Immunisation drives and the media

Health is at the top of the agenda for any country, and for India it is even more vital as its population burgeons. Every newborn infant requires health care to survive. Immunisation of a child starts soon after birth and is, therefore, indispensable. It is one of the most effective methods of preventing childhood diseases.

Every year, about 1.3 million children, below five, die from vaccine-preventable diseases--namely, tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, measles and hepatitis. Though vaccination coverage over the years has improved significantly in the country, sharp variations still exist in vaccination uptake--ranging from fully, partially and non-immunised children. RI (routine immunisation) in India targets 27 million infants and 30 million pregnant women, saving 2.5 million lives each year. Despite steady progress, the national full immunisation coverage is suboptimal at 65 per cent.

To expedite full immunisation coverage in the next five years, the Government launched Mission Indradhanush, under the Universal Immunisation Programme, on April 7—with technical support from UNICEF, WHO and Rotary International. In this flagship scheme, all uncovered children under the age of two years, along with pregnant women are being covered in 201 high focus districts—where about 50 percent of all unvaccinated or partially vaccinated children live. Of these districts, 82 are concentrated in the BIMARU states- Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh, where nearly 25 percent unvaccinated or partially vaccinated children live. The target is to reach 90 percent coverage in all states by 2020. Efforts are on to cover these states by July 2015.

In the polio campaign, media, through immunisation reporting, had played a major and strategic role in sharing information and creating awareness on issues. Once again, media have been engaged in Mission Indradhanush to accelerate immunisation.

UNICEF has identified 201 districts across 28 states where the vaccination coverage is very low. Most of these children are either not immunised or are left partially immunised. During the past two months, teams of journalists have visited villages in Dhanbad district in Jharkhand, Gaya and Patna (Bihar) and Badaun and Bareilly districts (UP) to gain first-hand knowledge about challenges and successes from the field. The thrust is on the high-risk areas identified under the polio eradication programme. These include urban slums with migration, nomads, brick kilns, construction sites, other migrants like fishermen villages, riverine areas with shifting populations and under-served and hard to read populations living in forested and tribal areas. Immunisation drives in these parts are proceeding at a slow pace.

State health officials cite a lack of awareness, superstition among parents, who are mostly tribals, migratory labour working in kilns and infrastructure construction site, difficult to access terrains, especially in hilly areas where populations are scattered, community and religious outlooks against vaccination as the main causes for the road block. Besides, unavailability of vaccines, shortage of electricity due to frequent outages of power, crucial to maintain vaccine storage at cold chain centres, and shortage of ground-level health workers have also contributed to the rising numbers of unvaccinated and partially vaccinated children. More than one lakh children are deprived of RI in Jharkhand, particularly in six districts (of the 201 identified). Vaccination coverage is low at Manera and Danapur villages, high-risk areas near Patna which are inhabited by the migrant population because these have poor accessibility and are highly prone to floods during rainy season.

State health directors and officials told visiting journalists that ANMs(Auxiliary Nurses and Midwives) are not adequately recruited by the government and the small numbers on duty have to carry excess workloads. Very poorly paid, even these frontline workers (FLWs) go on long leave after joining, citing some reason. Once children miss their periodic shots of vaccines, they run a greater risk of acquiring diseases.

More than any other media, for many parts of rural India, the sole connect to the outside world is 

the radio. Since most of the population in rural areas is illiterate, radio, the spoken medium rather than print medium, has the reach and power to bring about changes in thinking. Being a multi-language platform, local radio journalists act as a vital source of information apart from being responsible for keeping the hardest to reach audiences well connected with the rest of the diaspora.

Hence, UNICEF has held radio workshops for media persons in Delhi, Haryana and Chhattisgarh to create visibility around RI and gainful interaction among experts from the radio community, from AIR and also to build capacity of radio participants from low RI states. Radio professionals were motivated to devise innovative and inventive messaging around RI which would be incorporated in the existing categories.

Multi-media campaigns are needed to achieve results like in the case of polio campaign. The government should immediately address issues like shortage of staff, better remuneration and amenities for grassroots workers to  make this mission a success.