Sir, I am privileged as I had the opportunity to work exclusively and in-depth for improving Routine Immunization in 2 poor performing districts Deoghar and Jamtara of Jharkhand for a short period with MCHIP. MCTS is in the process of picking-up and started making a dent but not quick/adequate enough to rapidly close the gap. IRI came as boon. For line-listing the vaccination status of every child author developed a format which quantified left-out and child specific dropout depicting population immunity gap more accurately and closely (session site-wise) which helped in Rapid Backlog Clearance (RBC) and vaccinating children very close to the schedule in a very short period of 4 months. Very much contended and excited with the results, ANMs of Dewalbari declared that her area was “IRI FREE”. The study named as IRI simulation study was shared with the superiors (Un-published). This tool performed three primary functions: 1) LODO Meter 2) LODO Inhibitor and 3) Herd Immunometer with many other spin-off functions. On returning home state, where MCTS is doing better, on seeing Dewalbari model, the health workers of Primary Health Centre attached to my College (KVG) demanded the tool. It was suitably updated to meet state specific vaccination schedule, workers were oriented to the tool and through Supportive Supervision rapid improvement in vaccination coverage achieved in very short time shared as Peraje Template. In 3 months (Jan/Feb/March 2013 – the pentavalent era started from Apr 2013) entire PHC cleared the backlog. With the help of GoK, author had the opportunity to expand the programme to a district area with 57 planning units; 203 Health Sub Centers (June to Nov 2013) with similar results, shared as Christmas 2012 to Christmas 2013. As an offshoot, a small intervention termed ‘Operation SIgMA’ cleared 60% backlog in 4 days in an HSC area with 4500 population. Since all these started at Jharkhand during MCHIP tenure, I thought of sharing as a token of gratitude.

Thank you for this excellent feedback, Dr Narayana. It has been a privilege for MCHIP (and IMMUNIZATIONbasics before that) to work with Jharkhand for these past 10 years or so. The immunization achievements of your State have been a wonderful thing to observe and contribute to. Robert