Mapping of high-risk areas for better vaccination cover

The current map of high-risk areas used by the Mission Indradhanush was developed under the polio programme. It lists 4,400 hard to reach areas or areas that needed more focus such as slum clusters, construction sites,etc. About 98 lakh people live in these areas.

Delhi government’s immunisation department will undertake a massive on-ground survey to remap the high risk areas, where vaccine coverage is the lowest. These areas will be categorised according to the reason for vaccine denial to help the government in planning appropriate interventions.

Accredited Social Health Activist (ASHA) and Auxiliary nurse midwife (ANM) associated with the immunisation programme will be trained to collect the mapping data in a state-level workshop next month. The data collection will begin in November. (HT FILE)

The current map of high-risk areas used by the Mission Indradhanush was developed under the polio programme. It lists 4,400 hard to reach areas or areas that needed more focus such as slum clusters, construction sites,etc. About 98 lakh people live in these areas.

“The previous map was based on the requirements of the polio programme – where more cases were reported or where people could not be reached. The map had been integrated with the immunisation programme. Now, these high-risk areas will be mapped again, depending on six criteria such as the immunisation coverage, rate of refusal, cases of vaccine-preventable diseases etc,” said Dr Suresh Seth, Delhi’s state programme officer, immunisation.

The Accredited Social Health Activist (ASHA) and Auxiliary nurse midwife (ANM) associated with the immunisation programme will be trained to collect the mapping data in a state-level workshop next month. The data collection will begin in November.

The data collected will be validated by the district level officials and WHO monitoring teams.

“In Delhi, the vaccine coverage is anywhere between 80 to 90% in most areas, but in the high-risk areas it is usually lower. These areas have the migrant and mobile population who live in temporary hutments and are likely to be missed in the routine programme. A map like this is helpful for the programme and ensures that this does not happen,” said Dr Pradeep Haldar, deputy commissioner, immunisation, ministry of health and family welfare.

Almost 69% of children had been fully immunised in Delhi, according to the data from the fourth round of the National Family Health Survey in 2015-16 (NFHS 4). The report of the immunisation technical support unit (ITSU) put it at 87% in July 2018.

“Now, the number has gone up to 99% according to last month’s report of ITSU. It is hard to reach the last 1% and this will help,” he said.

“Once we categorise the high-risk areas by the reason for low vaccination coverage – whether religious belief, fear of adverse reactions, hard to reach areas on Yamuna bank and the health-seeking the behaviour of the community, we will be able to decide whether we need to send more vaccines to a particular area, whether we need to carry out awareness drives, whether we need to involve religious leaders, etc. This will help us in reaching the last mile,” said Dr Seth.

The vaccine coverage shot up after the government started the intensified Mission Indradhanush Kavach, monthly monitoring of immunisation data, and outreach activities by the ANMs.

“The immunisation cover shot up as a bi-product of the outreach and mapping activities done by the department before launching the Measles-Rubella Vaccine campaign in February this year. Our staff went door to door before the campaign and made people aware of the benefits of immunisation,” said Seth.