Dear Dr Samadhan Prakashrao
Thank you very much for sharing the above post with techNet community. This is giving KVG team an opportunity to share the following in response as to what we have already successfully done and have the potential to replicate.
Title: Reiteration of iterations for replication of successful models for rapid sustainable achievement:
- India is committed; WHO’s Expanded programme on Immunization [EPI] 1974 was launched in India in 1978.
- Since then passed through various strengthening strategies through programmes like Universal Immunization Programme [UIP], CSSM, RCH 1 & 2, NRHM / NUHM / NHM, Intensification of Routine Immunization [IRI] followed by India’s ambitious flagship programme: Mission Indradhanush [MI].
- Despite the efforts, of the estimated 19.9 million partially immunized or unimmunized children globally, an estimated 9.3million (46.73%) are in India.
- Special drives of IRI in the year 2012-13, multiple phases of MI / IMI between 2015 & 2018 could not infuse “Mission Mode” to the regular sessions of routine immunization as evidenced by the absence of “specific micro-plan” and session wise “specific due list” – the two key elements of MI / IMI.
- Global Vaccine Action Plan [GVAP] encourages mission mode through local innovation for achieving and sustaining – the 6th and the 5th strategic objectives to achieve >90% full immunization coverage [FIC] by 2020 which India advanced to achieve by 2018. This is in alliance with thinking globally and acting locally.
- Vaccination coverage is facing a paradoxical situation of better coverage in rural area, thanks to GoI for providing 3 ‘A”ces [ANM’s / AWW’s / ASHA’s – all 3 are females] than in the urban area. This is further accentuated by the quality of vaccination services in the urban area by the private service providers (~40% in metropolitan cities) with whimsical vaccination schedule – both denying and delaying one or more vaccines of National Immunization Schedule [NIS], preferably pushing optional vaccines and the potency of the vaccines are also uncertain as the vaccines have no VVM.
- On 5th June 2018, Urban Immunization Strategy Development workshop was held in a state attended by consultants from different states, centre and partner organizations. It was inaugurated by honorable Mission Director, from his previous experiences he was very apprehensive about the outcome of the workshop, specially requested the organizer and the consultants to come out with specific solutions but he was disappointed.
Sharing the true success stories for replication:
- Ambiguity in vaccination schedule causing either or both denial / delay in administering essential vaccines, lowering FIC and complete vaccination. Tested easily replicable simplest solution: “Combo-Card”.
- Specific micro-plan for spontaneous perpetual generation of session wise antigen wise specific due list: Tool – Extended Immunogram and the approach “Learning by doing, working together blended with supportive supervision”, e.g. IRI simulation study, Mission Indradhanush Simulation Study – MISS Sampaje, 10 lessons taught by MISS Sampaje. This promotes RI session to All Time Mission Mode [ATMM].
- Making attached planning units “Demo-sites” for cross learning visits by other PHCs of the block and District for easy and rapid replication, e.g. PHC Kollamogru, Guthigar attached to KVGMCH followed by retro visits for handholding and supportive supervision.
- Establishing Dedicated Vaccination Clinics in the Medical Colleges to roll out graduates and specialists with operational knowledge as per CDC / GoI. Replication is through cross learning visits and retro visits.
- Adoption of urban pockets for making models for replication on demand.
KVG team is proactive for the successful implementation of RI.
Hope KVG team may be of some use to the country in crisis.
Holla n Team