Mission Indradhanush

1. Presented by: Dr. Aneesh K Mathew
Mentor: Dr. Shubham Arora
Mission Indradhanush

2. Background
• India’s immunization programme, launched in 1985, is one of the largest health
programmes of its kind in the world, catering to a birth cohort of 2.7 crore (27
million) children annually.
• The programme provides vaccination against eight life‐threatening diseases
(diphtheria, whooping cough, Haemophilus influenzae type B (Hib) causing
pneumonia and meningitis, tetanus, polio, tuberculosis, measles and hepatitis
B) in the entire country.
• In spite of all positive changes, there are ongoing challenges and shortcomings
in the national immunization programme. Despite being operational for the past
more than 30 years, only 65% of children in India receive all vaccines
duringtheir first year of life, thus contributing to continued high burden of
morbidity and mortality in children from vaccine preventable diseases (VPDs).

3. • Based on full immunization estimated from routine immunization monitoring and
Mission Indradhanush data, it is estimated that annually, more than 70 lakh (7
million) children in the country do not receive all vaccines that are available under
the UIP.
• The Ministry of Health and Family Welfare, Government of India (MoHFW‐GoI) is
committed to rapidly address the inequity in immunization coverage and
consolidate the health systems strengthening efforts.
• To strengthen routine immunization planning and delivery mechanism, the
MoHFW, GoI, launched its flagship programme “Mission Indradhanush” in
December 2014 to achieve more than 90% full immunization coverage in the
country.

4. Mission Indradhanush
• Mission Indradhanush launched by MoHFW, GoI in December 2014.
• Objective: Increase child immunization coverage from 65% (2014) to at least
90% by 2020.
• Special catch-up drives implemented to reach unvaccinated and partially
vaccinated children.
• Identified 216 high-focus districts, with Uttar Pradesh and Bihar contributing
38% and 10% of total missed children.
• Maharashtra, Rajasthan, Gujarat, Madhya Pradesh, and Assam, with 61 high-
focus districts, account for 30% of total missed children.

5. Vaccines Given

6. Strategy
• A total of four rounds will be conducted under each phase of Mission
Indradhanush. Upon completion of each phase, districts must ensure that these
sessions are included in regular routine immunization plans.
• Mission Indradhanush is a special immunization drive spread over 7 days.
These 7 days do not include the routine immunization days planned in that
week. Such routine immunization sessions should be held as already planned.
• Targeted beneficiaries will be pregnant women and children up to 2 years of
age; however, children up to 5 years need to be focussed upon to improve
booster dose coverage and if required school campaigns may be conducted.

7. • The priority for conducting Mission Indradhanush sessions should be areas
with weak routine immunization coverage in the district. This will require
deployment of ANM to areas outside of her own sub‐centre and block.
• All ANMs should be engaged for 7 working days over and above the regular
routine immunization days excluding Sundays and holidays for conducting
session during Mission Indradhanush. Sub centres having delivery facilities
need to plan ANM deployment accordingly.
• Head count survey is a mandatory activity to be conducted through house to
house visits before the first round of Mission Indradhanush. The head count
survey will be utilized for preparation of name‐based due lists for tracking and
mobilization of beneficiaries.

9. Steps
Microplanning
• Microplanning at the district and block level was essential for stopping polio transmission
in India, with vaccinators tracking activities and district task forces identifying
unvaccinated children.
• High-risk areas posed challenges for immunization due to factors like geography, poverty,
migration, education, language diversity, cultural differences, and government distrust.
• Mission Indradhanush targeted communities with limited access to Routine Immunization
(RI) services, focusing on increasing coverage and equitable access to immunization.
• The initiative aimed to integrate additional immunization sites into the government’s RI
microplans, enhancing the reach of routine immunization services.
• Support from the WHO & UNICEF polio network was instrumental in ensuring the
inclusion of these additional sites into the RI microplans for comprehensive service
delivery.

10. Steps
Head count survey and due list preparation
• Head count process to develop session specific due‐list based on head count
should be initiated well in advance, and pre‐round validation of head survey
should be done for improving coverage. There is a need of regular orientation
and supervision of frontline workers for doing head count survey, due list
updation and mobilization of children.

11. Steps
Capacity building of frontline workers
• Frontline workers were trained prior to Mission Indradhanush with brief
orientation during subsequent campaign. These trainings will improve
technical and communication skills of frontline workers.
• Reorientation of frontline workers on IPC skills should also be conducted on a
regular basis.

12. Supervision Of Activities
Steps
• Strengthening Supervision: The STFI and DTFI are crucial, and there’s a need
for robust supervision at all levels, with national and state officials overseeing
Mission Indradhanush rounds to ensure improved quality of work.
• Leadership and Ownership: Active review by high-level officials like MD-NHM,
Secretary, or PS is vital for strong ownership and effective implementation of
Mission Indradhanush at the state, district, and block levels.
• Effective Communication: Utilizing technology such as video conferencing and
mobile SMS for feedback has proven to be an effective method of
communication and monitoring within the program

13. Vaccine and Cold Chain Management
Steps
• Urgent attention is needed to improve vaccine upkeep to ensure conditioning
of ice packs, maintenance of distribution register, implementation of open vials
policy and its records, and adherence to AVD plan.
• Focus on cold chain management training.

14. Social Mobilization
Steps
• Social Mobilization & Information, Education and Communication Materials:
Initial phases faced challenges with social mobilization due to unprepared IEC
materials, but national oversight led to improvements.
• Community Awareness: Information, Education and Communication activities
are vital for community awareness on immunization; thus, involvement from PRI
members, ration dealers, and local influencers is essential.
• Standardization and Engagement: There’s a need for standardizing information,
education and communication materials and enhancing community engagement
through mothers’ meetings, Nukkad Natak, and community videos.

15. Timing
Steps
• Special catch up rounds should be planned in a way to ensure better coverage
of migratory populations and HRG sites.
• In Mission Indradhanush, day should be fixed and not the date. We should
plan from a day in the week rather than date in the month.

16. Financial Issues
Steps
• Communication of financial guidelines for IEC activities should be shared well
in advance. The financial guidelines have to be released well on time for
replication.
• Ensure timely payments of incentives to motivate ASHAs/mobilizers.

17. Data Mnagement
Steps
• Newly designed tally sheet will help in reporting as well as tracking
beneficiaries during all rounds.
• Ensure completeness and quality of data transmission an issue.

19. Intensified Mission Indradhanush 5.0
• Special focus on improvement of Measles and Rubella vaccination coverage,
will conclude all three rounds on 14 October 2023.
• IMI 5.0 is being conducted across all the districts in the country and includes
children up to 5 years of age.
• Over 34 lakh children and 6 lakh pregnant women were administered vaccine
doses during the first 2 rounds of IMI 5.0 campaign across the country.

20. • IMI 5.0 campaign aims to enhance immunization coverage for all vaccines
provided under the Universal Immunization Programme (UIP) as per the
National Immunization Schedule (NIS).
• Special focus is on improvement of Measles and Rubella vaccination coverage
with the aim of Measles & Rubella elimination by 2023 and use of U-WIN digital
platform for Routine Immunization in pilot mode across all districts in the
country.
• IMI 5.0 was conducted in three rounds i.e., 7 -12 August, 11-16 September, and
9-14 October 2023 i.e., 6 days in a month with the inclusion of a Routine
Immunization Day. All States/UTs except Bihar, Chhattisgarh, Odisha and
Punjab would conclude all the three rounds of IMI 5.0 campaign by 14th
October 2023.

21. Thank You