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Resource centre on India's rural distress
 
 

India's mission to fight child mortality -Prof. Ramanan Laxminarayan and Dr Vinod Paul
-IBNLive.com

Earlier in the month of April 2015, our country accomplished a formidable feat. In the first round of Mission Indradhanush, an initiative launched by the Ministry of Health & Family Welfare, more than 50 lakh doses of vaccines were administered, free of cost, to nearly 20 lakh children and 6 lakh pregnant women.

To put numbers into perspective, in a span of 7 days, more children were vaccinated in our country than our born annually in the United States of America

How did we achieve this feat? By mobilizing and training an unprecedented number of health officials and frontline workers, by strategic and meticulous planning of immunization sessions and by intensifying communication campaigns for generating demand for vaccination within the community.

Vaccines are one of the most effective tools against childhood illnesses and by preventing infections, they help prevent millions of deaths, disabilities and illness in children every year. In the past two decades, vaccines have helped eradicate small-pox, eliminate polio and reduce the number of deaths caused by diseases such as measles, diphtheria and tetanus by over 85% in our country.

Yet, there remains an immunization coverage gap, and approximately one in every three children in our country remain partially immunized or unimmunized. There is evidence to suggest that partially immunized and unimmunized children not only suffer from a far greater number of preventable infections, but are also three to six times more likely to die, when compared to fully immunized children.

Mission Indradhanush aims to close this immunization gap, by conducting week long special immunization drives between April to July, in 201 high focus districts where nearly half of the country's partially immunized and unimmunized children reside. The mission also aims to strengthen immunization systems for improved vaccine delivery and generate more demand in the community.

Mission Indradhanush is an ambitious initiative and the success of its first round, held between April 7th- 14th, is largely attributable to high levels of commitment demonstrated by frontline workers and health officials at all levels.

The ANMs, the women health workforce that administer the vaccines to the children, were mobilized from one village to another, in high risk areas where the chance of disease outbreaks are high , hard to reach areas and areas with high numbers of unimmunized and partially immunized children.

Perhaps herein lies the greatest success of the mission as well. In addition to preventing millions of child deaths, disabilities and illnesses, it has, for the first time directed national discourse and brought recognition to the country's Universal Immunization Programme (UIP). In doing so, the mission has created awareness amongst and invigorated the millions of health-workers that tirelessly deliver vaccines and services every week to the country's 2.7 crore children. By bringing the focus on communication outreach and advocacy, the mission works to revitalize the country's Universal Immunization Programme.

A unique feature of the initiative was the rigorous monitoring mechanism set-up for providing real-time feedback. To achieve this, over a 1000 monitors were deployed across the length and breadth of the country to observe these special immunization drives. Feedback from the nearly 7000 immunization sessions monitored not only provided vital information on the impact of the mission but also highlighted critical gaps that plague the immunization programme and must be addressed in subsequent rounds of the campaign.

Key amongst these is the need to build capacity and train frontline health workers around safe and effective immunization practices. The need for beneficiary mobilization was also highlighted as an area requiring special attention. At the block level, issues in development of micro-plans for vaccination and transmission of communication materials underlined the need for greater ownership of the campaign from the district and state health officials.

Despite tremendous challenges, our country vaccinated around 20 lakh children against 7 life-threatening diseases in record time this month. That means lesser deaths, lesser diseases, fewer infections and also better health and greater productivity for these 20 lakh children. Due to herd immunity, it also means greater protection from these diseases within the community.

The momentum gained during this first round of the campaign, must be sustained in the three subsequent rounds of Mission Indradhanush, planned between May to June, 2015. In fact, the second round of special immunization drives have begun on May 7th.

If successful, the Mission will provide a unique opportunity to shoot multiple targets with a single arrow: achieving a full immunization coverage of over 90% in the next five years, and revitalizing the country's Universal Immunization Programme through strengthening the health system at all levels. If successful, the mission will pave the way for a healthier nation for decades to come.