UNIVERSAL IMMUNIZATION PROGRAMME

Indian public health has seen a massive improvement since independence. At the time of independence Life expectancy was only 32 years and we had a very high child and infant mortality rate. Various programs and initiatives from the government and non-government organizations have led to this development. Universal immunization program is one such  program which has helped in reduction of spread of disease covered under it. India started with the expanded Program of Immunization (EPI) in 1978 to reduce child mortality. Under this program six vaccines were covered (Bacillus Calmette-Guerin (BCG), TT, DPT, DT, polio, and typhoid). Subsequently, in 1985 the Indian government included Measles vaccination and launched the Universal Immunization Programme (UIP) and a mission to achieve immunization coverage of all infants and pregnant women by 1990’s. It is one of the largest immunization program in the world in terms of quantities of vaccine used, the number of beneficiaries, the geographical spread. It was launched in 1985 in a phased manner. Under this program government gives vaccine to children for seven diseases. Diseases covered under this program are;

  1. Polio;
  2. Hepatitis B;
  3. Childhood TB;
  4. Tetanus;
  5. Measles;
  6. Diphtheria;
  7. Pertussis;

It was also announced in 2014 that four vaccines will be added to the program namely rotavirus, rubella and Japanese encephalitis, as well as the injectable polio vaccine. Poliomyelitis (polio) is one of the disease covered under universal immunization program. It is a highly infectious viral disease, which mainly affects young children. The virus is transmitted by person-to-person spread mainly through the faecal-oral route. It multiplies in the intestine, from where it invade the nervous system and causes paralysis. Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization. In 2010 government started a drive against polio and in 2012 programme achieved big success when India was removed from active polio list of WHO. Similar to polio, Japanese encephalitis(JE) is also a viral disease. It is transmitted by mosquitoes in humans causing inflammation of the membranes around the brain. Japanese encephalitis is a leading cause of viral encephalitis in Asia generally spread from western pacific region in east to Pakistan in west and from Korea in north to Papua New Guinea in south.immunisation

Japanese encephalitis is a disease caused by a flavi virus that affects the membranes around the brain. Generally infections caused by Japanese encephalitis virus are mild (fever and headache) or without apparent symptoms, but sometimes 1 in 200 infections can result in severe disease characterized by rapid onset of high grade fever, headache, neck stiffness, disorientation, coma, seizures, spastic paralysis and death. Routine Immunization targets to vaccinate 26 million new born every year and 100 million children in between age 1-5 years for UIP. To achieve this task millions of sessions are conducted. Around 90 percent immunization is done by public sector and rest by private sector.

Union Government of India procures the vaccine and supplies it to the state governments. In order to keep the vaccines safe large number of cold chains are involved. It is necessary to correctly forecast and predict the requirement of state so that cold chains are not overburdened. Success of this programme depends upon the ASHA and Anganwadi workers, they mobilize eligible children to site and ensure that no one is left out. Due to all these efforts India has drastically improved its health indicators, despite being a poor country. IMR and MMR has been reduced to 44 per 1000 live births and 212 per 100,00 live births respectively. Although India has improved its health indicators but there is still a big scope for improvement. Targets set up by Millennium development goals are still far off. In order to improve the health conditions in India private sector should have to contribute more for it.