1. Narayana Holla
  2. Service delivery
  3. Sunday, 05 November 2017

Dear viewers

 All of us are witnessing rapid multidimensional growth of routine immunization in the current decade. Keeping pace with the rapidly expanding / frequently changing schedule itself is a challenge faced by the service providers, more so in the private sector.

Pilot study revealed dangerously poor operational knowledge among the Medicos who are the current and would-be programme managers at various levels. This is conspicuously accentuated by the absence of an uniform vaccination schedule and vaccines with no Vaccine Vial Monitor (VVM) in the private sector.

We collected vaccination record cards of various private institutions, including Medical Colleges, providing vaccination services and found that no two vaccination cards are mutually matching either with IAP schedule or with National Immunization Schedule (NIS), whether essential vaccines of NIS or optional vaccines.

This is creating divided opinion in the community and the caretakers generally have lot of faith and strongly believe what they were advised by the super specialists in the super specialty hospitals at the time of giving birth and insist administration of vaccines as per the vaccination card they have from the private Institution.

India gives birth to ~2.7 core (27 million/270 Lakhs) live infants in a year. Even if 10% avail services from the private sector, absolute number is ~27 Lakhs per year in the country. Most of these children are from APL families (Above Poverty Line) – especially of Doctors / Nurses / Engineers / community leaders and the like who are deprived of receiving vaccines with known potency indirectly depicted by the VVM free of cost from the government. Though eligible, many are deprived of Mother and Child Protection Card [Tayi-card] in Karnataka and the vaccination data are not shared with the Government, even on sharing it cannot be “MCTiSed” = uploading to MCTS and making online.

Please find the attached with only 3 examples though this number is more than a million for the whole country. This is beyond the scope of “Intensified Mission Immunization (IMI)” as of now.

RI should become “peoples’ movement” as aptly iterated by the Honorable Prime Minister, which can address some of these issues to a large extent.          

Solutions are with us – the deep lovers of RI, promoters of child health. Shelling out “my-self” from the “APATHY” itself is the first simplest and biggest step followed by empathy for the birthing children / future generation.

Doing right things properly at the right time and by the authorized persons itself are the easiest and the most gratifying social service in any field, more so in medical field, that too vaccination – providing quality life-saving services to the newborns and the children.

best wishes

Holla and the team

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Thank you for sharing these examples. The pictures speak more than a thousand words. 

I would like to read from others how the collaboraton with the private sector is working in their settings. The different schedules, wrong administration technique (IM vs ID) and the reporting issues can be significant.


  1. more than a month ago
  2. Service delivery
  3. # 1
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Dear Carolina

Thanks for responding. 

I shared the same with programme officers of my district / state / Country and the Development Partners especially those who are working in NPSP / a few IAP members. In fact as per Times Of India news(TOI); long back (shared with viewers), IAP has withdrawn its schedule because of conflict with NIS & this is the technical body supporting Routine Immunization in the country, actively attend all policy making meetings at the centre / state / District. 

However there is a huge communication gap, lack of proactive approach, lethargy, apathy in implementing even after sharing at the district level meeting and the like. 

The losers are mainly the children of super specialists / specialists / general doctors / staff nurses and then followed by other elites. Senior pediatricians have administered OPV with VVM in discard stage or with no VVM to their own children and grand children; even the newborn of a doctor working for Immunization in Global HQ is an example in Bangalore. 

In public health, right skill / right knowledge are not enough, it needs blending with AUTHORITY and to be supported by funding agencies. As a stakeholder, supported by Medical Director & local health authority from the Govt, we made vaccination card compatible with current National Immunization Schedule listed as Part A in accordance with Mission Indradhanush and the optional vaccines applicable to our country as per WHO vaccine position paper and IAP as Part B [Nation friendly Combo-card; also shared with the viewers long back parallel with Govt and other development partners of the country but with no reciprocation].

The sample of the edited card which are being issued to the mothers at the time of discharge is attached – same is displayed as job-aid and poster in the vaccination clinic for IEC / IPC and the medicos to keep updated.

We insist all mothers to register their pregnancy as early as possible and to procure Mother Child Protection Card (MCP Card) called "Taayi Card " in Karnataka, developed by the Govt, share the vaccination data with the grassroot level workers:- the 3 Aces (ANM/AWW/ASHA) for supporting the national Immunization programme and so on.. so on..

With best wishes


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  1. more than a month ago
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