Immunization Programme


Situational Analysis:
Immunization is an essential component of child health and it has led to a considerable decrease of immune preventable diseases in past. If immunization rates falls there is always the danger that some of these diseases could reappear.

The population of district Dehradun is 16,98,560 in 2011 (census 2011) 749,000 (Rural) 949,560 (Urban) and estimated population for the year 2012-13 will be 17,28,964 and children below the age of 12 month will be 30,948 (1.79 % of estimated population) and 1,99,868 (11.56% of estimated population) will be the under the age of six. Total fertility rate is 2.55 and Crude birth rate 17.9 per thousand. (AHS 2011)

Percent of fully immunized children is 68.7% in Dehradun (DLHS-III) Hence, it is important to improve full immunization coverage up to 100% during year 2012-13.

Objectives :

The overall goal is to increase immunization coverage rates. Based on review of past performance, assessment of critical bottlenecks and planned activities indicate below:

  • Immunization Coverage Targets

  • To improve Vaccine /Supply Logistics

  • To expand Cold Chain Reach and Improve Performance

  • Improve injection safety by introducing AD-syringes

  • Child health strategies proposed under RCH-II

  • Cold Storage Equipments Available with the District

District Profile :

Indicators

Current Situation

Source of Data

Total Population

17,28,964

Estimated for year  2012-13

Rural

762,407

Do

Urban

966,577

Do

Infant Mortality Rate (IMR)

37

AHS 2010-11

Crude Birth Rate (CBR)

17.9

AHS 2010-11

Infants / below one year

30,948

CBR x Estimated population for 2012-13

Blocks

6

DPRO 2011

Gram Panchayat

403

DPRO 2011

Revenue villages

714 (735)

DPRO 2011

Villages

1165

E-mamta Data Entry

Towns / Urban Areas

11

Census 2011

No. of CHCs

7

CMO Office, 2011

No. of PHCs

17 (23)

CMO Office, 2011

No. of Sub Centre

168

CMO Office 2011

Full immunization coverage (12 to 23 months children)

68.7%

DLHS III

Dropout BCG to Measles

10.3%

DLHS III

 

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Public Health Infrastructure :
 

Building

Sanctioned

No. of Functioning

With Functional Cold Chain Equipment

Proposed Expansion (No. Of Facilities)

Sub-centre

168

161

Nil

-

SAD

24

24

Nil

-

APHC

23

17

15

2

PHC

1

1

1

-

CHC/FRUs

7

7

7

-

DH /SDH

6

6

6

-


Strategy :
 
The universal immunization programme was launched to protect all infants (0-12 months) against six major but preventable diseases namely Tuberculosis, Diphtheria, Pertussis, Tetanus, Poliomyelitis and measles. The vaccination against Hepatitis B has also started from November 2011 in the district. In Dehradun 68.7% (DLHS-III) of the children aged 12-23 months have received all the doses of the prescribed vaccines or, in other words, are fully immunized. The dropout rate from BCG to Measles users is 10.3% (DLHS-III).
 
Activities :
  • Mother and Child Tracking System Software has already functioning and will identify children not immunized at all and dropouts. ASHA support services will be utilized to mobilize such children.

  • ANMs prepare and provide immunization cards to mothers and retain one copy with them. However, children not turning up for the second dose are neither monitored nor followed up. Monitoring systems will be strengthened to drastically reduce drop out rates and again MCTS will also help in this regard.

  • All PHCs will have vaccines depots and PHCs not having sufficient Deep Freezer, ILR, Cold box, Vaccine Carrier & Ice Packs will be supplied with them, through the GoI or State Govt. Supply.

  • Cold chain system will be streamlined from District to CHC/PHC level, by provision of fridges, deep-freezers and regular visits by vaccine vans to ensure adequate supply of vaccines at all levels.

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