Introduction:
Routine Immunization is the most significant, affordable and cost effective child survival interventions. Every child has the right to complete basic immunization irrespective of economic status, political affiliation, geographical location, gender, caste, color or religion. The amazing progress in child survival in the last decade is primarily a result of ever increasing immunization coverage. Universal immunization programme includes vaccines to prevent eight vaccine preventable diseases (TB, Polio, Diphtheria, Pertusis, Tetanus, Measles, Hepatitis ‘B’ & HIB). The State government has introduced MMR vaccine in 2009 to prevent diseases like Mumps, Measles and Rubella. Sikkim is the first state in the country to initiate MMR vaccination along with hepatitis ‘B’ vaccine.
To strengthen routine immunization, newer initiatives have been taken up like :-
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Provision of Auto Disabled (AD) syringe and hub cutter to ensure injection safety.
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Support for Alternate Vaccine Delivery (AVD) from PHCs to PHSCs as well as outreach sessions.
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Mobilization of children to immunization session sites by ASHAs (Rs. 150/- per session).
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Incentives of Rs. 150/- to ASHAs for full immunization of a child.
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Mother & Child Tracking System (MCTS) for tracking of children and pregnant women.
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Quarterly review meetings on immunization are being done at PHCs, districts and state levels.
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For capacity building, training of Medical Officers, Health Workers and Cold Chain Handlers is being organized every year.
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Besides rendering immunization services at all the health facilities, the service is also being reached through Village Health & Nutrition Days (VHNDs) in the anganwadi centers and outreach session in hard to reach areas.
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Cold Chain Officer & Cold Chain Technician is in place to ensure proper cold chain system in the state.
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For proper disposal of waste generated following immunization sessions, training of health workers have been done with provision of waste disposal bags, safety pits, hub cutters etc.
Acute Flaccid Paralysis (AFP) Surveillance and Adverse Event Following Immunization (AEFI) Committee
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To detect any case of Acute Flaccid Paralysis (AFP) under polio surveillance & adverse event following immunization (AEFI), weekly reporting is being done along with measles surveillance from all the PHCs and district hospitals.
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The state and district AEFI committees are in place and investigation reports of every serious AEFI are submitted within 15 days of occurrence.
| AEFI Details 2015-16 as per HMIS report | |
|---|---|
| Number of Cases of Abscess reported following immunization (AEFI) | 1 |
| Number of cases of other complications reported following immunization (AEFI) | 20 |
| Number of cases of death reported following immunization (AEFI) | NIL |
Pulse Polio National Immunization Day (NID) rounds
2 round of Pulse Polio NIDs for 0 to 5 years children to eradicate Polio are being conducted every year
| NID Rounds 2015-16 | ||
|---|---|---|
| Rounds | Target (as per District Action Plan) | Achievement |
| 1st (17th January 2016) | 49882 | 45581 (91.3%) |
| 2nd (21st February 2016) | 49882 | 45958 (92.13%) |
Full Immunization Coverage
| Particulars | Source | Sikkim |
|---|---|---|
| Full Immunization Coverage | DLHS 4 | 85.2 |
| NFHS 4 | 83 | |
| HMIS 2015-16 | CNA target (8396) | |
| 95% |
| Vaccine-wise Immunization Performance (2015-16) as per HMIS report | ||
|---|---|---|
| Vaccine | Target (as per CNA) | Performance |
| BCG | 8396 | 7865 (94%) |
| DPT 1 | 8396 | 3666 (44%) |
| DPT 2 | 8396 | 4438 (53%) |
| DPT 3 | 8396 | 5244 (62%) |
| DPT B | 8396 | 8017 (95%) |
| OPV 0 | 8396 | 7436 (89%) |
| OPV 1 | 8396 | 7731 (92%) |
| OPV 2 | 8396 | 7933 (94%) |
| OPV 3 | 8396 | 8021 (96%) |
| OPV B | 8396 | 8241 (98%) |
| Hep 'B' 0 | 8396 | 7036 (84%) |
| Hep 'B' 1 | 8396 | 3783 (45%) |
| Hep 'B' 2 | 8396 | 4443 (53%) |
| Hep 'B' 3 | 8396 | 5208 (62%) |
| Measles | 8396 | 8100 (96%) |
| MMR | 8396 | 7172 (85%) |
| Penta 1* | 8396 | 4228 (50%) |
| Penta 2* | 8396 | 3539 (42%) |
| Penta 3* | 8396 | 2826 (34%) |
| Full Immunization | 8396 | 7965 (95%) |
| DT (5 yrs) | 10560 (Census 2011) | 8301 (79%) |
| TT (10 Yrs) | 13543 (Census 2011) | 10028 (74%) |
| TT (16 Yrs) | 13428 (Census 2011) | 9132 (68%) |
| Vitamin 'A' (1st Dose) | 8396 (CNA) | 8094 (96%) |
| Vitamin 'A' (5th Dose) | 8715 (Census 2011) | 4796 (55%) |
| Vitamin 'A' (9th Dose) | 10560 (Census 2011) | 7334 %) |
| *Pentavalent Vaccine was launched in Sikkim on 7th October 2015 | ||
| TT for Pregnant Women as per HMIS report 2015-16 | ||
|---|---|---|
| Vaccine | Target (as per CNA) | Achievement |
| TT 1 | 9236 | 7150 (77%) |
| TT 2 / Booster | 9236 | 7800 (84%) |
| Other Immunization Performance | |
|---|---|
| Number of Immunization Sessions Planned | 8978 |
| Number of Immunization Sessions Held | 8807 (98%) |
| Number of Immunization Sessions Held where ASHAs were present | 7838 (89%) |
| Number of cases of Diphtheria reported in children below 5 yrs of age | 0 |
| Number of cases of Pertussis reported in children below 5 yrs of age | 0 |
| Number of cases of Tetanus Neonatarum reported in children below 5 yrs of age | 0 |
| Number of cases of Tetanus other than neonatarum reported in children below 5 yrs of age | 0 |
| Number of cases of Polio reported in children below 5 yrs of age | 0 |
NEW GOI INITIATIVE DURING 2015-16 :-
PENTAVALENT VACCINE :-
The Government of India decided to introduce Pentavalent vaccine in the national immunization programme throughout the Indian states. Initially, it was introduced in the states of Kerela and Tamil Nadu in December 2011. The vaccine was then subsequently introduced in late 2012 and early 2013 in a phased manner in six other states and union territories- Goa, Gujurat, Haryana, J&K, Karnataka and Pudducherry. Pentavalent vaccine was launched in Sikkim on 7th October 2015 & the vaccine is being administered to children at 6 weeks, 10 weeks & 14 weeks in-place of DPT vaccine in all government health facilities & in outreach immunization sessions free of cost. Pentavalent vaccine gives protection against Diphtheria, Pertussis, Tetanus, Hepatitis ‘B’, Hemophylus Influenza Type B (HIB).
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