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Mission Indhradhanush

 Mission-indradhanush

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 Indhradhanush - Districts covered

Phase I - 201 districts

S.NOSTATES.NODISTRICTS.NODISTRICT
1ANDHRA PRADESH1EAST GODAVARI2GUNTUR
3KRISHNA4KURNOOL
5VISAKHAPATNAM
2ARUNACHAL PRADESH1CHANGLONG2EAST KAMENG
3EAST SIANG4LOHIT
5UPPER SIANG
3ASSAM1BONGAIGAON2DARRANG
3DHUBRI4GOALPARA
5HAILAKANDI6KARIMGANJ
7KOKRAJHAR8NAGAON
4BIHAR1ARARIA2BEGUSARAI
3CHAMPARAN EAST4CHAMPARAN WEST
5DARBHANGA6GAYA
7JAMUI8KATIHAR
9KISHANGANJ10MUZAFFARPUR
11PATNA12SAHARSA
13SAMASTIPUR14SITAMARHI
5CHHATTISGARH1BALODABAZAAR BHATAPARA2BIJAAPUR
3BILASPUR4DANTEWADA
5JASHPUR6KORBA
7RAIPUR8SARGUJA
6DELHI1NORTH-EAST2NORTH-WEST
7GUJARAT1AHMEDABAD2AHMEDABAD CORPN.
3BANASKANTHA4DAHOD
5DANGS6KUTCH
7PANCHMAHALS8SABARKANTHA
9VALSAD
8HARYANA1FARIDABAD2GURGAON
3MEWAT4PALWAL
5PANIPAT
9JAMMU & KASHMIR1DODA2KISHTWAR
3PUNCH4RAJAURI
5RAMBAN
10JHARKHAND1DEOGHAR2DHANBAD
3GIRIDIH4GODDA
5PAKUR6SAHIBGANJ
11KARNATAKA1BANGALORE (U)2BELLARY
3GULBARGA4KOPPAL
5RAICHUR6YADGIR
12KERALA1KASARAGOD2MALAPPURAM
13MADHYA PRADESH1ALIRAJPUR2ANUPPUR
3CHHATARPUR4DAMOH
5JHABUA6MANDLA
7PANNA8RAISEN
9REWA10SAGAR
11SATANA12SHADOL
13TIKAMGARH14UMARIYA
15VIDISHA
14MAHARASHTRA1BEED2DHULE
3HINGOLI4JALGAON
5NANDED6NASIK
7THANE
15MANIPUR1CHURACHANDPUR2SENAPATI
3TAMENGLONG4UKHRUL
16MEGHALAYA1EAST KHASI HILL2WEST GARO HILLS
3WEST KHASI HILL
17MIZORAM1LAWNGTLAI2LUNGLEI
3MAMIT4SAIHA
18NAGALAND1DIMAPUR2KIPHIRE
3KOHIMA4MON
5TUENSANG6WOKHA
19ODISHA1BOUDH2GAJAPATI
3GANJAM4KANDHAMAL
5KHURDA6KORAPUT
7MALAKANGIRI8NABARANGPUR
9NUAPADA10RAYAGADA
20PONDICHERRY1YANAM
21PUNJAB1GURDASPUR2LUDHIANA
3MUKTSAR
22RAJASTHAN1ALWAR2BARMER
3BUNDI4DHAULPUR
5JAIPUR6JODHPUR
7KARAULI8SAWAI MADHOPUR
9TONK
23TAMIL NADU1COIMBATORE2KANCHEEPURAM
3MADURAI4THIRUVALLUR
5TIRUCHIRAPALLI6TIRUNELVELI
7VELLORE8VIRUDHUNAGER
24TELANGANA1ADILABAD2MAHBUBNAGAR
25TRIPURA1DHALAI2TRIPURA NORTH
3TRIPURA WEST
26UTTAR PRADESH1AGRA2ALIGARH
3ALLAHABAD4AMETHI
5AMROHA6AURAIYA
7AZAMGARH8BADAUN
9BADOHI10BAHRAICH
11BALRAMPUR12BANDA
13BARABANKI14BAREILLY
15BULANDSHAHAR16CHITRAKOOT
17ETAH18ETAWAH
19FARRUKHABAD20FEROZABAD
21GHAZIABAD22GONDA
23HAPUR24HARDOI
25HATHRAS26KANNAUJ
27KASGANJ28KAUSHAMBI
29KHERI30MAINPURI
31MATHURA32MEERUT
33MIRZAPUR34MORADABAD
35MUZAFFARNAGAR36PILIBHIT
37SAMBHAL38SHAHJAHANPUR
39SHAMLI40SIDDHARTHNAGAR
41SITAPUR42SONBHADRA
43SRAWASTI44SULTANPUR
27UTTARAKHAND1HARDWAR
28WEST BENGAL124-PARGANAS NORTH224-PARGANAS SOUTH
3BARDHAMAN4BIRBHUM
5MURSHIDABAD6UTTAR DINAJPUR

Phase II - 352 districts

For the complete list of districts covered as part of Phase II of Mission Indradhanush, click here.

Phase III - 216 districts

Phase IV - The fourth phase of Mission Indradhanush has already begun in North-eastern states - Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura from 7th February 2017 and will be rolled out in rest of the country in April 2017.

Strategy for Mission Indradhanush

Mission Indradhanush will be a national immunization drive to strengthen the key functional areas of immunization for ensuring high coverage throughout the country with special attention to districts with low immunization coverage.

The broad strategy, based on evidence and best practices, will include four basic elements-

Meticulous planning of campaigns/sessions at all levels: Ensure revision of microplans in all blocks and urban areas in each district to ensure availability of sufficient vaccinators and all vaccines during routine immunization sessions. Develop special plans to reach the unreached children in more than 400,000 high risk settlements such as urban slums, construction sites, brick kilns, nomadic sites and hard-to-reach areas.

Effective communication and social mobilization efforts: Generate awareness and demand for immunization services through need-based communication strategies and social mobilization activities to enhance participation of the community in the routine immunization programme through mass media, mid media, interpersonal communication (IPC), school and youth networks and corporates.

Intensive training of the health officials and frontline workers: Build the capacity of health officials and workers in routine immunization activities for quality immunization services.

Establish accountability framework through task forces: Enhance involvement and accountability/ownership of the district administrative and health machinery by strengthening the district task forces for immunization in all districts of India and ensuring the use of concurrent session monitoring data to plug the gaps in implementation on a real time basis.

The Ministry of Health and Family Welfare will establish collaboration with other Ministries, ongoing programmes and international partners to promote a coordinated and synergistic approach to improve routine immunization coverage in the country.

Intensified Mission Indradhanush (IMI)

The Intensified Mission Indradhanush (IMI) has been launched by the Government of India 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. The special drive will focus on improving immunization coverage in select districts and cities to ensure full immunization to more than 90% by December 2018.

With a sharpened focus on high priority districts and urban areas, under IMI, four consecutive immunization rounds will be conducted for 7 days in 173 districts - 121 districts and 17 cities in 16 states and 52 districts in 8 north eastern states - every month between October 2017 and January 2018. Intensified Mission Indradhanush will cover low performing areas in the selected districts and urban areas. These areas have been selected through triangulation of data available under national surveys, Health Management Information System data and World Health Organization concurrent monitoring data. Special attention will be given to unserved/low coverage pockets in sub-centre and urban slums with migratory population. The focus is also on the urban settlements and cities identified under National Urban Health Mission (NUHM).

ensified Mission Indradhanush will have inter-ministerial and inter-departmental coordination, action-based review mechanism and intensified monitoring and accountability framework for effective implementation of targeted rapid interventions to improve the routine immunization coverage. IMI is supported by 11 other ministries and departments, such as Ministry of Women and Child Development, Panchayati Raj, Ministry of Urban Development, Ministry of Youth Affairs among others. The convergence of ground level workers of various departments like ASHA, ANMs, Anganwadi workers, Zila preraks under National Urban Livelihood Mission (NULM), self-help groups will be ensured for better coordination and effective implementation of the programme.

Intensified Mission Indradhanush would be closely monitored at the district, state and central level at regular intervals. Further, it would be reviewed by the Cabinet Secretary at the National level and will continue to be monitored at the highest level under a special initiative ‘Proactive Governance and Timely Implementation (PRAGATI)’.

This Intensified Mission is driven based on the information received from gap assessment, supervision through government, concurrent monitoring by partners, and end-line surveys. Under IMI, special strategies are devised for rigorous monitoring of the programme. States and districts have developed coverage improvement plans based on gap self-assessment. These plans are reviewed from state to central level with an aim to reach 90% coverage by December 2018.

An appreciation and awards mechanism is also conceived to recognize the districts reaching more than 90% coverage. The criteria includes best practices and media management during crisis. To acknowledge the contribution of the partners/Civil Society Organization (CSOs) and others, Certificate of Appreciation will be given.

Source: Ministry of Health and Family Welfare



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