MEASLES

Catch-up
November 15, 2011
AN UPDATE OF THE INDIA IMMUNIZATION PROGRAMME

Message from the Chairperson, National Steering Committee

Dear readers:
The first phase of the measles campaign (Sept 2010 to March 2011) was a learning experience for everyone. As it was an injectable vaccine, the campaign needed to be conducted in a manner that ensured the highest levels of coverage and vaccine safety. I am happy to note that we were encouraged by the high levels of safety exhibited across the 13 participating states. There were no serious Adverse Events Following Immunization (AEFIs) reported and no deaths at all. Any allergic reaction was correctly managed, providing strong testament to the quality of pre-campaign planning and training. Nevertheless, improvements must be made during Phase 2 in some critical areas of operation. There were coverage gaps in all 13 states. Because measles is highly infectious and requires more than 90% population immunity levels to stop transmission, it is essential that microplans are effectively developed and implemented to reach and safely vaccinate a large proportion of targeted children. The recommendations made in the guidelines for use of IEC material provided to all campaign states must be followed strictly (most states demonstrated serious gaps in IEC in Phase I). ASHAs and AWWs must visit families, discuss with parents the importance of vaccination, and enlist the targeted children. All IEC efforts should be properly monitored and evaluated. All this also calls for strong inter-ministerial and interdepartmental coordination at the national, state and district levels. A National Steering Committee (NSC) comprised of representatives from the Immunization Division, MoHFW, Education, and Women and Child Development as well as partner organizations has been constituted to monitor the planning and implementation of catch-up campaigns. Similar inter-departmental coordination committees are required at the state and district levels. It is my pleasure to share with you the first issue of Catch-up, initiated by the NSC. The aim is to provide updates and best practices to the national and state colleagues and partners in the measles programme, for effective knowledge exchange. Please give your feedback so that subsequent issues can meet your needs fully. Wishing you all a successful measles campaign for the health and welfare of Indias children!

13.5 crore children to be protected from measles through vaccination drive

Approximately 13.5 crore children in 14 states of India will receive a measles vaccination through the national immunization campaign started by the Government of India. These states have measles vaccine coverage below 80%.The 14 states are: Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Jharkhand, Madhya Pradesh, Manipur, Meghalaya, Nagaland, Rajasthan, Tripura and Uttar Pradesh. In the remaining States and Union Territories of the country, a second dose of measles will be given in the routine immunization programme at 16-24 months of age. The first phase of the campaign was carried out in 45 districts of 13 states from November 2010 to May 2011. Overall, 12, 076,836 children 9 months to 10 years of age were vaccinated, representing an estimated coverage of 86%. The one exception, Uttar Pradesh, will conduct its Phase 1 campaign from December 2012. Through these campaigns, the Government of India hopes to prevent an estimated 60,000 to 100,000 children deaths per year and ensure a measles-free future for Indias children.

Anuradha Gupta Joint Secretary, RCH Ministry of Health and Family Welfare

PROGRAM
Madhya Pradesh conducts 2ndphase of campaign in 7 districts
On September 19, 2011, Madhya Pradesh kick-started the second phase of the measles catch-up campaign in 7 districts of the state: Ashok Nagar, Bhind, Datia, Guna, nd Gwalior, Morena, and Seopur. The coverage in the 2 phase has exceeded 80% in most districts but coverage gaps remain. Using information from rapid convenience surveys to identify low coverage areas, Madhya Pradesh is continuing the campaign in an attempt to reach at least 95% coverage.

North East also begins 2ndphase of campaign, with Manipur going ahead despite an extensive economic blocade
North Eastern states comprising Arunachal Pradesh, Assam, Meghalaya, Manipur, and Nagaland, have also started the second phase of the measles catch-up campaign, in spite of a number of social and geographic difficulties.

Measles Catch-up Campaign 2nd Phase Schedule (Updated 01.11.2011)

State Total Districts Districts Completed in Phase 1 Sept. 2011 Oct. 2011 Nov. 2011
Media workshop planned for 22nd Nov 14 Dist (7th Nov - 3 dist, 9th, 11th , 15th, 17th, 21st Nov - 1 dist each, 28th Nov - 7 dist) 6 Dist (10th Nov) 7 Dist (21st Nov) 8 Dist (19th Dec) 9 Dist (1st Dec) 5 Dist (26th Dec)

Dec.2011

Jan. 2012

Feb. 2012

Remark

National updates Arunachal Pradesh 16 1

National Steering Committee Meeting 1 Dist (17th Oct)

Assam Bihar Chhattisgarh Gujarat Haryana Jharkhand Madhya Pradesh Manipur Meghalaya

26 38 18

1 5 9 5

6 Dist (28th Oct)

8 Dist Rest yet to be decided

Rest yet to be decided Rest yet to be decided

21 24 50 9 7

5 5 5 1 1
7 Dist (19th Sept) 4 Dist (17th Oct) 6 Dist (10th Oct - 3 dist, 17th Oct - 3 dist) 10 Dist (10th Oct)

6 Dist (14th Nov) 10 Dist (18th Nov) 9 Dist (2nd Dec)

Rest yet to be decided 4 Dist (16th Nov)

Nagaland Rajasthan Tripura Uttar Pradesh

11 33 4 72

1 5 1 0

5 Dist (5th Dec) 2 Dist (6th Jan) 3 Dist (3rd Dec) 1 Dist

Rest yet to be decided

Rest yet to be decided

Measles Vaccination Catch-up Campaign India: Phase 2

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COMMUNICATION

Innovative IEC by Madhya Pradesh for 2ndPhase

Media:Workshops were conducted for electronic and print media. They were briefed about the campaign and appeal was made for wide coverage. There was wide coverage of the campaign the following day in all papers and media.

Advocacy:Partners meet with District Collector of Ashok Nagar and discuss about the campaign logistics. Joint Appealby Commissioner Health and ICDS was circulated to all the concerned departments. A copy of the appeal was given to all AWCs, ASHA workers, HWs and other stakeholders. Mikingwas done using autorickshaws in urban areas and cycle rickshaws in rural areas.

Invitation cards were distributed to the parents at homes by the AWW and ASHA workers and in all schools.

Posters: Besides vaccination sites, posters were pasted in public places in urban and rural areas.

Madhya Pradesh puts on thinking cap on IEC

OTHER IEC ACTIVITIES Hoardings: 4 hoardings erected in urban area (Collectorate, Civil Hospital Morar, Janakganj dispensary, and Hazira civil hospital). 4 in the bock headquarters. Wall Writings in 300 locations in urban areas; 190 locations in rural areas. Pamplets: More than 50,000 pamphlets distributed through newspapers. All health workers were also given pamphlets and instructed to distribute them in homes in their respective areas while doing one-toone communication. In rural areas, the Deendayal Chalit Aushadalya van was used to distribute the pamphlets apart from house to house distribution by workers.

Letter for telephone dial tone: Dial tone on all BSNL phones saying:Get every child 9 months to 10 years old vaccinated at the nearest school or anganwadi centre with the measles vaccine during the Measles SIA Campaign from 19th September to 9thOctober 2011. (This ran for 2 hrs from 810 am every day.) SMS: Sent to more than 4 lakh mobile subscribers of Gwalior district requesting them to get all the children 9 months to 10 years vaccinated. Planned to be repeated at different intervals. Film Show: Through the Deendayal Chalit Aushodalya in villages, films were run in different areas using projectors. Scroll on Local TV (Den Network Exclusive):Scroll with message In Gwalior district Measles SIA campaign is being run from 19 Sep 2011. Get your child vaccinated and protected during the campaign. This scroll was run approximately 2-3 times every 5 minutes, which is for about 900 times in a day. LCD Rath: A van was converted and fitted with an LCD TV on board. Films regarding measles were shown at prominent locations. Announcements were done during the day time. Phone-in Session: At the end of the School Sessions and before the Outreach Session, parents could phone-in and ask about the details of the campaign or about any other concern that they had. FM Radio (Lemon): Message from the CMHO broadcast on FM radio for a week preceding the campaign.

Measles Vaccination Catch-up Campaign India: Phase 2

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COMMUNICATION

Good practices in IEC: Examples from Phase 1

A number of states in the first phase of the measles catch-up campaign in 2010 conducted some excellent IEC and community mobilization activities, which contributed substantially in gaining good coverage in those states. Districts conducting the campaign in the second phase may adopt these good practices to ensure timely and efficient IEC and social mobilization and to achieve more than 90% coverage.

Good practices
Planning Communication microplans with school, outreach, hard to reach areas, HR, budget and vaccine logistics well developed. Regular DTF meetings were held to review progress and remedial action taken. Rapid Convenience Assessments were done to assess coverage. Significant vigil by state and district health officers SIO, JD (FW), CMO and DIO. Response was prompt. Training Advanced refresher training of ASHAs and AWWs on IEC and mobilization helped in motivating family and stakeholders. Media Media workshops ensured good media support and coverage. Advocacy Village councils/churches motivated community. Good inter-sectoral coordination among Health and other departments (Edu, WCD, PRI, SWD, Dept of Comm Medicine, Reg Inst of Med Sc). Appreciable coordination with para-military forces for immunization in high-insurgent areas. Additional budget provided to SDMO & Planning Units for advocacy and coordination meetings with other departments. Social Mobilization DC sent letters to VHSCs and Village Chiefs seeking support. Posters were localized having appeal of local kids; banners were used in large numbers and miking in campaign areas. Innovative IEC campaign, on local TV channel through local film stars, running advt. on local cable TV network.

Areas for improvement

School Sensitization Inadequate coordination with private schools leading to reluctance to campaign especially in urban areas. Urban areas had reported a significant number of refusals from private schools. Some schools were missed out in planning. Early closure of schools or extended vacations. Tagging of schools. Advocacy In most instances, campaign did not get expected contributions from other sectors such as from Education, Panchayati Raj and Women and Child Development, in all states. Training Poor participation of state level trainers in field training except by DIOs.

Haryanas media workshop for 2nd phase was well attended and receives extensive positive reporting
Produced by

Immunization Division
Ministry of Health and Family Welfare Government of India Nirman Bhawan, New Delhi For feedback & more information, please contact: Dr Ajay Khera, DC, Child Health and Immunization Dr Pradeep Haldar, DC, Immunization

Email: riindia2008@gmail.com
Call: 011-23061281 Supported by

Measles Vaccination Catch-up Campaign India: Phase 2

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