About Mission Indradhanush
The Ministry of Health and Family Welfare,Government of India has launched Mission Indradhanush on 25 December, 2014 as a special nationwide initiative to vaccinate all unvaccinated and partially vaccinated children under the Universal Immunization Programme by 2020.
The Mission focuses on interventions to expand full immunization coverage in India from 65% in 2013 to at least 90% children in the next five years. The programme provides immunization against seven life-threatening diseases (diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B) in the entire country. In addition, vaccination against Haemophilus influenza type B and Japanese Encephalitis is provided in select districts/states.
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This will be done through special catch-up campaigns to rapidly increase full immunization coverage of children by 5% and more annually.
Under Mission Indradhanush, the Health Ministry has identified 201 high focus districts across the country that have the highest number of partially vaccinated and unvaccinated children. Nearly 50% of all unvaccinated or partially vaccinated children are in these 201 districts. Of the 201 districts, 82 districts are concentrated in the four states of Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan and nearly 25% of the unvaccinated or partially vaccinated children of India are in these 82 districts of these four states. These districts will be targeted for intensive efforts to improve the routine immunization coverage in the country. The ultimate goal is to protect all children and pregnant women against vaccine preventable diseases in India
AREAS UNDER FOCUS
Mission Indradhanush will target 201 high priority districts in the first phase and 297 districts for the second phase in the year 2015. The implementation of the first phase of the Mission in 201 high focus districts will commence from 7th April 2015, World Health Day
Within the districts, the Mission will focus on the 400,000 high risk settlements identified by the polio eradication programme. These are the pockets with low coverage due to geographic, demographic, ethnic and other operational challenges. Evidence has shown that most of the unvaccinated and partially vaccinated children are concentrated in these areas.
The following areas will be targeted through special immunization campaigns:
· High risk areas identified by the polio eradication programme. These include populations living in areas such as:
o Urban slums with migration
o Nomads
o Brick kilns
o Construction sites
o Other migrants (fisherman villages, riverine areas with shifting populations etc.) and
o Underserved and hard to reach populations (forested and tribal populations etc.)
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· Areas with low routine immunization (RI) coverage (pockets with Measles/vaccine preventable disease (VPD) outbreaks).
· Areas with vacant sub-centers: No ANM posted for more than three months.
· Areas with missed Routine Immunisation (RI) sessions: ANMs on long leave and similar reasons
· Small villages, hamlets, dhanis or purbas clubbed with another village for RI sessions and not having independent RI sessions.STRATEGY FOR MISSION INDRADHANUSH
Mission Indradhanush will be a national immunization drive to strengthen the key functional areas of immunization for ensuring high coverage throughout the country with special attention to districts with low immunizationcoverage.
The broad strategy, based on evidence and best practices, will include four basic elements-
1. Meticulous planning of campaigns/sessions at all levels: Ensure revision of microplans in all blocks and urban areas in each district to ensure availability of sufficient vaccinators and all vaccines during routine immunization sessions. Develop special plans to reach the unreached children in more than 400,000 high risk settlements such as urban slums, construction sites, brick kilns, nomadic sites and hard-to-reach areas.
2. Effective communication and social mobilization efforts: Generate awareness and demand for immunization services through need-based communication strategies and social mobilization activities to enhance participation of the community in the routine immunization programme through mass media, mid media, interpersonal communication (IPC), school and youth networks and corporates.
3. Intensive training of the health officials and frontline workers: Build the capacity of health officials and workers in routine immunization activities for quality immunization services.
4. Establish accountability framework through task forces: Enhance involvement and accountability/ownership of the district administrative and health machinery by strengthening the district task forces for immunization in all districts of India and ensuring the use of concurrent session monitoring data to plug the gaps in implementation on a real time basis.
The Ministry of Health and Family Welfare will establish collaboration with other Ministries, ongoing programmes and international partners to promote a coordinated and synergistic approach to improve routine immunization coverage in the country.
National Level Monitoring
A control room has been established at ITSU for coordinating with State Nodal Officers and National Level Monitors regarding daily reporting of the progress of Mission Indradhanush activities. The control room will also collect, compile and analyze their filled assessment checklists data. The details of contact persons from ITSU control room has been shared with states and will be shared with national level monitors also.
For the monitoring of Mission Indradhanush, national level monitors have also been assigned one for each district, placing 201 monitors for 201 districts. These monitors have been pooled from various partner agencies viz, Ministry of Health and Family Welfare, National Health System Resource Center, National Institute of Health and Family Welfare, CORE, UNDP, ITSU, DELOITTE, BMGF, JSI, IPE Global, Rotary, UNICEF, WHO-NPSP.
They will reach the assigned districts one day prior to the start of the activity and will check the preparedness of the district for Mission Indradhanush. During their visit to the district, monitors will also meet district level officials and will give them feedback about their observations on daily basis. After monitoring at district headquarter, they will also visit blocks of the same district on subsequent days for monitoring the preparedness at block level. During their visit, they are also expected to visit session sites and monitor sessions on standard session site monitoring format to assess the quality of implementation of activities. The national level monitors will stay in the assigned district for at-least 4 days and will visit minimum 3-4 blocks of the districts during the whole monitoring period. The national level monitors will be using two checklists i.e. District Assessment Checklist and Block / Urban area Assessment Checklist and a monitoring tool for session site.
The data entry excel sheet tool based on the filled checklists will be submitted by monitors to Immunization Technical Support Unit (ITSU) by email on daily basis, and will be compiled by ITSU for feedback. The hard copies of all the formats will be submitted to ITSU immediately after monitor returns from the assigned district. The session site monitoring formats filled by the national level monitors will be handed over to local WHO-NPSP office in the district itself.
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