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Mission Indradhanush (as in Jan 2020)

Mission Indradhanush
The percentage of children, who are fully immunized (FIC), was found to be only 65% in 2013-14. This was despite the Universal Immunization Program (UIP) running since 1985 and Expanded Program on immunization (EPI) since 1978.
Mission Indradhanush was launched in December 2014 to:
• Actively achieve full immunization of 90 percent by 2020 and
• Simultaneously to boost the Routine Immunization (RI) infrastructure in the country

 It targeted children under 2 years of age and pregnant women for immunization.
o Though started with 8 VPDs, later on all the vaccines (against 12 Vaccine-Preventable Diseases) being provided in the routine immunization (RI) were provided during these rounds 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).
o Vaccination against Japanese Encephalitis and Haemophilus influenzae type B was provided in selected districts of the country.
 It was a nationwide initiative with a special focus on 201 high focus districts.
 It was carried out in 4 phases, each phase covering a selected districts in an area
o Each phase had 4 rounds of one week in each month to ‘catch-up’ the partially or unimmunized beneficiaries
o The pregnant women were administered the tetanus vaccine,
ORS packets and zinc tablets were distributed for use in the event of severe diarrhoea or dehydration and
o Vitamin A doses were also administered
 The vaccines given under the mission were to be entered in the MCP card and counted towards routine immunization
 Since the launch of Mission Indhradhanush, full immunisation coverage has increased by 5 per cent to 7 per cent.

Intensified Mission Indradhanush (IMI)
The MI target of achieving 90 percent full immunisation coverage (FIC) were preponed to be achieved by December 2018, instead of 2020. For the revised target, Intensified mission was launched on October 8, 2017
Under IMI, greater focus has been given on urban areas which was one of the gaps of Mission Indradhanush
Four consecutive immunization rounds were conducted for 7 days in 173 districts every month between October 2017 and January 2018. Intensified Mission Indradhanush has covered low performing areas in high priority districts and urban areas. Special attention was given to unserved/low coverage pockets in sub-centre and urban slums with migratory population.
It was carried out in 4 phases after
o enlisting the beneficiaries
o mobilizing the beneficiaries
o intensive publicity,
o Training of ASHAs, ANM and other staff, so as to immunize a maximum number.

Intensified Mission Indradhanush (IMI) 2.0
After the intensified mission, a coverage evaluation survey (IMI-CES) was done in 2018, which showed an impressive increase of 18.5% in full immunization coverage (FIC)
IMI 2.0 is planned for selected 271 districts where the immunization coverage was still low. The mission focuses on those left out from earlier immunisation drives, the dropouts, resistant families and those living in hard to access areas.

Intensified Mission Indradhanush 2.0 aims to achieve at least 90% pan-India immunisation coverage by 2022
The Intensified Mission Indradhanush 2.0 will target the districts which have immunisation coverage of 70% or below.
OR
• Polio surveillance (NPSP) and Vaccine Preventable Disease (VPD) surveillance data showing
o measles incidence more than 10 per lakh population or
o diphtheria & pertussis incidence more than 1 per lakh

The Intensified Mission Indradhanush immunization drive will consist of four rounds of immunization. The program will be completed by March 2020.
Several ministries, including the Ministry of Women and Child Development, Panchayati Raj, Ministry of Urban Development, Ministry of Youth Affairs and others have come together to make the mission a resounding success.
The salient features of IMI 2.0 are:
 Conduction of four rounds of immunization activity over 7 working days excluding the Routine immunization days, Sundays and holidays. (So that routine immunization is not shown as a part of IMI 2.0).
 The immunization session would have flexible timing and mobile sessions through coordination with departments in addition to health department
 Enhanced focus on left outs, dropouts, and resistant families and hard to reach areas like urban slums, underserved population and tribal areas.
 Inter-ministerial and inter-departmental coordination.
 Simultaneous strengthening of the routine immunization system

The gains achieved through Intensified Missions Indradhanush, need to be sustained through strengthening the immunization systems.

References:
GOI, 2020. Mission Indradhanush, National Health Portal, MoHFW. Available at: https://www.nhp.gov.in/mission-indradhanush1_pg, accessed on 17th Jan 2020
GOI, 2017. INTENSIFIED MISSION INDRADHANUSH Operational Guidelines. MoHFW, GOI
GOI, 2019. Operational Guidelines, STRENGTHENING IMMUNIZATION SYSTEMS TO REACH EVERY CHILD. MoHFW, GOI