REFERENCE NOTE No.47/RN/Ref./November/2016 For the use of Members of Parliament NOT FOR PUBLICATION 1 MISSION INDRADHANUSH Prepared by Smt. Sunanda Das Mohanty, Additional Director (23035036) and Shri Rajkumar Patton, Junior Library Assistant of Lok Sabha Secretariat under the supervision of Smt. Kalpana Sharma, Joint Secretary. The reference material is for personal use of the Members in the discharge of their Parliamentary duties, and is not for publication. This Service is not to be quoted as the source of information as it is based on the sources indicated at the end/in the text. This Service does not accept any responsibility for the accuracy or veracity of the information or views contained in the note/collection. MEMBERS' REFERENCE SERVICE LARRDIS LOK SABHA SECRETARIAT, NEW DELHI
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REFERENCE NOTE
No.47/RN/Ref./November/2016
For the use of Members of Parliament NOT FOR PUBLICATION1
MISSION INDRADHANUSH
Prepared by Smt. Sunanda Das Mohanty, Additional Director (23035036) and Shri Rajkumar Patton,
Junior Library Assistant of Lok Sabha Secretariat under the supervision of Smt. Kalpana Sharma, Joint
Secretary.
The reference material is for personal use of the Members in the discharge of their Parliamentary duties, and is not for publication. This Service is not to be quoted as the source of information as it is based on the sources indicated at the end/in the text. This Service does not accept any responsibility for the accuracy or veracity of the information or views contained in the note/collection.
MEMBERS' REFERENCE SERVICE
LARRDIS
LOK SABHA SECRETARIAT, NEW DELHI
contained in the note/collection.MISSION INDRADHANUSH
INTRODUCTION
The objective of Mission Indradhanush is to ensure high coverage of children and
pregnant women with all available vaccines throughout the country, with emphasis
on the identified 201 high focus districts. It was launched in December 2014 as a
special drive to vaccinate all unvaccinated and partially vaccinated children under
Universal Immunization Programme (UIP).1 The mission focuses on interventions
to improve full immunization coverage in India from 65% in 2014 to at least 90%
children in the next five years to be done through special catch-up drives.
OBJECTIVES
With the launch of Mission Indradhanush, the Government aims at
Generating high demand for immunization services by addressing
communication challenges;
Enhancing political, administrative and financial commitment through
advocacy with key stakeholders; and
Ensuring that the partially immunized and unimmunized children are fully
immunized as per national immunization schedule.
1 Universal Immunisation Programme (U.I.P.) is one of the largest in the world in terms of quantities of vaccine used, the number of beneficiaries, the number of Immunisation session organised, the geographical spread and diversity of areas covered. Universal Immunisation Programme (UIP) was launched in 1985 in a phased manner. The measles vaccine was added in 1985 and in 1990 Vit A supplementation was added to the program.
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AREAS UNDER FOCUS
Under Mission Indradhanush, in Phase I2, the Government had identified 201 high
focus districts across the country that have nearly 50% of all unvaccinated or
partially vaccinated children. Four States of Bihar, Madhya Pradesh, Rajasthan and
Uttar Pradesh account for 82 of the 201 high focus districts and nearly 25% of the
unvaccinated or partially vaccinated children of India. In Phase II3 of Mission
Indradhanush 352 districts have been selected including 279 mid priority districts,
33 from the North East States and 40 districts which commenced from 7 October
2015 for a week. In Phase-III of Mission Indradhanush 216 select districts in 27
States/Uts conducted for seven days in each between April and July 20164.
Key areas reached through Mission Indradhanush:
Areas with vacant sub-centers: No Auxiliary Nurse Midwife (ANM) posted
for more than three months.
Villages/areas with three or more consecutive missed Routine Immunization
(RI) sessions:
ANMs on long leave or other similar reasons.
High Risk Areas (HRAs)5 identified by the polio eradication programme.
Other migrant settlements (fisherman villages, riverine areas with shifting
populations)
2 A list of 201 high focus districts under Phase I has been provided in Annexure I. 3 Coverage Report (Phase-1 & 2) shows in Annexure II
4 The States/UTs-wise details of the number of districts covered are given in Annexure III
5 These include populations living in areas such as Urban slums with migration, Nomadic sites, Brick kilns
Construction sites.
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Underserved and hard to reach populations (forested and tribal populations,
hilly areas etc.).
Areas with low RI coverage, identified through measles outbreaks, cases of
diphtheria and neonatal tetanus in last two years.
Small villages, hamlets, dhanis, purbas, basas (field huts), etc., clubbed with
another village for RI sessions and not having independent RI sessions.
HIGHLIGHTS
Mission Indradhanush is a nationwide drive, with focus on 201 identified high focus
districts on Phase I 352 districts have been selected including 279 mid priority districts, 33 from the
North East States and 40 districts in the Phase II of Mission Indradhanush done on
7 October 2015. 216 select districts in 27 States/UTs conducted for seven days in each between April
and July 2016 carried out in Phase-III.
STRATEGY
The broad strategy6, based on evidence and best practices, includes four basic
elements-
Meticulous planning of campaigns/sessions at all levels: Ensure revision of
micro plans 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
6 The Ministry of Health and Family Welfare is working in collaboration with other Ministries, ongoing programmes
and international partners to promote a coordinated and synergistic approach to improve routine immunization
coverage in the country.
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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.
ACHIEVEMENT OF GOALS
PHASE I
The first round of the first phase started from 7 April 2015-World health Dayin
201 high focus districts in 28 States and carried for more than a week. This was
followed by three rounds of more than a week in the months of April, May, June
and July 2015, starting from 7th of each month. The 201 high focus districts
account for nearly 50% of all unvaccinated or partially vaccinated children in the
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country. Of these, 82 districts account for nearly 25% of all unvaccinated or
partially vaccinated children of the country. Within the districts, the Mission
focused on 4, 00,000 high risk settlements identified as pockets with low coverage
due to geographic, demographic, ethnic and other operational challenges.
PHASE II
In the second phase of Mission Indradhanush, 352 districts have been selected
including 279 mid priority districts, 33 from the North East States and 40 districts
from phase one where large number of missed out children were detected. The
second phase commenced from 7 October 2015 for a week and followed by
weeklong intensified immunization drives for three consecutive months, starting
from 7 November and 7 December 2015 and 7 January 2016.
PHASE III
Phase 3 of Mission Indradhanush was carried out in 216 select districts in 27
States/UTs. 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.
ACHIEVEMENTS UNDER MISSION INDRADHANUSH
Till June 2016, the Mission has covered 195.5 lakh children and 51.1 lakh pregnant
women from various States/UTs.
The Mission has covered 497 districts across 35 States/UTs.
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CURRENT STATUS
Mission Indradhanush aims to increase full immunization coverage in India to
atleast 90% children by 2020. Till June 2016, the Mission has covered 195.5 lakh
children and 51.1 lakh pregnant women. It has covered 497 districts across 35
States/UTs. The States/UTs-wise details of the number of districts covered are
given in Annexure III. As part of the Adverse Event Following Immunization
(AEFI) surveillance and monitoring system, the Ministry of Health and Family
Welfare constantly monitors the programme.
SOURCES CONSULTED
1. Mission Indradhanush : Aiming to Expand Full Immunization Coverage to
more than 90%, PIB dated 23.10.2015
2. Union Health Minister launches Phase 2 of Mission Indradhanush in 352
Districts targeting Full Immunization, PIB dated 05.10.2015
3. Shri J P Nadda announces start of 3rd Phase of Mission Indradhanush from
7th April in 217 select districts in 27 States/UTs, PIB dated 04.04.2016
4. Mission Indradhanush, Lok Sabha (Starred Question No. 92) dated
22.07.2016
5. Achieving a New Milestone towards Expanding Full Immunization
Coverage in the Country to reduce Child Mortality, PIB dated 26.03.2016
6. Achievement of Goals under Mission Indradhanush, Rajya Sabha (Unstarred