India has recently witnessed an ambitious commencement of intensified immunisation drives under Mission Indradhanush, which aims to cover all those children who are either unvaccinated or partially vaccinated against seven vaccine preventable diseases which include diphtheria, pertussis, tetanus, polio, tuberculosis, measles and hepatitis B.
As part of the national Universal Immunisation Programme (UIP) this Mission, conceived and implemented by the Union ministry of health and family welfare, is one of the largest programmes of its kind in the world.
Immunisation is a critical element in the Indian government’s child survival strategy. Several children across the country rely solely on the national public health system to access vaccines that protect them against deadly childhood diseases. Delivering vaccines to the children safely, adequately and effectively, especially to the underserved and marginalised, is a priority agenda for our government.
Whether we look back to 1994 when the malaise of polio was acknowledged and its eradication prioritised in Delhi or at the current health assurance mandate which will see that eventually Indians spend less out of their pockets on healthcare, ours is a tradition of identifying crucial problems and working incisively to resolve them. For developmental efforts our government is guided by the understanding that India’s greatest economic and social resource, its demographic dividend, needs to be safeguarded.
Started in 1985, UIP has been playing a critical part in India’s quest to achieve health Millennium Development Goals 4 and 5 by 2015. As the current set of MDGs reach their end in 2015, new global health paradigms focussing on universal health coverage and sustainable development are emerging, for which immunisation remains a vital strategy. In the past, catch-up campaigns for polio, measles and Japanese encephalitis have amply demonstrated the capacity of this nation’s well-developed immunisation system to deliver vaccines to millions of children, safely and effectively.
In the run-up to concluding the MDGs, our Union health ministry recognises the urgency of injecting new life into child health efforts. Mission Indradhanush plans to close existing immunity gaps so that disease outbreaks are curtailed and the process of immunisation in India is accelerated by 5% every year as compared to the current rate of 1% increase in coverage. With only 65% of children presently covered, the ‘Mission’ configuration will help achieve 90% full immunisation coverage by 2020.
Mission Indradhanush is planned as a systematic immunisation drive that will cover all those children who have been left out. To be carried out in two phases, these efforts have begun with 201 high focus districts where nearly 50% of all unvaccinated or partially vaccinated children reside. Of these, 82 are concentrated in the four states of Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan and constitute nearly 25% of the unvaccinated or partially vaccinated children across our country.
Under Mission Indradhanush, four special vaccination campaigns are being conducted starting from April to July 2015 and these will be monitored through sturdy and stringent structures. While 201 districts are being covered in the first phase, 297 will be targeted for the second phase in 2015-16. This Mission aims to cater to 89 lakh children in the country who have not yet received all the vaccinations available under UIP. It is our government’s firm conviction that focussed micro-planning, provision of additional financial resources and systematic immunisation drives will make the critical difference.
Mission Indradhanush will draw from the learnings of the polio programme. It will see unprecedented mobilisation of human resources as health workers, agencies and organisations will be leveraged for full coverage. High-risk areas such as slums, brick kilns, construction sites and migrant settlements that hold underserved segments of the population will be targeted.
Partner agencies such as WHO, Unicef and Rotary International are supporting this initiative with systems strengthening, specifically through technical facilitation and monitoring activities. People’s representatives including MPs, especially from high-focus states, will be actively engaged with to use their deep influence with the masses for advocacy and awareness generation on Mission Indradhanush.
Another aspect crucial to ensuring that this Mission achieves its objectives is its multi-pronged communication approach. The plan directs specific communication and multimedia activities at different levels of operation. These strategic communication activities include efforts that span engagement with target audiences via TV, newspaper, radio and SMS, supplementing traditional advocacy and Information Education and Communication/ Behaviour Change Communication (IEC/BCC) components.
Since it has been found that in 63% of cases people are ignorant about the benefits of immunisation, this multimedia campaign aims to widely disseminate information to bridge the awareness gap. Known to be one of the most cost-effective interventions in the history of public health, vaccines do not merely save lives, they allow children and their families to thrive by preventing the onslaught of illness, disability, hospitalisation costs and needless human suffering.
Vaccines also have long term benefits for individuals and society by contributing to improvements in cognitive development, educational attainment, labour productivity and economic development.