A shot in the arm
Mains Paper 4: Governance
Prelims level: Mission Indradhanush
Mains level: Important aspects of governance, transparency and accountability,
e-governance- applications, models, successes, limitations, and potential;
citizens charters, transparency & accountability and institutional and other
- Mission Indradhanush (MI), one of the largest public health
programmes in the world, and one of the greatest health-related
accomplishments of the Indian government, was championed and strategised by
the Ministry of Health & Family Welfare in 2014.
- Since then, immunisation seems to have taken centrestage as a
crucial pillar of public health and as a development-promoting agenda.
- Several countries are positioning immunisation as an important
component of the Sustainable Development Goals 2030.
- Hashtags such as #VaccinesWork on popular social media platforms
are driving the debate surrounding vaccines — are they needed? How many are
needed? Are there any side effects?
- The importance of vaccines in India cannot be overemphasised. But
the story of India is one of diversity and complexity.
- With the second-largest population (1.3 billion approximately),
around 27 million children are born every year here.
- India also has the largest burden of under-five mortality, more
than what prevails in some of the poorest countries in the world. Nearly 39
children under the age of five years die for every 1,000 live births each
year pneumonia and diarrhoea are the leading killers.
- Approximately 0.1 million children die due to rotavirus-induced
diarrhoea alone, which is around 50 per cent of all deaths attributed to
diarrhoea. Evidence shows that unimmunised and partially-immunised children
are most vulnerable to diseases and disability, and are at three to six
times higher risk of death than fully immunised children.
- A large percentage of under-five mortality in India can be averted
- As far as the vaccination programme is concerned, India faces a
- Low full immunisation coverage (65 per cent), limited basket of
vaccines and, issues regarding quality and logistics of vaccine management
for such a vast and diverse country.
- It is indeed heartening to know that the government has taken
multiple steps to boost the scope of immunisation.
- India’s full immunisation coverage (FIC), which used to be 61 per
cent in 2009, improved to 65 per cent in 2013 at a meagre increase rate of 1
per cent per year.
- It was then realised that with the prevailing 1 per cent annual
increase in immunisation, it would take a long time to cover the whole
country. At that tardy pace, India would have taken 25 years more to achieve
90 per cent full immunisation coverage.
- The Ministry of Health & Family Welfare launched Mission
Indradhanush (christened after the seven colours of the rainbow, termed as
Indradhanush in Hindi) in 2014.
- Under this, seven vaccines would be given to all those children
and pregnant women who have missed out or are left out under the routine
immunisation rounds. It would cover all far-flung areas.
- MI has used the Annual Health Survey (2011-12), District Level
Health Survey (2007-08), Coverage Evaluation study (CES-2009), Rapid Survey
on Children (RSOC, 2013-14), Integrated Child Health and Immunisation Survey
(INCHIS) data (2015-16), and risk analysis methods to identify and monitor
the progress in the initial 201 high-focus districts.
How it can be improved?
- To bring sharper focus onto the least vaccinated areas, MI has
been transformed into “Intensified Mission Indradhanush” (IMI) that aims to
reach those rural and urban slums that have under-performed during MI.
- One hundred and ninety high-focus districts and urban areas across
24 states have been selected for such intensified efforts.
- There is a sharper focus on surveillance activities and to create
partnerships with states, community-level departments and ministries for
grass roots implementation and monitoring.
- Mission Indradhanush has led to an impressive increase of close to
7 per cent in full immunisation coverage in one year as compared to 1 per
cent increase per year in the past. =
- This is apart from the Universal Immunisation Programme (UIP)
which targets to vaccinate about 27 million children against 12 deadly
diseases every year, more children than any other similar programme in the
world through more than nine million immunisation sessions conducted
- We now aim to achieve 90 per cent immunisation by December 2018.
- The efforts seem to be bearing fruits. The under-five mortality
rates have declined considerably from 126/1000 live births in 1990 to
39/1000 in 2017, much faster than the global rates.
- Much of this can be attributed to the successful immunisation
programme in India.
- On a global scale, MI/IMI is meant to reduce India’s contribution
to the global burden of disease, including deaths in children under five,
thereby achieving SDG-3 by 2030.
- The journey of Universal Immunisation Programme (UIP), which India
embarked upon in 1985, has thus been further bolstered by Mission
Indradhanush/Intensified Mission Indradhanush.
- An immunisation programme, anywhere in the world, is the most
cost-effective public health intervention.
- It is the basic and foremost right of children across the globe,
that they receive a safe and effective “shot in the arm” in a timely manner.
- This is the minimum which any country must deliver to save their
children from vaccine preventable diseases.
Q.1) With reference to Mission Indradhanush, consider the following
1. It launched by ministry of Ministry of Women and Child Development.
2. Its objective is to immunize all children under the age of two years and
3. The mission mode has been adopted to achieve target of full coverage by 2020.
Which of the statements given above is/are correct?
(a) 1 only
(b) 1 and 2 only
(c) 2 and 3 only
(d) 1, 2 and 3
Q.1) Critically evaluate the Mission Indradhanush has ensured that
immunisation takes centre stage.