Overview of

Routine Immunization Program in ASSAM

 Immunization schedule
Age Immunization Schedule
At birth BCG, OPV (0 dose), hepatitis B (birth dose)

6 weeks (1 ½ months ) OPV-1, pentavalent-1

10 weeks (2 ½ months ) OPV-2, pentavalent -2
14 weeks (3 ½ months )
OPV-3, pentavalent -3
& IPV
9 months Measles first dose, JE- 1, Vit. A

16–24 months DPT-booster first dose, measles second dose, OPV

booster dose , JE second dose

5–6 years DPT-booster second dose

10 years TT first booster dose
16 years TT second booster dose
Vaccine Preventable Diseases

Name of Vaccine Prevention of Diseases

Vaccines currently in use in UIP
BCG Tuberculosis
Hep. B Hepatitis – B
Pentavalent Diphtheria, Pertussis, Tetanus, Hepatitis B, H. influenzae B
meningitis and Pneumonia
Oral Polio Vaccine (OPV) Polio
Measles vaccine Measles
DPT Diphtheria, Pertussis (whooping Cough) and Tetanus
JE Japanese Encephalitis

TT Tetanus (for Adult & PW)

Newer vaccines introduced into the UIP

IPV (Inactivated Polio vaccine) Polio

National Immunization Schedule in Detail (UIP)

Vaccine When to give Max age Dose Diluent Route Site

For Pregnant Women

TT-1 Early in give as early 0.5 ml NO Intramus Upper Arm

pregnancy as possible cular
in
pregnancy
TT-2 4 weeks after 0.5 ml NO Intramus Upper Arm
TT-1 cular
TT- Booster If received TT 0.5 ml NO Intramus Upper Arm
doses in a cular
pregnancy
within the
last 3 yrs.

Give TT 2 or Booster before 36 weeks of pregnancy; however give even if more than 36 weeks
have passed; give TT even in labour if previously not received TT
 Background information
For the year 2016-17
32 million Total Population
668181 Targeted Infant
28105 No. of session/Month
177 No. of BPHC
4399 No. of Sub-Centre (Rented 1957)
816 No. of Cold Chain Points
10188 No. of ANMs
30617 No. of ASHAs
1746 No. of Link Worker
52561 No. of AWWs
Key Issues :
Human Resource :
• Post of DIO to be created : 6 numbers.
(Hailakndi/Dhemaji/Bongaigaon/Tinsukia/Morigaon/Dima Hasao)

In addition 2 posts of DIO vacant : Kokrajhar / Karimganj .

• Post of Addl. CM &HO(FW) to be created : 4

numbers.
(Chirang/ Baksa/Udalguri/Kamrup(M)

In addition number of Add.CM&HO post vacant : 11 numbers .

(Barpeta/Bong./Goal/Dhubri/Darrang/Lakhim/K-Anglng/Karim/Haila/Dhemaji)
Key Issues Continued …..

Programme :
• One time stand by Road permit required for GOI supply
item (free of cost) . : Vaccine ,Syringes and Cold-Chain
item.
(Proposal submitted to Tax Department)
• Vaccine Delivery Van required for Kamrup (M) and Jorhat.
• ILR to be replaced : 314 nos. (from GOI)
• DF to b replaced : 315 nos. (from GOI)
• Dry storage required : State level – 2 Nos. (for FW and UIP)
: District Level – 27 nos. ( for UIP)
 109.50
107.84
107.45
104.98
103.28
102.24
100.12
94.09
District wise Full Imm. Coverage (2015-16)

93.45
90.52
90.14
87.96

Assam
87.36
86.73

Full Imm
83.15
82.47
81.52
79.91
79.88
78.92
78.45
78.29
77.92
77.85
76.80
74.57
70.59

0.00
80.00

60.00

40.00

20.00
120.00

100.00
 100.00
120.00
140.00
160.00

40.00
60.00
80.00

20.00

0.00
50.00
62.52
64.56
66.47
68.07
70.05
70.2
70.86
74.42
74.78
75.95
77.91
79.17
79.98
80.57
85.44
86.89
88.69
90.23
90.99
92.71
95.58
101.58
114.11
115.51
121.46
District Wise Fully Imm. Coverage for the Year 2016-17 (April’16 to June’16)

133.55
0
20
40
80
100
120

60
68
72
76
77
77
80
81
81
82
82
83
83
83
86
89
90
90
92
93
96
98
98
99
103
106
107
111
 100.00
120.00

20.00
40.00
60.00
80.00

0.00
75.08
75.44
78.31
78.82
78.91
80.62
81.74
82.20
82.64
82.66
83.22
85.16
86.21
87.80
88.09
90.73
92.20
93.81
95.19
98.57
99.05
99.08
100.28
104.33
107.22
109.47
District Wise Measles Performance for the Year 2015-16

110.62
 100.00
120.00
140.00
160.00

20.00
40.00
60.00
80.00

0.00
52.57

62.01

66.80

67.80

68.35

70.42

70.44

70.56

70.70

73.12

74.37

76.03

78.30

81.40

83.42

85.44
for the Year 2016-17

85.63

87.17

90.62

91.02

91.69

92.71

96.72

114.19
District Wise Measles Performance from April’2016 to June’2016

116.62

122.33

139.34
 100.00
120.00
140.00

20.00
40.00
60.00
80.00

0.00
72.27
74.64
76.18
78.55
79.66
81.00
82.70
85.18
88.70
88.79
89.67
89.91
90.23
91.90
92.26
93.89
94.68
95.17
97.50
101.35
102.94
104.14
106.94
District wise BCG Coverage (2015-16)

114.05
121.95
123.50
125.01
 100.00
120.00
160.00
180.00
200.00

40.00
60.00
80.00
140.00

20.00

0.00
60.74

61.42

64.98

66.41

71.17

71.17

74.73

77.55

78.56

78.60

79.72

83.02

83.64

86.47

87.27
June’2016

88.09

88.11

96.08
for the Year 2016-17

96.69

97.20

103.79

108.11

111.40

119.66
District Wise BCG Performance from April’2016 to

120.86

153.88

174.85
 20.00
40.00
60.00
80.00
100.00
120.00

0.00
74.88

75.95

76.34

76.41

76.45

77.81

78.50

80.70

81.39

82.00

82.21

83.57

84.40

85.43

85.96

88.33

88.97

91.84
for the Year 2015-16

94.96

96.37

97.41

99.89
District Wise OPV-3Performance from

102.48

105.46

105.95

108.17

109.88
 120.00
140.00
160.00

20.00
40.00
60.00
80.00
100.00

0.00
55.03
67.49
69.99
73.94
74.36
77.51
78.24
79.21
80.28
82.06
84.87
87.77
89.94
91.28
91.77
94.82
96.56
99.35
99.72
99.91
100.73
District Wise OPV-3Performance from

106.85
for the Year 2016-17 (April’16 to June’16)

111.01
112.67
117.71
128.81
141.75
 100.00
120.00

20.00
40.00
60.00
80.00

0.00
59.73
61.25
66.08
68.57
69.20
69.69
71.15
72.02
72.42
72.75
73.35
75.58
75.73
76.09
76.63
78.52
79.03
79.22
80.26
84.10
85.28
88.62
89.97
90.30
District Wise Penta-3 for the Year 2015-16

91.46
93.13
100.49
 100.00
120.00
140.00
160.00

20.00
40.00
60.00
80.00

0.00
31.03

59.10

72.33

73.47

74.45

77.27

79.06

79.58

79.97

81.64

82.70

89.75

90.28

94.25

95.19

97.07
for the Year 2016-17

100.33

100.33

100.98

102.53

104.67

107.45

111.96

115.11
District Wise Penta-3 Performance from April’2016 to June’2016

123.79

134.96

136.22
 108.65
101.40
99.74
94.52
JE 1st Dose in RI for the Year2015-16

85.99
85.20
84.20
82.33
80.67
80.09
77.80
77.73
77.38
77.28
76.94
75.32
72.63
53.46
52.50
49.50
45.74
44.15
42.88
40.08
37.79
13.21
1.63

0.00
40.00
80.00

60.00

20.00
120.00

100.00
 100.00

20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00

10.00

0.00
29.28
29.96
33.44
36.44
42.26
45.85
46.64
47.18
53.37
56.01
57.96
58.73
63.21
67.12
70.11
74.43
77.05
77.35
78.50
79.46
79.52
79.77
82.15
82.68
District Wise JE-1st Dose in RI, April’16 to June’16

86.04
90.40
90.50
 110.55
92.28
85.27
80.55
JE 2nd Dose in RI for the Year2015-16

79.79
78.83
78.74
77.12
75.49
74.15
72.68
71.43
71.32
71.07
69.33
69.12
36.86
35.77
34.98
33.49
30.32
24.29
21.18
17.28
12.66
6.58
1.17

0.00
80.00

60.00

40.00

20.00
120.00

100.00
 100.00

20.00
30.00
40.00
50.00
60.00
80.00
90.00

10.00
70.00

0.00
3.39

32.34

35.32

36.98

44.02

45.97

54.49

55.09

60.48

63.19

65.68

69.62

72.57

74.86

75.75

76.66

77.90

80.45

83.68

85.25

87.32

87.71
JE 2nd Dose in RI for the Year2016-17

89.36

89.55

89.80

94.47

94.74
-40.00
-30.00
-20.00
-10.00
10.00
20.00
30.00
40.00

0.00
-29.63 JORHAT
-21.10 LAKHIMPUR
-17.38 DARRANG
-16.39 UDALGURI

-6.83 DIBRUGARH
-6.03 BAKSA
-4.64 NALBARI
-2.90 DHEMAJI
-2.74 TINSUKIA
SONITPUR 2.53
KAMRUP (R) 4.62
GOLAGHAT 5.17
NAGAON 5.58
K -ANGLONG 6.39
SIVASAGAR 10.38
MORIGAON 10.88
HAILAKANDI 13.70
GOALPARA 18.65
KARIMGANJ 19.09
BONGAIGAON 19.36
DHUBRI 19.97
DROPOUT BCG to Measles

KAMRUP (M) 20.30

BARPETA 20.50
CACHAR 20.95
N.C. HILLS 21.54
KOKRAJHAR 23.44
CHIRANG 29.62
JE Vaccine Campaign (1-15 yrs)
Starting from 2006-07, we have completed Children vaccination campaign of age
group 1-15 yrs in all the 27 districts of Assam and vaccinated more that 87 lakhs of
children. For the age group 0-1 yrs and 1-2 yrs the Routine Vaccine is being carried out in
all the districts of Assam.
Adult JE vaccination Camping (15-65 yrs)

During 2013-14, we have completed Adult JE vacciantion Campaign of age group 15-
65 yrs in Lakhimpur, Dibrugarh, Sivasagar, Tinsukia, Jorhat, Dhemaji, Golaghat, Kamrup
(R), Sonapur Block of Kamrup (M) , And during 2015-16 Adult JE vaccination campaign
was implemented in Darrang , Nagaon, Sonitpur, Barpeta, Udalguri. In above 13 districts
about 64 lakhs Adult beneficiaries were vaccinated.
During current year 2016-17 it is proposed for Adult JE vaccination in cachar
(Case-9, Death-0), Morigaon (Case-9 , Death-2), Nalbari (Case-10, Death-5), Bongaigaon
(Case-5, Death-1) and Block wise target beneficiaries (Total 23 lakhs) which is to be
vaccianted is already communicate to GOI for release for Vaccine and syringes and also for
related fund through ROP (C.1.u 2016-17).
Pulse Polio Immunization Programme :
Thereafter , PPI (Pulse Polio Immunization) was introduced in 1995 and yearly two
rounds of Pulse Polio Immunization are launching till now through NID & IPPI
programme against Polio Myelities . Now, India is not having Polio Myelities case since
13th Jan’2011 till to-day and WHO has declared “Polio- Free – India” on March’2014.
Major Achievement of the Programme :
• Pentavalent Vaccine (Including Hib) introduced in all the District of Assam
introduced on 18th Feb’2015.
• IPV (Inactivated Polio Virus Vaccine) introduced in six states of India .
Assam is one of tem introduced on 16th Dec’2015.
• Neo Natal Tetanus eliminated from the State of Assam.
• Polio Free Certificate (Polio Type-2) obtained from WHO , including South
East Asia Region.
• Initiatd for Global switch activity from trivalent OPV (type 1,2,3) to bivalent
OPV (type 1,3).
• Children JE Vaccination (1 to 15 yrs) completed in all the 27 districts of
Assam and incorporated in RI.
• Effective Vaccine Management study was being carried out by Various
medical colleges with the support of UNICEF.
• Adult JE Campaign Completed in 14 districts of State and this year Four
New district i.e. Cachar Bongaigaon , Nalbari and Morigaon is being
planned .
• To create felt need on Immunization among the marginalized society
DHS(FW), Esstt. SBCC cell to roll out RI communication strategy. Till date
14 nos. of district level and 29 block level SBCC training on RI already
completed .
• From this Month onwards fact for life (FFL) video show will be carried out
low RI coverage Tea garden and hilly terrain area in 15 districts .
 Coverage Report oF JE Vaccine under JE Camapign (Children and Adult)
Year Name of the District Target Achievement %
Cildren - (1-15 Yrs)
2006-07 Dibrugarh 409611 370653 90.49
Sivasagar 386228 264591 68.51
Golaghat 196304 135924 69.24
Jorhat 206095 186118 90.31
1198238 957286 79.89
2008-09 Tinsukia 419964 387608 92.30
Dhemaji 212236 187772 88.47
632200 575380 91.01
2009-10 Lakhimpur 380710 315731 82.93
Sonitpur 650156 431387 66.35
Kamrup(R) 501318 351040 70.02
1532184 1098158 71.67
2010-11 Nagaon 859192 795429 92.58
Sivasagar 437427 369659 84.51
Dibrugarh 431690 400989 92.89
Udalguri 281792 199878 70.93
2010101 1765955 87.85
2013-14 Barpeta 558753 420151 75.19
Darrang 304764 273591 89.77
Goalpara 331584 257720 77.72
1195101 951462 79.61
2014 -15 Morigaon 331997 200574 60.41
Nalbari 272601 203915 74.80
Sonapur Block of
Kamrup(M) 65442 41193 62.95
670040 445682 66.52
 Coverage Report oF JE Vaccine under JE Camapign (Children and Adult)
Year Name of the District Target Achievement %
Cildren - (1-15 Yrs)
2015 -16 Bongaigaon 256267 211570 82.56
Baksa 331365 226423 68.33
Cachar 608414 511484 84.07
Chirang 164451 74943 45.57
Dhubri 676405 548344 81.07
Dima Hasao 73357 60128 81.97
Hailakandi 231824 197121 85.03
Kamrup (Metro) 374661 202787 54.13
Karimganj 420825 381653 90.69
Karbi-Anglong 336650 273568 81.26
Kokrajhar 307621 171263 55.67
3781840 2859284 75.61
2013-14
Adult - (15-65 Yrs)
Lakhimpur 581331 482668 83.03
Dibrugarh 734295 683138 93.03
Sivasagar 197886 135131 68.29
Tinsukia 731925 467697 63.90
Jorhat 600192 538667 89.75
Dhemaji 386800 303038 78.34
Golaghat 585371 473485 80.89
Kamrup-Sonapur 104030 74264 71.39
Kamrup® 845217 561455 66.43
4767047 3719543 78.03
2015-16 Darrang 479006 400814 83.68
Nagaon 1538946 710330 46.16
Sonitpur 1051593 748133 71.14
3069545 1859277 60.57
Barpeta 920160 408602 44.41
Udalguri 437321 199530 45.63
1357481 608132 44.80
Mission Indradhanush Ph-I&II- Assam
•Districts Covered (Darrang, Bongaigaon, • Medium focus districts execept
Nagaon, Goalpara, Kokrajhar, Dhubri,
8 Hailakandi, Karimganj) 18 Phase 1 district and Karbi-
Anglong

11732 • Sessions conducted (96.6%) 15850 • Sessions conducted (96.6%)

193025 • Targeted Children 229000 • Targeted Children

• Children Vaccinated
127049 • Children Vaccinated (65.82%) 133430 (58.27%)

32041 56016 • Children fully immunized

• Children fullyly immunized

18662 Children completely immunized 34281 Children completely immunized

Pregnant women Pregnant women

44091 25333
immunized
immunized
Mission Indradhanush Ph-III- Assam

• Districts Covered (Barpeta ,Darrang, Bongaigaon,

12 Morigaon , Nagaon, Goalpara, Goalghat, Kokrajhar,
Dhubri, Hailakandi, Karimganj, Sonitpur.)

4625 • Sessions conducted (96.6%)

72707 • Targeted Children

48141 • Children Vaccinated (66.21%)

11539 • Children fullyly immunized

7434 Children completely immunized

6599 Pregnant women immunized

 The Achievement of Last Five years
Fully Immunization Coverage for infant
Year %

2011-2012 77.37 %

2012-2013 83.80 %
2013-2014 87.57 %
2014-2015 86.15 %
2015-2016 88.18 %
2016-2017 (Up to 75.56 %
Júne’2016) Against
proporsonate Target
 Brief Note on UIP
Immunization Programme (UIP)
At present all infants and children upto the age of 16yrs of the State
are getting vaccination against the vaccine preventable diseases. In the beginning,
vaccination was done against the diseases of poliomyelitis, Tuberculosis, Diphtheria,
Pertusis (Whooping Cough), Tetanus and Typhoid. Moreover, 2 doses of TT were
given to Pregnant Women.

Thereafter, the Govt. of India introduced the Programme of

vaccination under “ Universal Immunization Programme” since 1985. The vaccines
administered are the 2 doses of T.T for Pregnant Women and for infant & Children one
dose of BCG at birth/ at the age of 6 weeks of the infant; and OPV, DPT at the age of
6 weeks, 10 week, 14 weeks for infant and measles at the age of completed 9th month
of infants. 1st booster dose of OPV and DPT at the age of 16th to 23rd month of age, 2nd
booster dose of DT at 5 to 6 yrs, TT dose at 10 yrs and 16 yrs. of the children.
Moreover, 2 doses of TT were given to the pregnant women at the interval of 4 to 6
weeks. Under UIP the Typhoid vaccine was excluded and Measles vaccine was
included.
In the year 1990, along with the six vaccines against six VPD
(Vaccine Preventable Diseases) Vit-A solution by Half Yearly had been introduced
under UIP starting from 9th completed months upto 5 yrs. Total 9 doses are given at
the interval of 6 months.
 Brief Note on UIP Continued…
Thereafter, PPI ( Pulse Polio Immunization) was introduced in 1995
and yearly two rounds of Pulse Polio Immunization are launching till now
through NID & IPPI progamme against Polio Myelitis. Now, India is not
having Polio Myelitis case since 13th Jan’2011 till to-day the 6/08/2013 and
WHO has declared “Polio – Free - India” on March’2014.
In the year 2006, Hep-B was introduced in the districts of Jorhat and
Sivasagar. Then from 16th Nov’2011 the Govt. of Assam introduced Hep-B
in all districts in Routine Immunization Schedule under UIP starting at birth
and along with DPT 1st, 2nd & 3rd doses.
The Govt. of Assam has also introduced Measles 2nd dose to children
at the age of 16th to 24th months of children along with DPT & OPV booster
dose.
The Govt. of Assam also introduced JE -1st Dose Vaccine in 16
(Sixteen) high JE prevalent districts of Assam since 2006 in phase manner. (
Dibrugarh, Lakhimpur, Sivasagar, Golaghat, Tinsukia, Jorhat, Dhemaji,
Kamrup®, Sonitpur, Nagaon & Udalguri) and Barpeta, Darrang, Goalpara,
Nalbari & Morigaon is being included in Routine Immunization. As per the
incentive of the Govt. of India, JE-2nd Dose is introduced in Routine
Immunization from 1st April’13 in the 16( Sixteen) districts.
 Brief Note on UIP continued….
With initiative of Govt. of Assam, the Adult JE Vaccination Campaign was
conducted in 9 (nine) upper Assam district during Feb’2014.
As being proposed by the Govt. of Assam for the Adult JE Vaccination
Campaign along with Child JE Vaccination in left out district of Assam. The Govt.
of India has initiated to go for the Adult JE Vaccination Campaign for the age group
(15 – 65 yrs) in 5 district of (Barpeta, Nagaon, Udalguri, Darrang, Sonitpur) and
Children JE Vaccination Campaign for the age group of ( 1 – 15 yrs) in 11 districts
of (Bongaigaon, Baksa, Cachar, Chirang, Dhubri, Hailakandi, Kamrup(M), K-
Anglong, Karimganj, Kokrajhar, Dima Hasao) during the year 2015- 16 in phase
manner.
India has attained the milestone with the introduction of Haemophilus
influenzae type b (Hib) vaccine into the UIP as a Pentavalent vaccine (containing
Diphtheria – Pertussis - Tetanus [DPT], Hepatitis B and Hib antigens). The
introduction of Pentavalent vaccine will reduce the number of injections required for
vaccinating children at 6, 10 and 14 weeks of age. Thus, the Govt. of India is going
to introduce the Pentavalent Vaccine in 11 states of India including Assam for which
all the preparatory work would be completed by Dec’14 and so the Pentavalent
Vaccine has been introduced in Routine Immunization Programme in all the district
of Assam on 18th Feb’2015 by Govt. of Assam.
IPV (Inactivated Polio Virus Vaccine) introduced in Routine
Immunization during the month of Nov – Dec’15.
For strengthening Routine Immunization Mission Indradhanush Strategy was
introduced from 7th April’2015 in 8 districts and continue in moderate 18 districts
from 7th Oct’ 2015 for 4 Rounds and again 12 districts from 7th April’2016.
 Programme milestones
1978 Expanded Programme of Immunization (EPI) launched.
1985 1985 Universal Immunization Programme (UIP) launched in 31 districts with
a plan for country wide expansion
1992 UIP became part of Child Survival and safe Motherhood (CSSM) programme
.
1995 first National Immunization2014
Day for Polio eradication.
1997 UIP became part of Reproductive and Child Health (RCH) program. National
Polio Surveillance Project launched as WHO and Govt. of India
collaboration. India certified
2005 UIP became part of overall
Polioumbrella
Free health programme NRHM.
2015
JE vaccine introduced
2010 measles second dose introduced in the national immunization programme
Hep B universalized Introduction
of IPV, MR
2011 Last wild polio virus case reported from India.
Open Vial Policy was implemented for select vaccinesand Rotavirus
in UIP.
2012
vaccines
Declared as Year of ‘Intensification of Routine Immunization’ .
WHO removed India from the list of polio endemic countries.
 Introduction of New Vaccine
• IPV (Inactivated Polio Virus Vaccine) introduced in State on
23rd Nov’2015 and at District Level on 16th Dec’2015

• Last year (Dec’2015) we have been successfully initiated IPV

as pre-requisite of switch activity from trivalent OPV ( type
1,2,3) to biovalent OPV ( type 1,3) 17th Feb’2016.

• All 27 districts has completed successfully National tOPV to

bOPV Switch Programme on 25th April
Key Note :
• As discussed in earlier meetings Immunization Campaigns to be conducted
among poor performing identified 1022 SCs the breakup of facilities is as
followed
– Out of 1022 there are 278 NSCs where the performance will be low as these are at HQ
of Health Institution
– Also there are total 559 SCs in which 544 are only SCs& 15 are Medical SCs & among
the 544 SCs 60 are vacant SCs
– So the major focus may be given to 60 vacant SCs &remaining 484 poor performing
SCs where ANM is present
• To do the campaigns following could be the strategic plan
– Immunization sessions will be conducted in the last week of every month for
3 months from October to December except on Wednesday/RI session day
– ANM will conduct sessions in her respective poor performing areas along
with AWWs, the involvement of AWWs is needed to achieve the target
– To conduct such activity the main prerequisites of campaign are :
• Proper micro plan & due beneficiaries list on the basis of head count.
• Ensure the proper Alternate Vaccine Delivery Plan is in place for vaccine
transportation in recommended temp.
• To increase the incentive from Rs.- 75/- to Rs.-100/-.
• Session site wastage disposed as per CPCB norms.
• Timely release of funds/ incentive to the ASHAs for smooth functioning of the
programme.
• ASHA shall mobilise the beneficiaries - a reasonable incentive may be fixed to
ASHAs for mobilising the beneficiaries a per NHM norms
• Rational deployment of ANMs to vacant SCs for campaigns - a reasonable
incentive may be fixed to ANMs for conducting sessions as per NHM norms
• For above said all the activities monetary fund shall be allotted taking into
consideration as the need of the campaign
Key Note continued ..............
• Other Major Programmatic Points to be focused & strategies to scale up –
– One time stand by road permit may be issued for the immunization vaccine, logistic,
Cold Chain equipments and vehicles related to immunization programme by Tax
Department, Govt. of Assam toDHS (FW), Assam for the free transportation of these
items received from Govt. of India.
– Six District Immunization Officer post to be created at Hailakandi, Dhemaji,
Bongaigaon, Tinsukia, Morigaon, Golaghat,.
– Four Addl. Chief Medical & Health Officer (FW) to be created at Chirang, Baksa,
Udalguri and Kamrup(M)
– Fill the vacant posts of HR at all level (MOs, Specialists, ANMs, etc.) at least among the
most poor performing areas
– Space to be provided to respective State & Regional vaccine stores wherever necessary
to maintain the cold chain equipment
– Vaccine Vans available with 25 districts and two districts (Jorhat, Kamrup –M) not
having vaccine Van in place hence facing difficulties for transportation of vaccine.
– About 300 pairs of ILR and Deep Freezers are more than 10 yrs age which needs
replacement within 2 – 4 months, CSR (Corporate Social Responsibility) fund
generation is key to resolve such demand in favour of public welfare, MoU with CSR
enlisted agencies will be a sustainable example
– IEC – poster on updated Routine Immunization Schedule, 4 key massages at cold chain
points/public health facilities
– Demand generation among Tea gardens, Char areas, etc. by doing BCC activities
– Ensure the proper AVD plan is executed from starting point to return to respective CCP
within the stipulated time at all CCPs in State
– Review/Bottleneck analysis of poor performing district initially one or two districts
may be done by conducting visit from State Team of Experts to identify the gaps
&corrective actions to bridge the gaps identified at the District level itself
Minute of Desk Review Meeting on JE outbreak & performance of District Nagaon, Udalguri
Venue: Joint Director, Health Services (UIP) Chamber, Swasthya Bhawan , Hengrabari, Guwahati
Date: 8-8-2016
Meeting Chaired by Dr. Ruplal Nunisa, Jnt. Director Health Services - UIP, Assam
The Key discussion & strategies agreed upon as -
➢ Dr. Ruplal Nunisa Jt. Director Health Services - UIP mentioned that as we are having frequent
JE cases in Districts like Nagaon, Udalguri and many other Districts of Assam which have
reported clinically confirm cases of JE to prevent this we may implement a strategy to JE
vaccination campaign, which was commonly accepted by the officials
➢ Both DIOs from respective Districts shared their experience & current situation of JE cases as
well as the strategies to overcome the JE.
➢ The Nagaon& Udalguri District Officials shared about the activities to overcome JE they have
done as IEC, BCC activities, utilised the forum of VHSNCs, fogging done but lack of fund for
fogging is an issue raised by them, involvement of IMA, Private practitioners, regarding JE
awareness was done
➢ Dr. Arup Deka asked District officials to review your micro plan & prepare an action plan for
the said activity & also suggested to conduct the JE campaigns at Kamrup Metro
➢ Improve the microplan, Cold Chain, & regular Supervision is key to achieve the JE target
suggested by State SMO
➢ Dr. Manisha Chawla suggested that arrange the JE campaigns to address all the age groups
instead of targeting only Adult as we have evidence of having JE positive cases below 15yrs of
Age also, the JE cases
➢ Dr. Manisha Chawla also suggested about media briefing by Govt. Officials regarding JE
vaccine availability & brief plan on conducting the JE campaigns free of cost
➢ Er. B K Chouduary State CCO suggested to identify the high risk area, the pockets & review
the micro planalong withrequirement of JE vaccine block wise
➢ State CCO also suggested to do strong IEC campaign to address the demand generation &
schedule the JE campaigns at the most suitable areas for the respective age groups e.g.,
Schools, Public Forums, etc.
➢ State SMO also suggested about a request to Nagaland State Govt. needs to put for arranging
the JE campaigns in border areas as deaths occurred among that area
Continued....................
➢ At the end Jt. DirectorHealth Services - UIP suggested following immediate action taken
points as
– Districts are requested to review micro plan properly so that no one should not miss to be
vaccinatedamongst all age groups comprises of
– Prepare the micro plan & submit proposal to State about the requirement of Vaccine &
Syringe each block level as per the actual head count
– Continue the JE vaccination & schedule JE Campaigns to cover all age group
– State shall request GoI for the vaccine supply based on District requirement
– District requested to regularly update on the activities towards the JE Vaccination to State

Members Present -
• State Officials:
• Dr. Ruplal Nunisa, Joint Director Health Services (UIP), Assam
• Er. B.K.Chouduary, State CCO, Assam
• Dr. Arup Deka State SMO Assam
• Dr. Manisha Chawla, Health Specialist, UNICEF
• State RI Consultant UNICEF Supported

• District Officials:
• Dr. Jayanta Das , District Immunization Officer , Nagaon.
• Dr. Tangkeswar Baruah , CM &HO (CD), Nagaon.
• Dr. Ganesh Barman , District Immunization Officer , Udalguri.
• Dr. Syam Pramod Raj Meadki , SDM & HO , Udalguri.
•
STRATEGY FOR JE

A. For District Nagaon, Udalguri ASHA to be intrusted for due beneficiary list of
JE vaccination for the Age group - 9 months to <24months and 2Yrs to 15Yrs
• Place indent for additional vaccine & syringes for the age group 2 Yrs to 15
Yrs
• Prepare micro-plan for additional activity of JE vaccination (2Yrs to 15Yrs)
through Routine Immunization for injection load <75
• If the injection load of JE increases to 75 to 150 beneficiaries then identify
Day other than RI & venue possibly would be School/AWC

B. For Adult JE vaccination in Udalguri, Nagaon & Kamprup (M) following

strategy to be undertaken
• Udalguri : Through ASHA survey to be done or the remaining 47% of non-
vaccinated (JE) 15 -65 Yrs target population
• Nagaon: Similarly 54% of non-vaccinated (JE) 15-65 Yrs target population to
be identified
• Kamrup (M): Except the Sonapur BPHC all the remaining BPHC to be
proposed for Adult JE vaccination of age group 15-65 Yrs. (population*51%)
• NOTE- Proposal to be submitted by the District within 1st September, 2016
Initiatives to strengthen Immunization
in Assam
Mission Indradhanush
 Operation Closing
Mission Indradhanush: ‘Indradhanush’
the immunization gap

• Focus on 201 high focus

districts with largest
number of partially
vaccinated & left-out
children
• Active engagement of state
governments & partner
agencies – WHO, UNICEF &
Rotary

High Priority districts

Indradhanush = Rainbow7 colours7 vaccine-
preventable diseases

• Diptheria
• Pertussis (whooping cough)
Other vaccination:
• Tetanus (TT: Tetanus Toxoid) Japanese encephalitis,
• Hepatitis B Hib (Pentavalent vaccine)
Nutritional supplement-
• Measles Vitamin A

• Tuberculosis
• Polio (in the form of OPV: Oral Polio
Vaccine)
All vaccines are available free of cost under the Universal
Immunization Programme.
 Areas to be targeted
• Areas with sub-centers vacant for more than three months.
– ANMs on long leave or other similar reasons.
• High risk areas (HRAs) identified by the polio eradication
programme. These include populations living in areas such as
– Urban slums with migration , Nomadic sites, Brick kilns,
Construction sites .
– Other migrant settlements (fisherman villages, riverine
areas with shifting populations)
– 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.
 Strategy for Mission Indradhanush
• Number of rounds: four rounds have been conducted from April to July 2015
during Phase- 1 covering 8 districts , 4 rounds are being conducted from
October 2015 to January 2016 during Phase -2 covering 18 districts and last 4
rounds are being conducted from April 2016 to July’ 2016 during Phase -3
covering 12 districts.

• Duration of each round: upto seven days in a month (based on need)

• Targeted beneficiaries: Children under two years of age and pregnant

women
– Children above two years of age seeking vaccination at any Indradhanush session
will not be denied due vaccines
• Mechanism
– Fixed or outreach sessions
– Mobile sessions
 Role of partners
• WHO: Technical support for effective planning and
implementation, capacity building, preparedness and
performance monitoring at district/block level
• UNICEF: Support communication strategy for social
mobilization activities to generate adequate demand for
vaccination
• UNDP : Technical support for real time temperature
Monitoring and Vaccine Logistic under Immunization
Programme .
 Mission Indradhanush, Assam
• Completed 4 rounds of Mission Indradhanush in eight high focus
districts of the State to improve immunization coverage
• It was conducted in three phase the first phase covering 8 high focus
districts, the second phase covering 18 high focus districts, and the
third phase covering the 12 high focus district that account for nearly
50 per cent of all partially vaccinated or unvaccinated children in the
State.
• The objective of this campaign was to reach out to the unreached
children and pregnant women through targeted interventions.
• The campaign started in April 2015 and covered high-risk areas like
urban, peri-urban slums, brick kilns, construction sites, nomadic sites,
areas with measles and diphtheria outbreaks and other areas with
weak RI coverage.
 Frontline Workers: 3A’s (who drive the Mission
Indradhanush Rounds)

– ANM: Auxiliary Nurse Midwife

– ASHA: Accredited Social Health Activist
– AWW: Anganwadi Worker

•How it works: ANMs do the micro planning for holding

immunization sessions with the help of ASHAs and AWWs—by
tallying the names of all mothers and children in the area (mapping
the sub-centre’s villages and hamlets).
•ASHAs and AWWs are chosen from among the residents of the
village.
•ANMs further take help from the Panchayat, school teachers and
village elders to motivate families to attend the immunization
drives.
 Adult JE Vaccination campaign
In the year 2015 -16 the campaign was held in 3 districts: Darrang,
Nagaon & Sonitpur in first Phase:
– Estimated target: 30,69,545
– Total vaccinated: 18,59,277 (60.57%)
In the 2nd Phase: Barpeta & Udalguri
– Estimated target: 1368328
– Total vaccinated: 841243 (61.48%)
In the year 2016 -17 the campaign was been planned in four
districts: Nalbari, Morigaon, Cacahar, Bongaigaon for which
proposal submitted through PIP – 2016 - 17
Children JE Vaccination campaign
Nagaon & Sonitpur in first Phase
In the year 2015 -16 the campaign was held in 11 districts (Bongaigaon/ Baksa/ Cachar/
Chirang/ Dhubri / Dima-Hasao/ Hailakndi/ Kamrup(M)/ Karimganj/ Karbi-Anglong/ Kokrajhar
)
Estimated target: 37,81,840
Children vaccinated: 28,59,284 ( 75.61 %)
 Pulse Polio Imm. Programme

During the year 2015 – 2016 ( 0 – 5 yrs)

Target Achv. %
NID 1st Round 4725543 4730917 100.11

NID 2nd Round 4808406 4700750 97.76

NID – National Immunization Day

 Achievement for the year 2015-16
• Pentavalent Vaccine (including Hib) introduced in all the
District of Assam introduced on 18th Feb’2015 .
• IPV (Inactivated Polio Virus Vaccine) introduced in six states
of India. Assam is one of them introduced on 16th Dec’2015.
• Neo Natal tetanus eliminated from the State of Assam .
• Polio Free Certificate (Polio Type - 2) obtained from WHO,
including South East Asia Region.
• Initiated for Global switch activity from trivalent OPV ( type
1,2,3) to bivalent OPV ( type 1,3)
• Children JE Vaccination ( 1 to 15 yrs) completed in all the 27
districts of Assam and incorporated in RI.
• Effective Vaccine Management study was being carried out by
Various medical colleges with the support of UNICEF.
 Improving Routine Immunization
• Thirteen posts of Refrigerator mechanics have been filled up during July’2015 to
improve the cold chain system in the State and in turn improve immunization
programme overall.
• Five Regional Vaccine Store Managers have been appointed at each Region to
operationalize the 5 Regional Vaccine Stores which will improve the vaccine and
logistics management system in the State and will reduce shortage and stock outs
of vaccine
• Vaccinators Diary has been printed by the State for each vaccinator. This will
educate the vaccinator regarding immunization programme, improve the vaccine
and logistics management, and will help in tracking of the left outs and drop outs.
• Initiative taken to update the performance of the Tea Garden areas along with the
High to Risk areas and Hilly areas though Social Behavior Change Communication
and planned to use the Education-Entertainment approach as outlined in the Stat
RI communication Strategy on immunization in the 15 low performing districts,
where routine immunization coverage is affected due to improper communication
like inadequate messages, limited community awareness, low level of health
seeking behaviour and geographical constraints.
• Partnership with RED FM to raise awareness on Immunization Established SBCC
cell to roll out State RI Strategy
 Effective Vaccine Management
Assessment
EVM assessment was done
in Aug- Sep 2014
(UNICEF supported) in
all 27 districts of Assam
at:
 State Vaccine Store (SVS)
 Four Regional vaccine
stores (RVS)
 27 District Vaccine stores
(DVS)
 Sub-district Level:
✓ 54 cold chain points

Assessment was done in real time using mobile devices

Data available at www.evmindia.org.in
EVM Assessment was done to improve:
• vaccine and supplies management
• quality and layout of sites and buildings
• physical capacity of storage and transport
• quality of fixed equipment and vehicles
• preventive maintenance mechanism for
equipments and buildings

EVM improvement plan has been developed and submitted to GOI

Partnership with RED FM to raise awareness on
Immunization
THANKS