Documentation of vaccine handling and service delivery at outreach immunization sessions across 27 districts of India

Manoja Kumar Das,Narendra Kumar Arora,Thomas Mathew,Bhadresh Vyas,Monica Sindhu,Abhishek Yadav

doi:10.1016/j.heliyon.2018.e01059

Manoja Kumar Das, Narendra Kumar Arora + Show 4 more

Open Access

https://doi.org/10.1016/j.heliyon.2018.e01059

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Abstract

BackgroundOutreach sessions constitute a major share of routine immunization service under national program in India. ObjectiveTo document the organisation, logistics, vaccine handling and services delivered during outreach sessions in India. MethodThis cross-sectional study was undertaken at 136 outreach sessions across 27 districts in three states (Bihar-62, Gujarat-43 and Kerala-31). Data was collected on session organization, vaccine supply, handling, beneficiary interaction, documentation, and waste handling. ResultsAll essential items and vaccines were available at 52.2% and 59.7% of sessions. The overall beneficiary turnout was 72.6%. Matching diluents were available for 94.4% of lyophilised vaccine vials. All four messages were given to 58.8% beneficiaries and 40% were advised to wait for 30 minutes. Few sites received vaccine vials with unusable vaccine vial monitors and frozen free-sensitive vaccine vials. ConclusionProgram attention is needed to improve organisation, logistics and vaccine handling at the outreach sessions to ensure optimal service delivery and beneficiary experience. The supportive supervision and monitoring must be strengthened focusing on updated beneficiary list, vaccine handling, counselling and waste handling.

Highlights

Vaccination is one of the most effective and powerful preventive measures for reducing the deadly morbidities and thereby mortality
These beneficiaries are vaccinated through over 9 million immunization sessions, and the outreach sessions constitute a major share (59% of the vaccination given through the public health system) [1, 2]
7.4% of the sessions in Kerala were linked with the Village Health and Nutrition Days (VHNDs) compared 71% and 62.8% in Bihar and Gujarat, respectively

Summary

Introduction

Vaccination is one of the most effective and powerful preventive measures for reducing the deadly morbidities and thereby mortality. UIP in India covers about 30 million pregnant women, 26 million infants born annually and about 100 million 1e5 year children [1] These beneficiaries are vaccinated through over 9 million immunization sessions (fixed, outreach and mobile), and the outreach sessions constitute a major share (59% of the vaccination given through the public health system) [1, 2]. The ANM is expected to remind parents about the four key messages including (a) what vaccine was given and what disease it prevents, (b) when and where to come for the visit, (c) what are the minor side effects and how to deal with them and (d) safe keep of the immunization card These are part of the supervision and monitoring of the outreach sessions under UIP.

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