MEASL ES

No 2, January 2012

Measles second dose intervention will reduce Indias disease burden

GLOBALLY an estimated 400 children die from measles every day. Approximately three-fourths of these deaths are happening in India alone 60,000 to 100,000 child deaths annually!! Active measles infection reduces immunity and makes the child vulnerable to complications such as pneumonia, diarrhea, encephalitis, and middle-ear infection. Malnourished children are especially at risk of complications and death after an acute attack of measles. While India has made considerable progress in child survival, measles remains a leading cause of death and disability among young children. Routine measles vaccination coverage is 74%, and with vaccine efficacy of 85% when given at 9 months of age, it is estimated that 41% of children in each birth cohort continue to remain susceptible to measles due to dropout, left out, and failure to develop immunity. One of the goals of the multi-year strategic plan of the Government of India, therefore, is to reduce the number of measles deaths by 90% in 2013 relative to 2000 estimates. The Government of India launched the second dose in the campaign mode with specific objectives to: Provide a second opportunity for measles immunization to eligible children ensuring more than 90% coverage.

4.15 crore children to be vaccinated against measles in Phase-2 of campaign

AFTER COMPLETING the first phase of the national measles catch-up campaign successfully, the second phase has been launched to immunize more than 4 crore children in the country in 157 districts in 14 states.

Achieve at least 90% Measles Containing Vaccine (MCV1) coverage nationally, and at least 80% MCV1 coverage in all districts.
Conduct measles surveillance within an integrated vaccine preventable disease surveillance system. Achieve full investigation and appropriate clinical case management of all measles outbreaks.

This national-level campaign gives evidence of high-level commitment by the Centre and states, political support, and strategic planning in implementing the campaign with the objective to make Indias children safe from measles.

Fourteen states were identified by the National Technical Advisory Group on Immunization (NTAGI) as having less than 80% coverage. These states were advised to introduce a measles catch-up drive for children between the ages of 9 months to 10 years. In the rest of the country, the second dose of measles vaccination will be given as part of the Routine Immunization (RI) programme.

Campaign Alert!
(States starting campaign in January 2012)

States Date Rajasthan Jan 9 Tripura Jan 12 Jan 30 Haryana Jan 18 Gujarat Jan 30

No of Districts 5 1 Remaining 2 Remaining all 5

PROGRAMME

Status of Measles Catch-up Campaign in India (As of 31 Dec 2011)

st

Measles campaign completed in entire state Measles campaign will be completed in entire st state in 1 Quarter of 2012 (FY 2011-12) Measles campaign will be completed in entire state in FY 2012-13

Out of the 14 states, 5 finished the campaign in 2011 and 4 will finish in the first quarter of 2012. The challenge will be to finish the campaign in the remaining 5 states which have the major bulk of the target beneficiary population to be covered. This will need a meticulous plan and appropriate action. Those districts completing catch-up campaign will also start the 2nd dose of measles in RI six months after.

Reporting of MCV2 in RI for Phase 1 campaign districts

(Source HMIS: Data analysed for Oct-Dec 2011, as on January 19, 2012) S. No. State No. of Districts in Measles 2nd dose Phase 1 reported in HMIS 1 2 3 4 5 6 7 8 9 10 11 12 13 Arunachal Pradesh Assam Bihar Chhattisgarh Gujarat Haryana Jharkhand Madhya Pradesh Manipur Meghalaya Nagaland Rajasthan Tripura Total 1 1 5 9 5 5 5 5 1 1 1 5 1 45 0 0 4 6 0 1 1 4 0 1 1 4 1 23

There is a need for improving the 2nd dose measles vaccination coverage in RI and proper reporting. The Government of India is monitoring the situation closely, and all states must upload data on HMIS regularly.

Note: Uttar Pradesh conducted its campaign only in the 2nd phase in December 2011.

Measles Vaccination Catch-up Campaign India: Phase 2

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COMMUNICATION

Haryana parliamentarians endorse measles catch-up campaign in the state

xtensive and timely advocacy with parliamentarians helped the Health Department of the Haryana state to achieve high-level political support and visibility to the measles campaign. The participation was viewed positively by the communities as endorsement of the campaign by their political representatives. In its second phase (Nov 14Dec 7), Haryana conducted the catch-up campaign in five districts of the state: Bhiwani, Mahindergarh, Panipat, Rohtak, and Sonepat.

The campaign in Mahindergarh district was inaugurated by Honbe Health Minister Rao Narendra Singh at the fixed booth in the General Hospital of Narnaul. The minister also inaugurated the introduction of HepB in the Routine Immunization Programme on the same day. Similarly, in Rohtak, Sonepat,

Haryana Health Minister Rao Narendra Singh at the General Hospital of Narnaul launching the measles campaign

and Panipat districts, the campaigns were inaugurated by the Members of the Legislative Assembly (MLA) of the respective constituency accompanied by the Civil Surgeons and District Collectors of the districts.

RCH Director in Rajasthan asks campaign managers to stick to microplanning timelines

IN A LETTER addressed to the campaign programme managers, the Director of RCH of Rajasthan state has conveyed that the timelines decided for microplanning must be adhered to strictly for successful conduct of the measles campaign. The instruction was accompanied by a table which listed 12 core activities, deadline for the conduct of activities, persons responsible and supervisors. The 12 activities were: 1. 2. 3. 4. 5. 6. 7. 8. Submission of Block microplans to District. Submission of District microplans to State Directorate in Jaipur. Identification of cold chain needs at every cold chain point. First District Task Force meeting. Identification of AEFI centres and designated medical officers in those centres. Coordination meetings with education department/school at the Block/District/Sector level. Distribution of IEC material at the CHC/PHC level. Training of vaccinators and sensitization of Anganwadi and ASHA workers. Training on AEFI management to the designated medical officers. Second District Taskforce Meeting. Distribution of vaccination logistics at the CHC/PHC level. Pre-campaign monitoring.

Meghalaya CM exhorts parents to avail measles campaign opportunity

IN WHAT could be seen as support from the top, Meghalaya Chief Minister Dr Mukul Sangma made a personal appeal to the parents in the campaign districts to avail the opportunity of making their children safe from measles. The vaccine is very important for the health and well-being of the children. I urge each one of you to be kindly vigilant against rumours and misconceptions and came forward to take this opportunity to make Meghalaya a measles-free state and be a partner in saving lives of our beloved children, says his letter of appeal which was widely distributed. The appeal was also broadcast by the local news channel. Page 3

9. 10. 11. 12.

Measles Vaccination Catch-up Campaign India: Phase 2

COMMUNICATION

Bihar focuses strongly on advocating with principals of urban schools in 2nd phase

he success of the measles campaign rests strongly on how actively schools participate. This was one of the key lessons learned from the first phase of the campaign held in 2010. Schools, especially from urban areas, had shown a lot of resistance to vaccinating their children. This had directly contributed to low coverage, thus defeating the purpose of the campaign and keeping unvaccinated children exposed to potential threat of measles infection. It has to be noted that in the four-week campaign duration, the first week is dedicated to conducting the campaign with school children in their respective schools. To increase the coverage, sustained advocacy with schools is necessary. Schools in turn must take proactive steps to orient parents to the

Principals from both government and private schools were oriented about the campaign and need for support.

necessity of getting their children vaccinated. Good coverage results can then be assured! Partner support in Bihar was extremely encouraging. UNICEF supported extensively with the orientation of schools and media through workshops in all 15 districts of the state which conducted the campaign.

North Eastern states innovate on IEC material to promote participation in the measles campaign

States must use their logos on the IEC prototypes to gain campaign credibility
STATES scheduled to conduct the 2nd phase of the measles campaign beginning January 2012 have been sent a revised set of IEC prototypes. It is recommended that before printing the revised prototypes, states must insert the logos alongside the three logos of NRHM, UNICEF and WHO already placed on the top right-hand corner of all IEC material.

Insert state logo here!

PRODUCED BY: Immunization Division, Ministry of Health and Family Welfare, Government of India, Nirman Bhawan, New Delhi ADVISOR: Ms Anuradha Gupta, IAS, Joint Secretary (RCH) EDITORIAL COMMITTEE: Dr Ajay Khera, DC, India: Phase Immunization Measles Vaccination Catch-up Campaign Child Health and 2 Dr Pradeep Haldar, DC, Immunization For feedback & more information, please contact: Email: riindia2008@gmail.com, Call: 011-23061281
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