Universal Immunization programme
Background:
Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease. Immunization is one of the most cost-effective interventions for disease prevention. The benefit of quality vaccination is not only in the prevention of diseases and disabilities but also the opportunity for a healthier & a more productive life.
Objective:-
The objective of Immunization programme is to achieve and sustain more than 90% full immunization coverage in all districts across the country. The Full Immunization coverage of State has shown a steady improvement over the period i.e. 36.1% (NFHS 1 report) to 90.5% (NFHS 5 report), which is highest among all States.
Trend of improvement in Full Immunization coverage of Odisha:
Key Interventions:
Vaccine & Cold Chain Management:
One of the important elements for improving the immunization coverage with quality is holistic management of Immunization Supply Chain System (iSCS), which deals with cold chain and vaccine logistics along with human resource, infrastructure, Management Information System (MIS) and supportive supervision. Currently, State is managing a fleet of Electrical & Non-Electrical Cold Chain Equipment for Routine Immunization Programme.
Immunization supply chain structure in the State:
| Sl. No. | Name of the Store | Nos. |
| 1 | State Vaccine store | 1 |
| 2 | Regional vaccine store (RVS) | 9 |
| 3 | District vaccine store (DVS) | 32 |
| 4 | Cold chain points (Sub -district) | 1230 |
Alternate Vaccine Delivery System: (AVDS)
AVD has the following advantages.
- It helps the vaccinators to start sessions in time and get adequate time for conducting immunization sessions smoothly. It helps to ensure timely delivery of vaccines & other logistics to the session site and return the same from the session site to the concerned cold chain point. It also helps to maintain the Vaccine safety and quality. It helps in improving community participation in the National Programme. As per Alternate Vaccine Delivery System, vaccines and logistics should be delivered to the health workers at the immunization session sites so that she/he can start the immunization session on time, vaccine are collected on the same day and unused/ opened vials and immunization waste are brought to PHC/CHC on the same day.
Routine Immunization Session
RI micro planning is the basis for the delivery of RI services to the community. Micro planning is the most important component and forms the base for the planning and management of immunization services. It ensures that immunization services reach every community.
- Adverse Events Following Immunization:
Adverse event following immunization (AEFI) is defined as any untoward medical occurrence which follows immunization, and which does not necessarily have a causal relationship with the usage of the vaccine. The adverse event may be any unfavorable or unintended sign, abnormal laboratory finding, symptom or disease. Majority of the adverse event are coincidental i.e unrelated to vaccine or vaccination process but have to be reported as the symptoms or signs have occurred after vaccination. AEFI is being classified in three different types i.e. Minor, Severe & Serious Reaction.
- Surveillance for vaccine preventable diseases:
Surveillance is the basic tool for understanding the epidemiology of a disease. Its key objectives are to Trigger public health control measures, identify outbreaks and assess the effectiveness of Prevention programmes. Under Immunization Programme, Vaccine Preventable Disease surveillance is being implemented for AFP (Polio), Fever with Rash for Measles Rubella elimination and Diphtheria, Pertussis and Tetanus.
- Mission Indradhanush Drive:
India launched its flagship programme, Mission Indradhanush (MI), a periodic immunization intensification drive, in December 2014, with an aim to strengthen Routine Immunization. The mission, over the years, has shown a positive impact on immunization coverage. The mission was further intensified in 2017 with increased focus on urban areas with better interdepartmental coordination. The governance structure for intensified efforts has also been defined. The aims of MI/IMI to strengthen Routine Immunization coverage and track & vaccinate all left out / drop out children aged 0 to 5 years & pregnant women.
- IPPI Programme:
Intensified Pulse Polio Immunization Programme (IPPI) is a flagship programme of Govt. of India for Polio eradication. The IPPI programme has been implemented since 1995. Under this programme National Immunization Day is celebrated on an Identified Sunday followed by two days mop up drive. Children less than five year of age are being administered with two drop of Oral Polio Vaccine irrespective their previous Vaccination Status.
- ISO Certification of Vaccine Stores:
Vaccines are crucial for saving lives, protecting against various diseases. What often goes unnoticed is crucial work in the background in storing, managing and transporting the vaccines from the point of manufacturing to the beneficiaries with a recommended temperature. Despite many challenges, Odisha state is vaccinating all children with increase in full immunization coverage. In 2018, when vaccine stores in Odisha were assessed based on WHO/UNICEF Effective vaccine management (EVM) protocol. Follow up was done for corrective measures. In the meantime State played a catalytic role in implementation of about twenty focused indicators which would not only improve the quality of Immunization supply chain but qualify each facility for an ISO- 9001:2015 certification. ISO certifications have been done in 7 numbers of RVS and 23 Numbers of DVS.
- Management Information System under Routine Immunization Programme
- Electronic Vaccine intelligence Network (eVIN) Portal
Electronic Vaccine intelligence Network(eVIN) is a technological innovation that aims to ensure equity in vaccine distribution through efficient distribution and timely availability of vaccines to all mother and children. The mobile and web-based application being implemented by the Ministry of Health and Family Welfare enables real-time visibility of vaccine cold chain logistics by digitizing stock supplies and storage temperatures. The smart system also supports the immunization system by empowering vaccine handlers at the last mile and connecting the health workers and programme managers with the help of the vaccine and cold chain manager placed in every district.
- U-WIN
The U-WIN platform is a digital solution to facilitate tracking of every pregnant woman, new-born, child and adolescent for vaccination. The system will allow planning of vaccination sessions, registration of beneficiaries, updating of vaccination status digitally on real-time basis from the last mile of service delivery by the vaccinator, recording and reporting of all data for the UIP. The system will hence provide a common database for effective management of immunisation services. It will also support improved vaccination coverage by facilitating appropriate intervals between doses, digital verification and tracking of beneficiaries, promoting consistency in vaccination schedules and communication with beneficiaries.
- SAFEVAC:-
This is a portal for reporting and tracking of Severe and serious AEFI cases and the same is used at District, State and National level. In this portal the district will entry and upload the CRF and CIF form which is received from concerned PHC and CHC. The Detail information like vaccination detail, vaccine details, cause of AEFI are mentioned in this portal by District and State.
- National Cold Chain Information System (NCCMIS) acts as a repository of cold chain equipment and tool for planning and future innovations in cold chain and vaccine management. This web portal is developed by the Govt of India with support from UNICEF, India. It is being updated every month including the preventive maintenance of cold chain equipment.
- Effective Vaccine Management (EVM) -An EVM assessment provides a systematic analysis of strengths and weaknesses across the supply chain. It is part of the EVM process which is designed to embed good vaccine storage and distribution practices. The National EVM Assessment 2018 was one of the world’s largest EVM assessment carried out so far. In Odisha, State has conducted till now four nos. of EVM assessments during the year 2007, 2009, 2014 & 2019.
- Rapid Immunization Skill Enhancement (RISE) –
The objective of this programme was to ‘develop a constructive, interactive, continuous, and adaptable knowledge and skills building package for health workers, cold chain handlers, program managers and mobilizers working in the UIP, supplementing the existing training programs.