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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The reference material is for personal use of the Members in the discharge of their Parliamentary duties, and is not for publication.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.
2
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.
3
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.
4
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
5
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.
6
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
Question No. 543) dated: 28.04.2015
Annexure I
List of 201 High Focus Districts
S No State S No District S No District
1 East Godavari 2 Guntur
1 Andhra Pradesh 3 Krishna 4 Kurnool
5 Visakhapatnam
1 Changlong 2 East Kameng
2 Arunachal Pradesh 3 East Siang 4 Lohit
5 Upper Siang
1 Bongaigaon 2 Darrang
3 Assam 3 Dhubri 4 Goalpara
5 Hailakandi 6
Karimganj
7 Kokrajhar 8 Nagaon
1 Araria 2 Begusarai
3 Champaran East 4 Champaran West
5 Darbhanga 6 Gaya
4 Bihar 7 Jamui 8 Katihar
9 Kishanganj 10 Muzaffarpur
11 Patna 12 Saharsa
13 Samastipur 14 Sitamarhi
1 Balodabazaar Bhatapara 2 Bijaapur
5 Chhattisgarh 3 Bilaspur 4 Dantewada
5 Jashpur 6
Korba
7 Raipur 8 Sarguja
6 Delhi 1 North-East 2 North-West
1 Ahmedabad 2 Ahmedabad Corpn.
3 Banaskantha 4 Dahod
7 Gujarat 5 Dangs 6 Kutch
7 Panchmahals 8 Sabarkantha
9 Valsad
1 Faridabad 2 Gurgaon
8 Haryana 3 Mewat 4 Palwal
5 Panipat
1 Doda 2 Kishtwar
9 Jammu & Kashmir 3 Punch 4 Rajauri
5 Ramban
1 Deoghar 2 Dhanbad
10 Jharkhand 3 Giridih 4 Godda
5 Pakur 6 Sahibganj
1 Bangalore (U) 2 Bellary
11 Karnataka 3 Gulbarga 4 Koppal
5 Raichur 6 Yadgir
12 Kerala 1 Kasaragod 2 Malappuram
13 Madhya Pradesh 1 Alirajpur 2 Anuppur
3 Chhatarpur 4
Damoh
5 Jhabua 6 Mandla
7 Panna 8 Raisen
9 Rewa 10 Sagar
11 Satana 12 Shadol
13 Tikamgarh 14 Umariya
15 Vidisha
1 Beed 2 Dhule
14 Maharashtra 3 Hingoli 4 Jalgaon
5
Nanded 6 Nasik
7 Thane
15 Manipur 1 Churachandpur 2 Senapati
3
Tamenglong 4 Ukhrul
16 Meghalaya 1 East Khasi Hill 2 West Garo Hills
3
West Khasi Hill
17 Mizoram 1 Lawngtlai 2 Lunglei
3
Mamit 4 Saiha
1 Dimapur 2 Kiphire
18 Nagaland 3 Kohima 4 Mon
5 Tuensang 6 Wokha
1 Boudh 2 Gajapati
3 Ganjam 4 Kandhamal
19 Odisha 5 Khurda 6 Koraput
7 Malakangiri 8 Nabarangpur
9 Nuapada 10 Rayagada
20 Pondicherry 1 Yanam
21 Punjab 1 Gurdaspur 2 Ludhiana
3
Muktsar
1 Alwar 2 Barmer
3 Bundi 4 Dhaulpur
22 Rajasthan 5 Jaipur 6 Jodhpur
7 Karauli 8 Sawai Madhopur
9 Tonk
1 Coimbatore 2 Kancheepuram
23 Tamil Nadu 3 Madurai 4 Thiruvallur
5
Tiruchirapalli 6 Tirunelveli
7 Vellore 8 Virudhunager
24 Telangana 1 Adilabad 2 Mahbubnagar
25 Tripura 1 Dhalai 2 Tripura North
3
Tripura West
1 Agra 2 Aligarh
3 Allahabad 4 Amethi
5 Amroha 6 Auraiya
26 Uttar Pradesh 7 Azamgarh 8 Badaun
9
Badohi 10 Bahraich
11 Balrampur 12 Banda
13 Barabanki 14 Bareilly
15 Bulandshahar 16 Chitrakoot
17 Etah 18 Etawah
19 Farrukhabad 20 Ferozabad 21 Ghaziabad 22 Gonda
23 Hapur 24 Hardoi 25 Hathras 26 Kannauj 27 Kasganj 28 Kaushambi 29 Kheri 30 Mainpuri
31 Mathura 32 Meerut 33 Mirzapur 34 Moradabad 35 Muzaffarnagar 36 Pilibhit 37 Sambhal 38 Shahjahanpur 39 Shamli 40 Siddharthnagar
41 Sitapur 42 Sonbhadra 43 Srawasti 44 Sultanpur
27 Uttarakhand 1 Hardwar
1 24-Parganas North 2 24-Parganas South
28 West Bengal 3 Bardhaman 4 Birbhum
5 Murshidabad 6 Uttar Dinajpur
*Source: Lok Sabha Starred Question No.82 dated 4 December 2015.
ANNEXURE II
Mission Indradhanush Coverage Report (Phase-1 & 2)
*Source: Rajya Sabha Unstarred Question No.990 26th
July, 2016
Sl.No. Indicator Phase I Phase II Total
1 No. of sessions held 9.7 11.6 21.3
2 No. of antigen administered 191.9 174.9 366.8
3 No. of pregnant women immunized 21.1 17 38.1
4 No. of pregnant women completely
immunized 11.2 9 20.2
5 No. of children immunized 76.8 71.6 148.4
6 No. of children fully immunized 20.2 18.5 38.7
7 No. of children vaccinated for the first time N/A 9.3 9.3
8 No. of Vit A doses administered 20.5 21.2 41.7
9 No. of ORS packets distributed 17.1 13.9 31
10 No. of zinc tablets distributed 57.3 45.2 102.5
Annexure III
State/UT-wise Details of number of districts and children covered in Mission Indradhanush
S. No. States/UTs
Number of Total no. of children Total no. of children
districts immunized fully immunized
1 A&N Islands 2 67 0
2 Andhra Pradesh 13 141,748 39,004
3 Arunachal 16 32,602 5,559
4 Assam 26 290,838 75,497
5 Bihar 20 946,258 230,128
6 Chandigarh 1 4,530 868
7 Chhattisgarh 19 411,986 126,812
8 D&N Haveli 1 458 113
9 Daman & Diu 1 629 118
10 Delhi 8 930,084 264,299
11 Goa 1 826 220
12 Gujarat 23 454,804 146,975
13 Haryana 16 916,954 206,628
14 Himachal 6 11,340 4,089
15 Jammu & 11 84,016 23,107
16 Jharkhand 13 639,503 180,467
17 Karnataka 17 587,667 143,303
18 Kerala 9 90,808 19,339
19 Madhya Pradesh 38 1,603,196 445,179
20 Maharashtra 28 284,972 73,890
21 Manipur 8 33,383 8,041
22 Meghalaya 7 71,064 12,293
23 Mizoram 7 9,405 1,378
24 Nagaland 11 26,640 4,663
25 Odisha 23 341,489 66,733
26 Puducherry 3 598 210
27 Punjab 14 149,885 41,663
28 Rajasthan 24 1,350,726 390,895
29 Sikkim 2 65 14
30 Tamil Nadu 26 588,009 196,725
31 Telegana 9 160,962 56,195
32 Tripura 8 10,880 2,225
33 Uttar Pradesh 66 8,643,420 2,165,396
34 Uttarakhand 5 195,750 43,775
35 West Bengal 15 422,214 92,776
Total 497 19,553,253 5,106,441
* Source: Lok Sabha Starred Question No. 92 22nd
July, 2016