Institutionalizing early vaccination of newborns delivered at government health facilities: Experiences from India

Abstract

Newborn Vaccination is identified as a critical par ameter for evaluating the overall performance of im munization programs with guidelines clearly advocating for administration of BCG, OPV zero dose and Hepatitis B b irth dose to newborns. However in spite of sustained improvement in full immunization coverage in India, coverage o f newborn vaccines has remained traditionally low.The USAID supported Maternal and Child Health Integrated Progr am (MCHIP), operational in India from 2009 - 2014 provided tech nical support to the Universal Immunization Program (UIP) at the National level and in the states of Jharkhand and U ttar Pradesh. During the project period, MCHIP unde rtook an assessment in 46 selected health facilities across 5 districts of the two states to study the implemen tation of the newborn vaccination program. Key findings from the assessment included a lack of knowledge among staff about t he benefits of newborn vaccination, absence of written guidelines, unavailability of one vaccine compromising the administration of the remaining two and poor documentation practices. Following the assessment technical support was provided to strengthen implementation at these selected facilities which included providing on-the-job orientations to staff members posted in delivery rooms, establishing a s ound supply chain mechanism to ensure round the clock availability of vaccines in labour rooms, strengthening documentat ion by incorporating separate columns in the delivery regi sters for recording vaccine administration and impr oved Supportive Supervision mechanisms. The intervention produced favorable results with a progressive increase in cov erage of not only BCG and OPV zero dose but also Hepatitis B birth dose which was introduced in the UIP during the cours e of the intervention.