline – 3 Phases in 3 Months In view of the involvement in Covid vaccination and Covid surge the earlier guidance is relaxed Unlike in the past, each round will be conducted for seven days , including RI days, Sundays, and public holidays Timings : Flexible timing; as agreed with community IMI- 4.0 13 Round Date (2022) 1 7 th February onwards 2 7 th March onwards 3 4 th April onwards

14. Target Population The target beneficiaries include, Un/Partially vaccinated children less than 2 years (0 to 23 Months) Unvaccinated or partially vaccinated pregnant women Pregnant women target includes all those who are currently pregnant on the day of headcount survey and due for vaccination either with primary or booster dose for Td. The target children include all those born in or after February 2020 and due for one or more vaccines IMI- 4.0 14

15. Focus area IMI- 4.0 15 Areas with disrupted RI services due to COVID-19 pandemic High-risk areas : Migratory population, Nomadic sites, Brick Kilns Construction Sites Others New-born who was delivered at home. Villages/areas with Vacant sub centers, two or more consecutive missed routine immunization sessions. Hard to reach and areas with vaccine hesitancy Urban areas specially slums, Areas with outbreak of Measles, and other VPDs, Areas like orphanage, prisons, red-light areas, riverine areas, migration for agriculture etc. Tribal areas Other difficult areas: Areas hit by natural calamities (e.g., flood). The areas under social/political/or other conflicts need additional administrative support.

16. IMI session planning Outreach and mobile sessions Criteria for selection of session site: C loser to the community Easily accessible and information reachable to community in advance Acceptable by the community Highly visible to people Suitable for Covid situation IMI- 4.0 16 All efforts need to be made to ensure inclusion of all settlements including urban, periurbal , rural and and temporary population at fringes of the village

17. Microplanning Target of at least 90% FIC Identification of beneficiaries missed during COVID-19 pandemic Key strategies and activities During campaign: Intensive monitoring and supervision Communication Planning Governance and Multi-sectoral collaboration System Strengthening Follow COVID appropriate behaviors at sessions

18. Accountability Framework IMI- 4.0 18

19. State Level State Steering Committee meeting : once for inter-departmental coordination Meeting of State Task Force for Immunization : before and immediately after both rounds State Workshop : Build capacity of key officials from IMI districts, preferably through virtual platforms (One day) Media Sensitization Meeting (Half day) Review of districts for preparedness : Principal Secretary/ MD-NHM to review preparedness of IMI districts before each round (Half day)

20. WOMEN & CHILD DEVELOPMENT EDUCATION Supporting departments HOUSING & URBAN AFFAIRS YOUTH AFFAIRS AND SPORTS INFORMATION & BROADCASTING PANCHAYATI RAJ TRIBAL AFFAIRS

21. District Level Task Force Participants Function Frequency District Task force for Immunization (DTFI) Chairperson : District magistrate / collector Member secretary: District Immunization Officer Responsibility: CS / Chief Medical Officer   Reviews: sensitize the stake holders, plan, review the progress, strengthen interdepartmental coordination, identify the bottle necks, and resolve the issues Review the preparedness, performance in between rounds At least twice before IMI 2022 and once between rounds District Task force for Urban Immunization -DTFU (I) Chairperson : District magistrate / collector Member secretary: District Medical and Health Officer/CMO   Municipal Commissioner, DIO, District coordinator/nodal officer NUHM, Medical superintendent from DH, District Development Officer, District Education Officer, District Project Officer ICDS, District Public Relation Officer, Municipal Health Officer Critically review the Immunization progress, identify gaps, and decide strategic actions to improve RI coverage.   At least twice before IMI 2022 and once between rounds.

22. District Level Group/ Workshop Participants Function Frequency District review committee Headed by CMO/CS Members include nodal officers, district officials of key departments, representatives of district level partners, and CSOs. Review micro plan, Develop communication strategy, Ensures timely reporting formats, Monitor vaccine and logistics supply chain and cold chain management. Availability and distribution of funds and logistics   District workshop   Training of medical officers: Participants: Two per block / urban planning unit (MOIC and one MO) District Program Manager (NHM), district IEC consultant, district ASHA coordinator, district cold chain handler, district data manager, district M&E coordinator (NHM), district accounts manager (NHM) One day Training of Program / Accounts managers Block program and accounts managers DIO, District Program Manager, Master trainer (MO/District training officer), partner agencies One Hour Training of Data Handlers Half a day Training of cold chain handlers Half a day Media sensitization workshop: to sensitize media person, media coverage, demand generation, and to resolve their queries. Half a day

23. Block/ City Level Identification of Supervisors : in blocks/ planning units Meeting of Block/ Urban Task Force for Immunization : one each before, during and immediately after each round Training of health workers : Build capacity of ANMs, LHVs and Health Supervisors (One day for each session) Orientation of Mobilizers : ASHAs and AWWs (Half day for each workshop) Development of microplans including Communication plan Monitoring of Communication activities Daily Evening Review Meeting : During implementation phase

24. Village/ Session Site Level Head Count Survey and preparation of due-lists Appropriate session site/s identification by ANM/ASHA Display of IEC material at strategic sites Meeting with Panchayat representative for involvement and support in social mobilization - utilize meetings for Gram Swaraj Abhiyan Immunization session/s to be conducted on pre-defined dates Mobilization of beneficiaries to session sites by NYK, NSS, NCC, local volunteers and PRIs

25. Microplanning

26. Step-1: Identification of influencers: Identify the influencers in the catchment area. Influencers can be gram Pradhan, community or religious leaders, teachers, NGO members, or ward members, counsellors etc. Step-2 : Identify best venue, time, date/day: To be decided in consensus with the influencer. Step 3: Due listing of beneficiaries: The due list of beneficiaries is to be informed to the leaders of the community (elderly, religious leaders, gram Pradhan etc.). The leaders of the community may be encouraged to certify that all the children and pregnant women due for any vaccination have been captured in the due list. Step-4: Update micro plans to conduct sessions as per community needs Step-5: Engage community leadership for mobilization IMI- 4.0 New Activity Proposed ‘ Vaccination on Demand’ in urban areas

27. Display communication materials on COVID appropriate behaviors Availability of handwashing/ sanitization station for beneficiaries/ caregivers Vaccination team to wear 3 layer surgical mask Screen beneficiaries for flu-like symptoms Avoid crowding, ensure physical distancing of “2 gaz ” Sanitize hands after vaccinating every beneficiary Provide messages to caregivers/ beneficiaries Disinfect seating space and equipment after completion of session Infection Prevention & Control at Session Site

28. THANKS