Healthy Babies, Happy Parents, Energized Health Workers

A collaboration between UNICEF and Chhatrapati Sambhajinagar (formerly Aurangabad) and Nashik district and local government bodies that began in mid-2021 has given the Urban Routine Immunisation programme fresh impetus.

Aimed at identifying and plugging equity gaps, UNICEF interventions have helped the authorities achieve broader immunization coverage. Alongside the re-energized and better-equipped health workers, one now comes across healthier babies and their happy parents, too!

The project aimed at three goals identified at the outset: Maximise Reach, Monitor Progress, and Mobilise People. UNICEF's intervention is making it possible to move closer to these goals.

On the one hand, UNICEF trained and upskilled health workers and simultaneously introduced improvements in the physical infrastructure utilized by the teams in the field. A less tangible but equally crucial intervention has been the mentoring and direct support given by UNICEF to the field teams comprising the Auxiliary Nurse Midwives (ANM) of the Health Care Centres and the Accredited Social Health Activists (ASHA) in every locality.

Taking the message to every home, every gully

At the project launch in 2021, intensive mass training sessions for the ANMs were conducted in each city, followed by a detailed assessment of critical steps required to boost routine immunisation campaigns. The UNICEF teams identified and addressed areas where infrastructure needed to be strengthened. 

These included well-designed, simple education materials such as booklets, posters, immunisation monitoring cards and megaphones, IEC vans, and portable projectors for mass awareness campaigns and mobilisation drives.

Boosting Infrastructure

The Cold Chain Points, where bulk vaccine doses are stored under proper conditions, were upgraded with new freezers and better temperature controls where necessary. Large flow charts and posters highlighting standard storage processes and monitoring procedures, precautionary measures and steps to be taken in emergencies and other valuable guidelines were printed by UNICEF and displayed alongside the equipment. This helped to strengthen the management of these vital points in the supply chain.

Above all, there are two measures initiated by UNICEF that have contributed significantly to improving the efficiency of field workers. This included the provision of collapsible and portable field tents that create a relatively safe and controlled environment even in remote areas and low-income communities while ensuring that field personnel and beneficiaries are sheltered from the elements.

This also included distributing easy-to-carry routine immunisation kit bags for the ANMs with specific placeholders for everything they have to transport to the field. When opened, these bags become vial-positioning vaccine stands and offer a place to lay out all necessary equipment, too.

Community Mobilisation: Support in the Field

UNICEF’s field support teams have also played a crucial role in mentoring the health teams and providing them with practical support in the field. The Field Resource Persons (FRPs):

• lead planning as well as assessment sessions with the health workers and accompany them to every routine immunisation session;
• provide support in door-to-door campaigns in slums and government housing colonies; and
• help in mobilising, monitoring and overcoming challenges.

Another area where UNICEF interventions have led to important transformations is community mobilisation. Some of the important initiatives in this area include

• Reorganising the Mahila Arogya Samitis (MAS), collectives of women from within the community who are involved in the planning and execution of various health and nutrition-related drives.
• Identifying the communities who have remained outside the health network and drawing them in.
• Identifying and building trust with influencers and enablers from within the community.

Ensuring Efficient Monitoring

UNICEF has also helped the local health officials develop a strong monitoring and reporting system over the past two years so that field reports reach higher administration levels rapidly. Problem areas and other lacunae are quickly identified and addressed, and longer-term trends are studied so the learnings can guide further improvements and advances in the planning and execution of routine immunisation drives.

Clearly, the impact of all these efforts is seen most clearly in the breakthroughs achieved in areas where routine immunisation coverage was non-existent earlier or remained low. Many examples can be cited in these two cities such as

• Nomadic communities such as the Wadars of Kasliwal slum in Chhatrapati Sambhajinagar and the Sayyed community in the Aurangabad Road slum in Nashik
• Migrant workers at the Brick Kiln in Pawan Nagar, CIDCO, Nashik
• Minority community pockets such as Gosaviwadi and Koknipura in Nashik and Aurangapura in Chhatrapati Sambhaji Nagar
• The government resettlement colony in MHADA Gharkul, Ambad, Nashik.