Deep dive exercise for improving the coverage of Pneumococcal Conjugate Vaccine in Maharashtra, India
Pneumococcal conjugate vaccine (PCV) was introduced in the state of Maharashtra, India under the routine immunization programme in June 2021 at the peak of COVID-19 pandemic. 
The trainings of medical officers and health workers for this introduction were conducted in a hybrid mode. This might have led to gaps in the knowledge of healthcare workers, issues in the recording and reporting, and various challenges in the implementation of PCV, thereby affecting its coverage. John Snow India (JSI) is the lead technical partner supporting us in the introduction of PCV in Maharashtra.
To ensure that issues are addressed and there is good coverage of PCV with improved knowledge of health workers and a uniform recording and reporting system for PCV vaccination, the state with JSI support, decided to conduct a deep dive exercise in two districts, Chhatrapati Sambhaji Nagar (Aurangabad) and Ratnagiri. During the deep dive exercise, the knowledge retention regarding PCV was assessed amongst the vaccinators (ANM). Of the sessions monitored, it was found that 100% of ANMs were aware of why PCV was introduced in the UIP. Furthermore, 100% of ANMs were aware that PCV is freeze-sensitive and should not be kept on the ice pack.
About 80% of ANMs were aware regarding interchangeability between PCV 10 and PCV 13. The deep dive also elucidated that 100% of ANMs were aware of the correct sequence of vaccine administration when multiple vaccines were administered. The deep dive also documented few best practices in the two districts. The facilities have the flexibility to plan their sessions on their own. This ensures that all the sessions planned are held. At the session site, the team saw an innovative practice of using a information board.
Authors: Dr Govind Pandit Chaudhari (SIO, Maharashtra), Dr Syed F Quadri (Program Manager, JSI, India), Dr Puskarr Deshmukkh (Regional Technical Manager, PCV Expansion, JSI India).