Mission Indradhanush

Paper-2 PT-MAINS-Personality test (Government policies &Health)

Mission Indradhanush was launched by the Ministry of Health and Family Welfare, Government of India on December 25, 2014. Between 2009-2013 immunization coverage has increased from 61% to 65%, indicating only 1% increase in coverage every year. To accelerate the process of immunization by covering 5% and more children every year, Indradhanush mission has been adopted to achieve target of full coverage by 2020.

Objective

The Mission Indradhanush aims to cover all those children by 2020 who are either unvaccinated, or are partially vaccinated against vaccine preventable diseases. India’s Universal Immunisation Programme (UIP) provide free vaccines against 12 life threatening diseases, to 26 million children annually. The Universal Immunization Programme provides life-saving vaccines to all children across the country free of cost to protect them against Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts).

Implementation

Focused and systematic immunization drive will be through a “catch-up” campaign mode where the aim is to cover all the children who have been left out or missed out for immunization. Also the pregnant women are administered the tetanus vaccine, ORS packets and zinc tablets are distributed for use in the event of severe diarrhoea or dehydration and vitamin A doses are administered to boost child immunity.

Mission Indradhanush Phase I was started as a weeklong special intensified immunization drive from 7th April 2015 in 201 high focus districts for four consecutive months. During this phase, more than 75 lakh children were vaccinated of which 20 lakh children were fully vaccinated and more than 20 lakh pregnant women received tetanus toxoid vaccine.

The Phase II of Mission Indradhanush covered 352 districts in the country of which 279 are medium focus districts and remaining 73 are high focus districts of Phase-I. During Phase II of Mission Indradhanush, four special drives of weeklong duration were conducted starting from October 2015.

Phases I and II of the special drive had 1.48 crore children and 38 lakh pregnant women additionally immunized. Of these nearly 39 lakh children and more than 20 lakh pregnant women have been additionally fully immunized. Across 21.3 lakh sessions held through the country in high and mid-priority districts, more than 3.66 crore antigens have been administered.

Phase III of Mission Indradhanush was launched from 7 April 2016 covering 216 districts. Four intensified immunization rounds were conducted for seven days in each between April and July 2016, in these districts. These 216 districts have been identified on the basis of estimates where full immunization coverage is less than 60 per cent and have high dropout rates. Apart from the standard of children under 2, it also focussed on 5-year-olds and on increasing DPT booster coverage, and giving tetanus toxoid injections to pregnant women.

Overall, in the first three phases, 28.7 lakh immunisation sessions were conducted, covering 2.1 crore children, of which 55 lakh were fully immunised. Also, 55.9 lakh pregnant women were given the tetanus toxoid vaccine across 497 high-focus districts. Since the launch of Mission Indhradhanush, full immunisation coverage has increased by 5 per cent to 7 per cent. Mission Indradhanush has resulted in a 6.7 % annual expansion in the immunization cover.

Phase IV of Mission Indradhanush was launched from 7 February 2017 covering the North-eastern states of Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. It has been rolled out in rest of the country during April 2017.

The four phases of Mission Indradhanush have reached to more than 2.53 crore children and 68 lakh pregnant women with life-saving vaccines.

The Ministry is being technically supported by WHO, UNICEF, Rotary International and other donor partners. Mass media, interpersonal communication, and sturdy mechanisms of monitoring and evaluating the scheme are crucial components of Mission Indradhanush.

Areas Under Focus

Mission Indradhanush targets 201 high priority districts in the first phase, 297 districts for the second phase in the year 2015 and 216 districts in the third Phase during 2016.

Within the districts, the Mission focusses on 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 are targeted through special immunization campaigns:

1. High risk areas identified by the polio eradication programme. These include populations living in areas such as:
   • Urban slums with migration
   • Nomads
   • Brick kilns
   • Construction sites
   • Other migrants (fisherman villages, riverine areas with shifting populations etc.) and
   • Underserved and hard to reach populations (forested and tribal populations etc.)
2. Areas with low routine immunization (RI) coverage (pockets with Measles/vaccine preventable disease (VPD) outbreaks).
3. Areas with vacant sub-centers: No ANM posted for more than three months.
4. Areas with missed Routine Immunisation (RI) sessions: ANMs on long leave and similar reasons
5. Small villages, hamlets, dhanis or purbas clubbed with another village for RI sessions and not having independent RI sessions.

Mission Indradhanush

Report on Immunization among ChildrenNational Statistical Office (NSO) released a report on immunization among children. The survey was conducted during July 2017-June to 2018.

Highlights of the report -

• Around 60% of children under five years of age were fully immunized.
• This includes about 59% of boys and 60% of girls across the country who had been fully immunized with all eight prescribed vaccinations (BCG, OPV- 1, 2,3, DPT- 1,2,3 and measles).
• In rural India (58%) and Urban (62%) were fully immunized.
• Majority of the children rec
  eived vaccination from government hospitals or clinics.

Mission Indradhanush

The Government will launch the second phase of nationwide immunisation drive, i.e. Intensified Mission Indradhanush 2.0, to mark the 25 years of the Pulse polio programme.

• Intensified Mission Indradhanush 2.0 aims to achieve at least 90% pan-India immunisation coverage by 2022.
• Mission Indradhanush, which was launched in December 2014, has increased India’s immunisation coverage significantly to 87% from 67% in 2014.
• However, official data on India’s immunisation coverage is still 62%, given to the National Family Health Survey-4 (2015-16).

Immunization Programme in India

• The immunization Programme in India was introduced in 1978 as ‘The Expanded Programme of Immunization (EPI) by the Ministry of Health and Family Welfare.
• In 1985, the Programme was modified as the ‘Universal Immunization Programme (UIP)’. The stated objectives of the Programme include:
  • Rapidly increasing immunization coverage,
  • Improving the quality of services,
  • Establishing a reliable cold chain system to the health facility level,
  • Introducing a district-wise system for monitoring of performance,
  • Achieving self-sufficiency in vaccine production.
• UIP prevents mortality and morbidity in children and pregnant women against 12 vaccine-preventable diseases. But in the past, it was seen that the increase in immunization coverage had slowed down and it increased at the rate of 1% per year between 2009 and 2013.
• To accelerate the coverage, Mission Indradhanush was envisaged and implemented since 2015 to rapidly increase the full immunization coverage to 90%.

Mission Indradhanush

• The aim is to fully immunize more than 89 lakh children who are either unvaccinated or partially vaccinated under UIP.
• It targets children under 2 years of age and pregnant women for immunization.
• It provides vaccination against 12 Vaccine-Preventable Diseases (VPD) i.e. diphtheria, Whooping cough, tetanus, polio, tuberculosis, hepatitis B, meningitis and pneumonia, Hemophilus influenza type B infections, Japanese encephalitis (JE), rotavirus vaccine, pneumococcal conjugate vaccine (PCV) and measles-rubella (MR).
• However, Vaccination against Japanese Encephalitis and Haemophilus influenzae type B is being provided in selected districts of the country.
• It is a nationwide initiative with a special focus on 201 high-focus districts. These districts accounted for nearly 50% of the total partially vaccinated or unvaccinated children in the country.
• The rate of increase in full immunization coverage increased to 6.7% per year through the first two phases of ‘Mission Indradhanush’.

Intensified Mission Indradhanush

• The Intensified Mission Indradhanush (IMI) was launched by the Government of India in 2017 to reach each and every child under two years of age and all those pregnant women who have been left uncovered under the routine immunisation programme.
• Under IMI, greater focus has been given to urban areas which were one of the gaps of Mission Indradhanush.
• The target under IMI was to increase the full immunization coverage to 90% by December 2018. However, only 16 districts in the country have achieved 90% coverage so far.
• The Intensified Mission Indradhanush 2.0 will target the districts which have immunisation coverage of 70% or below.

Pulse Polio Immunization Programme

• With the global initiative of eradication of polio in 1988 following the World Health Assembly resolution in 1988, the Pulse Polio Immunization programme was launched in India in the financial year 1994-95.
• It was started with the objective of achieving a hundred per cent coverage under Oral Polio Vaccine.
• Children in the age group of 0-5 years are administered polio drops during national and sub-national immunization rounds (in high-risk areas) every year.
• WHO on 24th February 2012 removed India from the list of countries with active endemic wild poliovirus transmission and in 2014, India was declared Polio free.
• As a risk mitigation measure, the country has also introduced Inactivated Polio Vaccine across the country in all states.