Improving coverage of new vaccines under routine immunization program in Bihar, India

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Bihar 1Several new vaccines including Rotavirus vaccine and Pneumococcal Conjugate Vaccine (PCV), were introduced under the Universal Immunization Program (UIP) in Bihar.

The most recent introduction was PCV in 2017, in selected districts, with subsequent expansion across the states in 2018.

During the COVID 19 pandemic, routine immunization (RI) activities were severely affected. It took time for the coverage to recover to pre-pandemic levels. In March 2023, John Snow India (JSI) supported the State Health Department, Bihar, in doing a deep dive exercise to understand the barriers and enablers of improving and sustaining high RI coverage including PCV. 





The state health department in Bihar, followed a multi-pronged strategy, to improve the coverage of RI and new vaccines:  

  • Intensive monitoring and review: Regular comprehensive reviews (State Task Force & monthly review meetings) were conducted at state and district level to assess the status of RI and PCV coverage, identify bottlenecks, and develop strategies for improvement. Districts with low coverage were visited by state officials to understand challenges and provide on-ground support to improve coverage. 
  • Digital platform for microplan: Microplans are developed on digital platform containing information about all the sessions of each ANM.
  • Regular data validation and analysis: All the districts have data validation committees to ensure no data discrepancy occurs in the Monthly progress report in paper and HMIS. Regular analysis of poor-performing districts was carried out to provide guidance and support along with tracking the progress of coverage data as reported on HMIS. 
  • Model Immunization Centre with all the modern amenities to facilitate the vaccination has been developed across the state.

These simple but effective steps of regular monitoring, along with effective data management and innovative measures, can be replicated in other geographies to improve RI and PCV coverage. 

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Authors:Dr. N K Sinha, State Immunization Officer, Government of Bihar; Mr. Sanjay Kumar Singh, Executive Director, Government of Bihar; Dr. Amrita Kumari, Program Specialist, John Snow India. 
Photo 1 caption: MIC, Patna
Photo 2 caption: Digital microplan, Nalanda

 

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