Mission Indradhanush was first launched in December 2014 to achieve universal immunisation coverage. India had an immunisation programme from 1978. The ‘Expanded Programme of Immunisation’ was launched by the Ministry of Health and Family Welfare, which was one of the largest in the world. In 1985, it was modified and changed into ‘Universal Immunisation Programme’ (UIP), which catered for around 2.7 crore children annually. The programme covered vaccination for eight diseases (now, it consists of 12 diseases—tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, measles, hepatitis B, rotaviral gastroenteritis, Japanese encephalitis, rubella, pneumonia, and pneumococcal pneumonia as well as meningitis.). However, despite the efforts of the government, only 65 per cent of the children in India receive all vaccines during their first year of birth.
Therefore, to strengthen the immunisation programme, planning, and delivery mechanism, the Government launched the ‘Mission Indradhanush’ programme to achieve more than 90 per cent full immunisation coverage in the country by 2020 and is still being implemented. For this, the government identified 201 high focus districts which had around 50 per cent of total partially vaccinated or unvaccinated children. With the first two phases, the programme was able to achieve an increased coverage of 6.7 per cent but it is still low than the targeted 90 per cent.
With the involvement of technology, the monitoring and identification of the target group could improve.
Intensified Mission Indradhanush
To address and further improve the coverage of vaccination, Intensified Mission Indradhanush (IMI) was launched in 2017. The target was to reach all pregnant women and every child aged below 2 years. IMI also aimed to cover all the left-out and dropouts in the selected districts and urban areas with low routine immunisation coverage. Those districts/urban areas were selected which had less than 70 per cent coverage of DPT3 (a class of combination vaccines in humans against diphtheria, pertussis or whooping cough, and tetanus) or where the number of people missing DPT3 was greater than 13,000. Additional districts were also selected if the states requested. This programme was closely monitored at the central and state levels. IMI 2.0, 3.0, and 4.0 were launched in 2019, 2020, and 2022, respectively. IMI was implemented in areas of low immunisation coverage in 416 high-focus districts across India. The number of children vaccinated under IMI 4.0 is 59,99,158.
Thereafter, IMI 5.0 was launched in various states to ensure vaccination of all the sections of society. The main focus of IMI 5.0 is on zero-dose children between 0–5 years of age and pregnant women. IMI 5.0 aims to eliminate measles and rubella by ensuring complete vaccine coverage of MRCV (Measles-and Rubella-Containing Vaccine), and also to provide awareness and remove barriers to vaccination including hesitation, myths, and taboos. It will be implemented in three phases (from August 7 to 12, September 11 to 16, and October 9 to 14) in 2023.
Integrating technology for efficient tracking and record-keeping is an integral part of IMI 5.0. The state-of-the-art platform, U-Win portal, helps healthcare professionals to effectively track and document the vaccination status of children and expectant mothers, ensuring complete coverage and prompt interventions. Training was provided to all health workers including doctors, Anganwadi workers, and others to ensure the achievement of an efficient and inclusive vaccination programme.
Conclusion
The success of IMI 5.0 or any IMI requires not only awareness about vaccination but also an approach to ensure the overall health of pregnant women and expectant children. So, the government should make efforts to improve the number of institutional births to have better results from vaccination. IMI should aim to reach the interior villages of the country, especially tribal and forest areas. It has also been observed that the vaccinated population is lower in urban cities compared to villages mainly due to the existence of slums and homeless people in urban areas. Therefore, the government should also ensure that the benefits of vaccination reach all sections of the population and their settlements in every district.
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