Directorate of Family Welfare under its MCH Program Unit has been engaged in implementation of various health focused developmental interventions for improving Maternal and Child Survival as important Millennium Development Goals. Under the 20 Point Program Umbrella, child immunization with special reference to Measles Immunization is one such intervention.
Under the Routine Immunization Program, the department has been able to significantly improve the fully immunized infant/child status in the State due a number of programmatic inputs and activities that have been systemized. The latest Unicef Coverage Survey Report, 2006 show that 81.9% children get fully immunized with all the essential childhood vaccines (BCG, DPT: 3 doses, OPV: 3 doses, Measles). The same report mentions measles vaccine coverage to the extent 89.2%. Similarly, a district wise survey was also undertaken in the State during the year 2005-06 for assessing the immunization coverage status in the districts, the report again suggests that it ranges between 70-80% (relevant pages of this report are attached for reference). However, coverage amongst families residing in ‘Katcha’ houses is relatively lower in comparison to districts averages. Under the State plan of action, it is this group which is being focused more & more.
The basic objective of immunization is to reduce the vaccine preventable disease load out of which Measles, diphtheria, neonatal tetanus & polio are considered as serious illnesses with potential mortality.
Considering the above a booster dose of measles to all children 15-18 months (through the State Specific MMR vaccine) and the single dose of typhoid vaccine (to a child between 2-5 year of age), and vaccination against Hepatitis -B disease at birth, and then followed by 6,10 & 14 weeks of age, are other states specific immunizations, that are available as a part of the system at nearly a 650 regular primary level health care units (MCWC of MCD, IPP-VIII Centre of MCD, Delhi Administration Dispensary of NCT), all colony hospitals, all district level hospitals and all secondary & treasury level hospital in the State belonging to various agencies (CGHS, Railways, ESI, MCD, NDMC, NCT Delhi & Private Sector Hospitals as grantees of Directorate of Family Welfare).
Immunization Days at all the primary health facilities are uniformly followed on Wednesdays and Fridays through out the working time of the facility on these days, while all the hospitals provide vaccination on all six working days of the week.
In addition to the facility based immunization service, Outreach Immunization Sessions are being conducted through Mobile Health Scheme (410 JJ Clusters/Slums), RCH ANMs (about 700), ANMs from MCWC & IPP-VIII centers. The frequencies of such sessions are one per month/per 10,000 allocated population.
Considering that there are pockets of under privileged population, which do not have access to regular immunization services from the above arrangements, partnership with district level functional service NGOs has been promoted as a strategic intervention for improving immunization coverage in these target population.
Quality Assurance: - The department accords highest level of considerations to maintaining quality in immunization services. The following inputs are used to this end:
All immunization injections are given by using Auto Disable Syringes, so that cross infection from one child to the other child is prevented. These syringes cannot be used a second time, since they get locked after one use and any unscrupulous use is not possible.
Cold Chain Assurance: All vaccines and their diluents are stored and transported under strict recommended cold chain conditions. Vaccine vial monitors on OPV & Hepatitis ‘B’ vaccine are important management/guidance tools helping the service providers in ensuring quality, while immunizing a given child.
Supervision and Field Monitoring of Immunization Sessions is a regular practice followed by program officers at various levels of the system, wherein “on site” skill up gradation of health workers engaged in immunization, is carried out regularly.
Trainings & Capacity Building: The Health and Family Welfare Training Institute of this department in collaboration with training institutes of IPP-VIII, MCWC, NIHFW & Govt. of India has been organizing training on quality and coverage aspects of immunization for Medical Officers and all categories of health workers, all through the year.
District Level Adverse Event Following Immunization teams have been constituted and trained for management and investigation of any rare adverse event that gets reported following immunization. As a part of this, the department is in the process of making arrangements with registered private nursing homes in the whole state for free and prompt medical management of any child brought with AEFI.
Reporting and VPD Surveillance is being gradually improved through imparting trainings to health workers for detecting any out break of any VPD in their field area for immediate reporting and under taking containment immunization activity.
Field survey on neonatal tetanus was carried out during the year 2007-08 in collaboration with WHO & Govt. of India in two districts of this state (S & SW), which showed that occurrence of neonatal tetanus has been reduced drastically, which is a direct reflection of good antenatal services (2 doses of TT to pregnant women accords protection against tetanus to herself and her baby).
Immunization schedule that is followed in the State is as given below in the IEC pamphlets used extensively in all field interactions, at each level of service delivery.
Facilities where services are available
All of the: 130 MCWC (of MCD)
28 IPP8 Health Centres
193 Delhi Administration Dispensaries spread over 9 districts,
46/51, Major & Middle level hospitals (of MCD, Delhi NCT, CGHS, NDMC, Railways, Cantt. Board, NGO’s etc).
Private Practitioners (under DMA/IMA) etc.
Contact details of District AEFI (Adverse Event Following Immunization) teams:
Delhi Administration Dispensary Building, A-2, Paschim Vihar, New Delhi-110063.
CDMO (North East)
Dr. G.P.Sinha, Mob. 9968295551
Addl.CDMO (North East)
Dr.Sunil Gomber, Professor Pediatrics
Ph. 22581730 (Extn.501)
Mob. 9810654564 email@example.com
Guru Teg Bahadur Hospital, Shadhara Delhi-110095
The Department of Family Welfare, Delhi has included 3 childhood vaccines in its Expended Program of Immunization (EPI) as a policy initiative for improving child survival, based on scientific evidence. The vaccines are MMR (Measles, Mumps & Rubella) in 1999, Hepatitis –‘B’ in August, 2001 & Typhoid vaccine in November, 2004.
The Coverage Survey Report (CES – 2006, by Unicef), mentions the status of routine immunization as under:
Full Immunization * by age 12 months
Booster Dose (Children age 18-23 months)
Coverage levels according to different antigens (%) – district wise (source: ICMR survey,2006)
Immunization status of Children (source: ICMR survey, 2006)
Complete Partial Not
Immunization status of children according to type of house-district wise (%)