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Poor coverage Of Measles vaccination And later doses of basic vaccines such as polio, diphtheria, pertussis, and tetanus (DPT) are dragging the proportion of fully immunized children. This nonetheless indicates a poor mechanism for tracking pre-registered children in the vaccination system A Mother and Child Tracking System (MCTS) has been in force since 2009.
The recently released NSO report on health for 2017–18 shows that coverage for measles vaccines dropped to only 67%, from more than 94% coverage for the BCG vaccine given at birth, 9–12. Given between months, the worst coverage among all basic vaccines required to count a child as fully vaccinated.
Similarly, from the 94% coverage of the oral polio vaccine (OPV) birth dose, the coverage subsequently reached 80% from the third dose with each dose. DPT vaccine coverage went from 91% coverage for the first shot at 78% in six weeks to a third shot at 14 weeks. This meant that the proportion of fully immunized children in India remained at around 60% in 2017-18, which was not very different from the 2015-16 National Family Health Survey, which found it to be around 62%.
While this was a major improvement from only 44% in 2005-06, the budget allocated for vaccination has also been allocated from around Rs 473 crore in 2005-06 to around Rs 2,000 crore. Universal vaccination program (UIP) excluding shared costs such as staff costs, establishments etc.
India’s vaccination coverage has been low relative to its neighbors. 99% of children in Sri Lanka are fully immunized. According to the World Health Report 2020, coverage for DPT-3 was 98% in Bangladesh and 93% in measles 2018. In Nepal, the coverage of the third pill of DPT was 91% and measles was 69%. .
A child is considered completely immune if he or she is given BCG, three doses of OPV, three shots of the DPT vaccine, and measles vaccine. All these, if delivered on time, within the first year of the child, with measles being the last. There are booster shots and vaccines for other diseases, but they do not count for considering a child to be fully vaccinated.
Mission Indradhanush of the Central Government launched in December 2014, setting a target to ensure Full vaccination For children up to two years old and pregnant women. The government identified 201 high-focus districts in 28 states with the highest number of partially immunized and non-immunized children. The government said the increase in full immunization coverage was just one percent per year earlier, but increased to 6.7 percent per year through the first two phases of Mission Indradhanush.
Dr. of the Department of Community Medicine at PGIMER, Chandigarh. A 2017 district-level study on regular vaccinations in Haryana led by Shankar Prinja said the challenge of reducing dropouts and enrollment without any vaccinations became ever more challenging as the country added 12.5 million partially each year A pool of protected children. According to the NSO survey, 3% of children received no vaccination. Given that the survey was looking at children under six, even 3% would amount to millions of children. This ratio was as high as 7-8% in some states.
“Initially, Mission Indradhanush closed very well with an 18% increase in coverage in 190 districts. But instead of focusing on the identified backward districts, states have insisted on doing it in all districts and reduced its impact over time. As soon as the fatigue goes away, the mission becomes routine and this means that the children who were to be covered under the regular immunization, joined the mission, rather than the children of the mission who missed the regular immunization, ”Dr. Anish Sinha told Indian Institute of Public Health In Gandhinagar stating that this was happening because the regular vaccination system was not sufficiently strengthened.
“The weakest link in the regular system is health workers who are poorly paid. A very motivated Asha gets Rs 4,000 every month, which includes all incentives. It is almost impossible to find anyone for that salary in urban areas where domestic help also almost doubles. Dr. Sinha said that even in rural areas it is very less.
Mobile-based applications launched to track mother and child tracking systems and various other technology platforms and data have failed. Public health researchers point out that any technology is only as good as the people who operate it and the data it enters and thus it gets bored with the expectation of all health workers entering the data.
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