Guidelines Selected: immunization: immunization toolkit and guidelines on reducing inequities in immunization

Country context: India

I am working with WHO-India NPSP at sub-national level as Administrative Assistant, Andhra Pradesh, India. My work involves Administrative and technical support to Surveillance Medical Officer at my Unit office Sub district level and Sub National level Immunization strengthening activities including polio endgame strategy, polio transition activities, MR elimination activities and VPD surveillance.

Immunization is one of the most cost effective interventions that prevent needless suffering through sickness, disability and death. The benefits of immunization are not restricted to improvement in health and life expectancy but also have social and economic impact at both community and national levels. Moreover, an effective, equitable immunization program and its impact on reducing the burden of vaccine preventable diseases will greatly contribute to the achievement of the Millennium Development Goal 4 (MDG4) that envisages a two third reduction in child mortality.

In the last three decades, India has made significant progress on sustainable and inclusive growth. There is now a greater sense of awareness and expectations from the people as the country makes further social and economic progress. Investments on the social determinants of health have improved availability and access to health services though there still remain challenges of inequity and affordability.

SWOT Analysis summary of selected strategy:

Strength:

Good commitment and support from National and Sub National level for strengthening routine immunization services

Regular training of health staff including medical officers and health workers in routine immunization

Good implementation of immunization campaigns by corporation including, Mission Indradhanush campaign, polio SIAs and Measles-Rubella campaign

Tracking mechanism of Immunization – State Task force Meeting for Immunization at State level and District task force meeting for Immunization at District/sub district level.

WHO, UNICEF, Rotary and Gates foundation etc… Partners support for strengthening of Immunization

Weakness:

Manpower vacancies

Large number of contractual manpower with high attrition rates

Large catering areas for urban PHCs / un qualified staff

Large number of migratory floating populations

Elite population take immunization services from private sector; but reporting from private sector on immunization services is poor.

Sub-optimal supervision and monitoring of immunization activates

Opportunities:

All high risk areas validated during polio SIA campaign and Mission Indradhanush vaccination campaign

Good supervisory structure in corporation health department though priority is not on Immunization supervision and monitoring

Private sector supported well during MR vaccination campaign. Sustained collaboration for strengthening routine immunization needs stress

Presence of large number of medical college institutions; can be utilised for RI strengthening

Threats:

Growing Peri-urban areas and areas not being catered by any PHC

Difficulty in setting denominators.

Service delivery in overlapping areas

Vacancy positions leading to additional responsibility for existing health workers

Multiple health program implementations by same health staff with limited manpower