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STRATEGIES AND PROGRESS

STRATEGIES AND PROGRESS. IMMUNIZATION. SITUATIONAL ANALYSIS. Evaluated coverage of 43.5% by NFHS 3 and 62.4% by UNICEF CES 2006 fully immunized children. 20 lac more children fully immunized in one year. Immunization coverages increased in traditionally low performing states (NFHS 2-3).

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STRATEGIES AND PROGRESS

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  1. STRATEGIES AND PROGRESS IMMUNIZATION

  2. SITUATIONAL ANALYSIS Evaluated coverage of 43.5% by NFHS 3 and 62.4% by UNICEF CES 2006 fully immunized children 20 lac more children fully immunized in one year

  3. Immunization coverages increased in traditionally low performing states (NFHS 2-3) Immunization coverages decrease from 4-19.6% in high performing states-(NFHS 2 to 3)

  4. GENERIC INTERVENTIONS • Introduction of new vaccines based on disease specific mortality and morbidity indicators – JE, Hep B • System Strengthening : • Activity based funding to strengthen service delivery • Alternate vaccine delivery to ensure reach into villages • Alternate Vaccinators to ensure sessions are held • ASHA/Link workers used for Social Mobilization to ensure demand creation in community. • Strengthening supportive supervision by support for POL • Half yearly meeting at State with districts to ensure monitoring. • Capacity Building: Trainings at all levels for all aspects of immunization service delivery • Monitoring and supervision of the programme at service delivery level • Demand generation: Social Mobilization • Injection Safety: AD syringes and waste disposal guidelines for immunization sessions

  5. STRATEGIES TO INCREASE IMMUNISATION IN LOW PERFORMING STATES

  6. STRATEGIES TO INCREASE IMMUNISATION IN HIGH PERFORMING STATES

  7. JE Hep B Highest Priority District High Risk Districts Medium Risk Districts PROGRESS • New vaccines introduced in UIP • Hep B in 10 states • JE in endemic districts • 11 Districts in 2006 • 27 districts in 2007 • 24 districts in 2008 • Validation of elimination of Maternal and neonatal tetanus in • 15 States -Andhra Pradesh, Kerala, Tamil Nadu, Karnataka, Maharashtra, West Bengal, Haryana, Goa, Sikkim, Punjab, Chandigarh, Pondicherry, Lakshadweep, HP, and Gujarat • Routine Immunization monitoring systems (RIMS) introduced in all districts and being used by nearly 180 districts • Catch-up rounds and Immunization weeks in low performing states • Training of more than 90,000 ANMs and other health workers

  8. IMMUNISATION: KEY ISSUES • Shortage of vaccines and cold chain equipment • Inconsistent delivery of vaccines to outreach session sites. • Operational issues : • Immunization sessions not being held regularly • HR shortages at all levels • Inadequate mobility of health workers and supervisors at district & state levels • Urban areas - inadequate health infrastructure, multiple agencies, poor coordination.

  9. IMMUNISATION: WAY FORWARD • Introduction of new vaccines based on disease specific mortality and morbidity indicators/ NTAGI inputs • HepB-DPT-HiB Pentavalent • 2nd Dose of measles and Rubella in select states • JE in remaining 42 districts • System Strengthening : • Operationalization of RIMS in all districts. • Activity based funding to strengthen service delivery • Alternate vaccine delivery to ensure reach into villages • Alternate Vaccinators to ensure sessions are held • Strengthening Supportive supervision • Half yearly meeting at State with districts to ensure monitoring. • Support for POL to assist active supervision • Demand generation through social mobilization • 3. Streamline procurement and supply chain • 4. Capacity Building: Training of the remainder of >100,000 health workers & managers • 5. Survey of more states for MNT elimination validation • 6. Mid term evaluation of the program against the milestones stated in the multi year plan

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