The document summarizes immunization program data from Jharkhand, India. It provides coverage rates, dropout rates, and categorizes districts based on these metrics. It also reviews vaccine stock status, monitoring and supervision activities, and key issues like inadequate monitoring and timely supply of materials. The state has taken new initiatives to improve coverage like monthly review meetings and implementing a new MCH card statewide.

1. Review cum Workshop on Immunization Programme 18 th- 20 th May’2011, New Delhi Jharkhand Dr. Ajit Kr. Prasad

2. Current Scenario Coverage Annual Target Coverage – DLHS 3 Quantum Infants (A) Pregnant Women (B) Fully Immunized (C) BCG-DPT3 Dropout rate (D) Number of Children Not Fully Immunized [100-(C)] x (A)/100 Number of BCG-DPT3 Dropout Children (D) x (A)/100 815021 939751 54.1 % 22.4 % 37 4094 182564

3. Fully Immunized Children Jharkhand = 54.1 % Source: DLHS 3 data < 30%(2) 30% to 40%(3) 40% to 50% (5) > 50% (14) D u m k a J a m t a r a D e o g h a r G i r i d i h K o d e r m a G o d d a S a h i b g a n j P a k u r D h a n b a d S i n g h b h u m E a s t G a r h w a P a l a m u C h a t r a L a t e h a r L o h a r d a g a G u m l a S i m d e g a S a r a i k e l l a S i n g h b h u m W e s t B o k a r o K h u n t i R a n c h i H a z a r i b a g h R a m g a

5. Drop out Rate Source: DLHS 3 data >20%(3) 20% to 30%(9) 10% to 20% (10) <10% (1) D u m k a J a m t a r a D e o g h a r G i r i d i h K o d e r m a G o d d a S a h i b g a n j P a k u r D h a n b a d S i n g h b h u m E a s t G a r h w a P a l a m u C h a t r a L a t e h a r L o h a r d a g a G u m l a S i m d e g a S a r a i k e l l a S i n g h b h u m W e s t B o k a r o K h u n t i R a n c h i H a z a r i b a g h R a m g a

7. Microplanning Cold Chain Equipment Total Needed Total Available Functional ILR Small 281 270 DF small 332 320 ILR Large 579 210 195 DF Large 298 267 259 WIC 5 5 5 WIF 02 2 2 Cold Box (L) 5000 859 859 Cold Box (S) 5000 906 906 Vaccine Carrier 933900 29769 29769 No. of Districts with micro plans revised in 2011 Percent Planned sessions held Number of Sessions Alternate Vaccinators hired (last FY) 24/24 89 34863

8. Health Worker - Training MO - Training Training Load Trainings Completed No. of Health Workers No. of Batched Planned No. of HWs Trained % HWs Trained 63647 279 27398 43% Training Load Trainings Completed No. of MO No. of Batched Planned No. of Batches Completed No. of MO Trained % MO Trained 1917 79 42 635 33

9. AEFI No. of Districts with AEFI Committees No of Serious AEFI Reported No. of AEFI Deaths Reported No. of Serious AEFI Investigated 24 10 (4 during Measles SIA round) 5 10

10. Access analysis Coverage (BCG, DLHS 3) Dropout Rate (BCG-DPT3, DLHS 3) Low (< 20%) High (> 20%) High (> 70%) Bokaro, Garhwa, Gumla, Hazaribagh, Latehar, Lohardaga, Ranchi, Khunti, Saraikella, East Singhbhum, Ramgarh (11) Chatra, Deoghar, Dhanbad, Dumka, Koderma, Pakur, Palamu, Sahibganj, Simdega, West Singhbhum (10) Low (< 70%) Jamtara (1) Giridih, godda (2)

11. Utilization analysis Coverage (BCG, DLHS 3) Dropout Rate (BCG-Measles, DLHS 3) Low (< 20%) High (> 20%) High (> 70%) Bokaro, Garhwa, Gumla, Hazaribagh, Latehar, Lohardaga, Ranchi, Khunti, Saraikella, East Singhbhum, Ramgarh, Chatra, Deoghar, Dhanbad, Dumka, Pakur, Palamu, Sahibganj, Simdega, West Singhbhum (20) Koderma Low (< 70%) Jamtara, Giridih, godda (3) Nil

13. Status : Alternate Vaccine Delivery 2009-10 2010-11 Sessions Planned (Nos) 374637 361207 Held (Nos) 344476 338756 % age Held 92 94 Alternate Vaccine Delivery (AVD) No of sessions planned with AVD 374637 361207 No of sessions held with AVD 295689 169596 % Sessions held with AVD 78.93% 46.95%

14. Status : Alternate Vaccinators & Mobilizers 2009-10 2010-11 Sessions planned using Alternate Vaccinators Planned (Nos) 374637 7200 Held (Nos) 344476 4546 % age Held 92 63.13 Mobilizers (Paid mobilizers like ASHAs/ Link workers/ Others) No of sessions planned with soc mobilizers 374637 361207 No of sessions held with mobilizers 233234 116401 % Sessions held with mobilizers 62.3 32.22

15. Status :Computer Assistants Computer Assistants 2009-10 2010-11 Required in State (No) 25 25 Hired (No) 23 25 % CA s in place 92 100

16. Waste Disposal Pits Waste Disposal Pits 2009 2010 Required in State (No) 221 221 Pits Built (No) 221 221 % age pits in place 100 100

20. Key issues regarding vaccine stocks State Level Name of Item Opening balance ( In Lakh Doses) Receiving ( In Lakh Doses) Distribution ( In Lakh Doses) Closing Balance ( In Lakh Doses) BCG 14.7 26.2 33.7 7.2 TOPV 3 62 54.4 10.6 DPT 12.5 36.36 44.61 4.25 Measles 7.49 4.99 12.39 0.09 TT 12.43 41.9 37.5 16.83

23. Measles Catch-up Campaign Coverage Sr No Name of District Target Population Vaccinated % Coverage 9 m to < 5 y 5 y to < 10 y Total Number 1 DEOGHAR 283016 114976 136096 251072 88.7 2 JAMTARA 146181 54807 64289 119096 81.5 3 GUMLA 196745 83936 100619 184555 93.8 4 LOHARDAGA 90514 33930 43569 77499 85.6 5 KHUNTI 110085 40751 48605 89356 81.2 State Total 826541 328400 393178 721578 87.3

30. Immunization Budget Status *State resources/funds also used for RI, IEC & training on Surveillance of VPD’s. Consolidated status 2010-11* Total Funds released to state (Immunization PIP fund) Total Allocation ` 1662.13 Lakh A OB = ` 505.00 Receiving = ` 556.00 Total = ` 1061.00 Lakh Total Funds Utilized based on SOEs recd from districts (upto 31 st Mar’11) B ` 429.00 Lakh Unspent balance available with State as on 1/4/2011 A-B ` 632.00 Lakh

31. Component wise expenditure 2010-11 Consolidated year status Alt. Vaccine delivery Alt. Vaccinators Hired Social Mobilizers (ASHA/ Others) Computer Assistants Waste disposal pits Printing /Stationery Fund Allotted (PIP fund approved) 240 50.40 500 30.60 30.90 55 Fund Utilized based on SOEs recd from districts (as on 31 st Mar’11) 122 15.91 104.05 23.36 1.56 55 % age Fund Utilized based on SOEs recd from districts (as on 31 st Mar’11) 50.83 31.56 20.81 76.34 5.04 100

32. Component wise expenditure 2010-11 Other heads under which funds utilized Supervisory Visits (funds for State level) Supervisory Visits (Funds for District Level) RI Review meetings (State & below Level) Fund Allotted (PIP fund approved) 13 129.70 Fund Utilized based on SOEs recd from districts (as on 31 st Mar’11) 6.88 7.84 % age Fund Utilized based on SOEs recd from districts (as on 31 st Mar’11) 52.92% 6%

42. Vision…Where do we want to reach? System Component Indicator* Target by 2012 Service Delivery % Fully Immunized Children (FIC) 80 % Dropout Rate (BCG-DPT3) <10 % Program Management Supportive supervision system established in state All 24 districts Monitoring and Surveillance % districts monitored by government functionaries 100% AEFI surveillance system established Already established in all districts Reporting system and data quality Timely monthly HMIS reports 100% Advocacy and communication Communication Strategy made In place