Mission Indradhanush Immunisation Programme

With the aim of expanding immunization coverage to all children across India by the year 2020, on 25th December 2014, the Ministry of Health and Family Welfare launched Mission Indradhanush. It was formed to expand the ongoing Immunization Programme which started in the year 1978 as the ‘Expanded Programme of Immunization (EPI)’.
Although the Immunization program(EPI) was modified in 1985 under the ‘Universal Immunization Programme’ (UIP). However, the sluggish progress between the 2009 and 2013 time period triggered the need for another program targeted to achieve at least 90% coverage of India by 2020. And since then, five improved versions of the programmes have been launched. Let us look at the efficacy rate of each one of them:

Mission Indradhanush 2014 

The purpose was to vaccinate children up to two years of age and pregnant women. Absolutely identical to its name Indradhanush – the 7 colours of the rainbow, Union Health Minister J. P. Nadda launched Vaccination for 7 Life-threatening diseases Poliomyelitis, Hepatitis B, Diphtheria, Measles, Meningitis, Tetanus, Tuberculosis, and Whooping cough.
In addition to these Japanese Encephalitis (JE) and Haemophilus Influenzae type-B (Hib) were also covered in selected states identified by the government.

Later in the year 2016, 4 more vaccines got added to the mission Rubella, Japanese Encephalitis, Injectable Polio Vaccine Bivalent, and Rotavirus. 

1. The campaign was launched to fully immunize: 
    – Unvaccinated (left out) or children who did not take the vaccine for some reason
    – Partially Vaccinated (Dropout) or those who could not complete all the doses
    – Who was not covered (Missed out) because their area was not reached

 2. In 2014 it covered 528 districts in 35 states and Union Territories. Where the main focus was on 201 districts in 28 states, which had the maximum population of unimmunised or partially immunised children. Hence, within a year it achieved 6.7% immunisation coverage in 2015.  

3. Until August 2017 more than 2.53 crore children and 68 lakh pregnant women got vaccinated.      

One important thing to remember is that Mission Indradhanush is different from Abhiyaan Indradhanush. Later is an initiative to make ESIC (Employees’ State Insurance Corporation) hospitals more colourful, clean, and hygienic. In Abhiyan Indradhanush, the hospital bedsheets ‘colour’ is kept as per the VIBGYOR pattern on different days of the week.

Intensified Mission Indradhanush:

On 8th October 2017, another Mission Indradhanush vaccination programme was launched by Honourable Prime Minister Narendra Modi this time it was ‘Intensified Mission Indradhanush’ with a more robust plan to reach out to the maximum population.

1. Once again the Government’s aim was to cover all Left outs and Dropouts under the routine immunisation programme/UIP.

2. The main focus was on the low routine immunisation coverage area in the selected 173 districts and 17 cities. It included places like
 –  Slums, unauthorized colonies
 –  Places without Auxiliary Nursing Midwives (ANM)
 – Subcenters where it was difficult for  workers to cover the  entire population
 – Those who Consecutively missed routine immunisation

3. In fact, any child who missed out on immunisation dosage earlier and was under 5 years of age could take these Vaccines. This programme covered all 12 vaccines that have been mentioned above.

4. Normally any routine immunisation programme is kept only for two days Tuesday and Friday in any government health centres.  But in the case of Intensified Mission Immunisation (IMI), it was executed on all 7 days in a month, for the consecutive 4 months. And these 7 days would mostly start from the 7th of every month. 
The purpose of keeping 7 days in a month from the 7th date was to continue its association with the colours of Rainbow.

5. The focus of this drive was to improve immunisation coverage in select districts and cities to ensure at least more than 90% immunisation by December 2018 instead of 2020.

Basically, it was started to clear up all the lags in the Mission Indradhanush. 

Intensified Mission Indradhanush  (IMI) 2.0:

1. A nationwide immunisation drive was initiated to commemorate the 25 years of the Pulse polio programme on December 2, 2019.
2. Aimed to intensify its target of achieving 90% pan-India immunisation coverage by 2022.
3. It targeted full immunization coverage in 272 districts in 27 states and at the block level (652 blocks) of Uttar Pradesh and Bihar. Because in these two states there were gaps in the target achieved. They are among hard-to-reach areas, existing health care facilities at that time were not good and maximum tribal populations were there.
4. In order to collect all the information about the children and pregnant women to be vaccinated Government had launched Portal for IMI 2.0.  
5. At the beginning of this Mission 3.39 crore children and 87.2 lakhs, pregnant women were already vaccinated. 

After seven phases of Mission Indradhanush (from April 2015 to March 2020), 690 districts comprising 3.76 crore children and 94.6 lakh pregnant females were vaccinated.

Intensified Mission Indradhanush (IMI) 3.0:

1. This was the fourth Mission Indradhanush launched in February 2021 to further enhance the programme.
2. It continued with its mission to vaccinate children and pregnant women, particularly those who missed their vaccine doses due to the Covid-19 pandemic.
3. In this, there were two rounds each of 15 days and it covered 250 districts/ urban areas across the 29 States or Union Territories.
4. Those who migrated during Covid-19 or in areas hard to reach were targeted. So the main focus was to vaccinate households who were missed out during Covid-19.
5. Till April 2021 the immunisation programme vaccinated 3.86 crore children and 96.8 lakh pregnant women.
   

Intensified Mission Indradhanush (IMI) 4.0:

1. It began in Feb 2022 to ensure that routine Immunization reaches the unvaccinated and partially vaccinated children and pregnant women. Here again one of the objectives is also to catch up on the gaps that might have been created during Covid 19 pandemic.
2. Three rounds will be conducted in 416 districts these include 75 districts specifically identified to mark Azadi ka Amrit Mahotsav in 2022.
3. In the first round to be held between Feb-April 2022, the following 11 states i.e. Assam, Uttarakhand, Gujarat, Meghalaya, Jammu & Kashmir, Rajasthan, Mizoram, Nagaland, Sikkim, Chhattisgarh, Tripura will conduct IMI 4.0. The rest of the 22 states will start the immunisation rounds from April to May 2022.
4. Intensified Mission Indradhanush 4.0 portal also has been launched by the Health Ministry.
5. While launching IMO 4.0 Union Health Minister Mansukh Mandaviya said that –
   “India is implementing the largest immunisation programme globally where we annually cover more than 3 crore pregnant women and 2.6 crore children through the Universal Immunisation Programme (UIP).”
6. As of January 2022, a total of 10 phases of Mission Indradhanush have been implemented and successfully reached out to 701 districts across India.

Finally, because of the consistent efforts of our health workers, government, and Indian Citizens we have arrived at a commendable achievement. If we compare the latest reports of the National Family Health Survey (2019-21) with the National Family Health Survey-4 (2015-2016) reports, it clearly indicates that there has been an increase from 62% (NFHS-4) to 76.4% (NFHS-5) among 12-13 months old children. And soon we will be able to eradicate more than 90% of these diseases at a national level in India.