IMMUNIZATION PROGRAMME IN INDIA

1. IMMUNIZATION PROGRAMME IN INDIA Dr.S.T.V.Raghavamma Associate professor, CIPS

2. EDWARD JENNER

3. HISTORY • 14 May 1796 - Jenner inoculated James Phipps, an 8 yr old boy with cowpox lymph taken from Sara Nelms, a milkmaid. • Boy recovered after a brief illness

4. Jenner inoculated pus taken from a small pox patient. • Boy showed no reaction. • Jenner recommended vaccination for prevention of smallpox

5. Smallpox vaccination being a safe, simple, effective and inexpensive procedure, gained universal acceptance. • Main instrument for eradication for smallpox at global level. • Small pox has since been eradicated but Jenner lives for ever.

7. SMALL POX

8. Small pox eradicated in 1977. • IMMUNIZATION MOST POWERFUL & COST EFFECTIVE TOOL.

9. The first vaccine having been sent by jenner himself and used in bombay in 1802. • The pilot projects began during 1960. • WHO certified India to be free of smallpox in march 1977. • The global eradication of smallpox is arguably the greatest achievement of twentieth century medicine

10. VACCINE PREVENTABLE DISEASES

11. VPD • An infectious disease for which an effective preventive vaccine exists. • If a person dies from it, the death is considered a vaccine-preventable death.

12. 8 TARGETED VPDS Diphtheria Hepatitis B Measles Pertusis Poliomyelitis Tetanus Tuberculosis JE

13. DIPHTHERIA • PERTUSSIS • TETANUS • POLIO • TUBERCULOSIS • MEASLES

14. DIPHTHERIA

15. PERTUSSIS

16. PERTUSIS

17. TETANUS

18. POLIO

20. TUBERCULOSIS

21. MEASLES

22. MEASELS

23. MUMPS

24. CHIKEN POX

25. FULLY IMMUNIZED CHILD • A child who received One dose of BCG, Three doses of DPT and OPV One dose of measles before one year of age. • This gives a child the best chance for survival

26. MILESTONES IN THE IMMUNIZATION PROGRAM IN INDIA • 1978: Expanded Program of Immunization (EPI) introduced after smallpox eradication: BCG, DPT, OPV, Typhoid. • Limited to mainly urban areas

27. 1985 : Universal Immunization Program (UIP) introduced; Expanded to entire country; Measles added. • 1990 : Vitamin-A supplementation. • 1992: Child Survival and Safe Motherhood Program.

28. 1995: Polio National Immunization Days. • 1997: Reproductive and Child Health Program (RCH I). • 2005 : RCH-II and the National Rural Health Mission (NRHM).

29. EXPANDED PROGRAMME ON IMMUNIZATION 1974 • 1974-

30. EXPANDED… • Adding more disease controlling antigens to vaccination schedules. • Extending coverage to all corners of a country. • Spreading services to reach the less privileged sectors of the society

31. 1978 – PRIMARY HEALTH CONCEPT • ALMA – ATA declaration included immunization as one of the strategies for achieving HFA by 2000 AD. • WHO named this immunization programme as EXPANDED PROGRAMME ON IMMUNIZATION.

32. 1985 – UNICEF re named it as “UNIVERSAL IMMUNIZATION PROGRAMME”. • There is no difference between both the prog.

33. The goal was to achieve universal immunization by 1990. • EPI is regarded as an instrument of UPI.

34. EPI IN INDIA 1978 • The Govt of India launched it’s EPI in 1978. • The objective was to reducing mortality, morbidity resulting from VPDs. • To achieve a self sufficiency in vaccine production.

35. EPI IN INDIA 1978 • BCG, OPV, DPT & Measles- under 5 children. • TT- pregnant women. • Typhoid added. • OPV- 1979.

36. UNIVERSAL IMMUNIZATION PROG • 1985 in remembrance of then Prime Minister, Indira Gandhi.

37. The UIP was taken up in 1986 as National Technology Mission & became operational in all districts in the country during 1989-90. • UIP become a part of the Child Survival and Safe Motherhood (CSSM) Programme in 1992 and Reproductive and Child Health (RCH) Programme in 1997.

38. COMPONENTS OF UIP 1. Immunization of pregnant women against tetanus. 2.Immunization of children in their first year of life against 6 VPDs.

39. 2 COMPONENTS OF UIP

40. 3. The aim was to achieve 100 % coverage of pregnant women with 2 doses of TT. • & at least 85% coverage of children under one year (with 3 doses of DPT, OPV & one dose of BCG, One dose of MMR) by 1990

41. UIP was first taken up in 30 selected districts & catchment areas of Medical Colleges. • A technology Mission on Vaccination & Immunization of Vulnerable Population was set up to focus on all aspects of immunization activity.

42. OBJECTIVES • To increase immunization coverage. • To improve quality of service. • To achieve self sufficiency in vaccine production

43. To train health personnel. • To supply cold chain equipment and establish a good surveillance network. • To ensure district wise monitoring

44. CHANNEL OF SERVICE PROVISION • Immunization services are provided through the existing HCDS. (MCH centers, PHC, HSc, Hospitals, Dispensaries).

45. Though the target was 100% coverage no country in the world has reached the coverage figure. Therefore it can be interpreted as “NO CHILD SHOULD BE DENIED OF IMMUNIZATION.”

46. STATUS OF VPD -INDIA

47. PROGRAMME IMPLEMENTATION PLAN • PIP was set to strengthen programme implementation.

48. COMPONENTS: • 1.Support for alternative vaccines delivery from PHC to HSc & out reach sessions. • 2.Deploying retired manpower to implement vaccination services in urban slums & underserved areas

49. 3. Mobility support to Dist Immunization Officer. 4. Reviewing meeting at state level with the districts at 6 monthly intervals. 5. Training of ANM, cold chain handlers, mid level managers, refrigerator machines.

50. MOBILITY SUPPORT