India’s Union Minister for Health and Family Welfare Dr Mansukh Mandaviya launched Intensified Mission Indradhanush (IMI) 4.0 on 7 February 2022 to enhance the coverage of the Universal Immunization Programme (UIP).
Three rounds of IMI 4.0 are scheduled to be conducted in 416 districts across 33 states/union territories between February and May 2022. Each round will be conducted for seven days, including routine immunization days, Sundays, and public holidays.
WHO-NPSP surveillance medical officer Dr Sumit Kataria vaccinates an unimmunized child during Polio National Immunization Day on 27 February 2022 at Kemankathi Kalyuga village in Jhajha block of Jamui district in Bihar. Photo: Mr Manoranjan Kumar / © WHO India
India achieved a DPT3 coverage (three doses of diphtheria, tetanus toxoid and pertussis vaccine) of 91% in 2019 as per WHO UNICEF National Estimates of Immunization Coverage, but there was a fall of 6 percentage points in coverage in 2020. Children who do not receive the first dose of DTP are considered zero dosers, and those not receiving subsequent doses are considered dropouts.
A deep dive conducted by WHO India in August 2021 found the decline was largely a result of the suspension of routine immunization sessions during the COVID-19 pandemic.
WHO NPSP teams supporting immunization of missed children at Madrasi Camp near Jungpura in South-East district, Delhi. The children in this neighbourhood were missed mostly because the parents had migrated for work or feared adverse events following immunization. (Photo: Mr. Satvir Yadav / © WHO India)
WHO technical teams supported the Ministry of Health and Family Welfare in formulating Operational Guidelines for IMI 4.0 and facilitated the National Orientation of State Programme Officers and other key stakeholders. These trainings were cascaded to the district and block levels with the active support of WHO.
WHO field teams are in the frontlines with health workers to independently monitor IMI sessions and conduct community assessment of coverages, including reasons for vaccinations being missed. Monitoring data at subnational levels is critical to help countries prioritize and customize vaccination strategies and operational plans to address immunization gaps.
Shri Mangal Pandey, Health Minister of Bihar giving oral polio vaccine to a baby at the launch of the IMI 4.0 campaign at Indira Gandhi Institute of Medical Sciences, Patna. (© WHO India)
Vaccines are one of the most effective, affordable and safe methods to protect communities from infectious diseases that may cause serious illnesses, disabilities or death. The goal of IMI 4.0 is to identify and reach unvaccinated and partially vaccinated children and pregnant women.
All vaccines provided free under UIP are delivered during Mission Indradhanush, which is one of the flagship schemes under Rashtriya Gram Swaraj Abhiyan (16 850 villages in 541 districts) and Extended Gram Swaraj Abhiyan (48 929 villages in 112 aspirational districts) launched by the Government of India for the transformation of aspirational districts.
WHO team supporting a joint monitoring session of IMI 4.0 in Kilaghat,Bhagalpur district, Bihar. (Photo: Mr Nasimuddin / © WHO India)
WHO Country Office for India has also been assisting the national and state governments to expand immunization coverage through capacity building, identification and coverage of high risk and low performing areas, monitoring and data analysis, and advocacy for implementation of evidence-based corrective actions.
In Bihar, due beneficiary lists are prepared following house-to-house surveys by the health staff. IMI sessions were set up to vaccinate all beneficiaries who were overdue for any vaccines. WHO-NPSP teams have been supporting the planning, training, validation of house-to-house surveys and monitoring the campaign across states.