Mission Indhradhanush

Mission Indradhanush (MI) was launched by the Ministry of Health and Family Welfare (MoHFW) on 25th December 2014.

It is a special catch-up campaign under the Universal Immunization Program (UIP), conducted in the areas of low immunization coverage to vaccinate all the children and pregnant women left out or dropped out from Routine Immunization.  The initiative's mammoth task is being fulfilled with the support of an integrated and committed task-force, ensuring full immunisation coverage.  

Objective

The Mission Indradhanush aims to cover all those children who are either unvaccinated, or are partially vaccinated against vaccine preventable diseases. India’s Universal Immunisation Programme (UIP) provide free vaccines against 12 life threatening diseases, to 26 million children annually.  The Universal Immunization Programme provides life-saving vaccines to all children across the country free of cost to protect them against Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts).

Implementation

Focused and systematic immunization drive will be through a “catch-up” campaign mode where the aim is to cover all the children who have been left out or missed out for immunization. Also the pregnant women are administered the tetanus vaccine, ORS packets and zinc tablets are distributed for use in the event of severe diarrhoea or dehydration and vitamin A doses are administered to boost child immunity.

Mission Indradhanush Phase I was started as a weeklong special intensified immunization drive from 7th April 2015 in 201 high focus districts for four consecutive months. During this phase, more than 75 lakh children were vaccinated of which 20 lakh children were fully vaccinated and more than 20 lakh pregnant women received tetanus toxoid vaccine.

The Phase II of Mission Indradhanush covered 352 districts in the country of which 279 are medium focus districts and remaining 73 are high focus districts of Phase-I. During Phase II of Mission Indradhanush, four special drives of weeklong duration were conducted starting from October 2015.

Phases I and II of the special drive had 1.48 crore children and 38 lakh pregnant women additionally immunized. Of these nearly 39 lakh children and more than 20 lakh pregnant women have been additionally fully immunized. Across 21.3 lakh sessions held through the country in high and mid-priority districts, more than 3.66 crore antigens have been administered.

Phase III of Mission Indradhanush was launched from 7 April 2016 covering 216 districts. Four intensified immunization rounds were conducted for seven days in each between April and July 2016, in these districts. These 216 districts have been identified on the basis of estimates where full immunization coverage is less than 60 per cent and have high dropout rates. Apart from the standard of children under 2, it also focussed on 5-year-olds and on increasing DPT booster coverage, and giving tetanus toxoid injections to pregnant women.

Overall, in the first three phases, 28.7 lakh immunisation sessions were conducted, covering 2.1 crore children, of which 55 lakh were fully immunised. Also, 55.9 lakh pregnant women were given the tetanus toxoid vaccine across 497 high-focus districts. Since the launch of Mission Indhradhanush, full immunisation coverage has increased by 5 per cent to 7 per cent. Mission Indradhanush has resulted in a 6.7 % annual expansion in the immunization cover.

Phase IV of Mission Indradhanush was launched from 7 February 2017 covering the North-eastern states of Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. It has been rolled out in rest of the country during April 2017.

The four phases of Mission Indradhanush have reached to more than 2.53 crore children and 68 lakh pregnant women with life-saving vaccines.

The fifth phase of Mission Indradhanush was carried out in 190 lowest performing districts. At the end of six phases of Mission Indradhanush, 554 districts across the country were covered.  A survey (IMI- CES) carried out in 190 districts covered in Intensified Mission Indradhanush (5th phase of Mission Indradhanush) shows 18.5% points increase in full immunization coverage as compared to NFHS-4.

On completion of seven phases (from April 2015 to March 2020), 690 districts wherein 3.76 crore children were reached and 94.6 lakh pregnant females were immunized.  As of April 2021, during the various phases of Mission Indradhanush, a total of 3.86 crore children and 96.8 lakh pregnant women have been vaccinated. As of January 2022, ten phases of Mission Indradhanush have been completed covering 701 districts across the country. As of October 2023, 12 phases have been completd and a total of 5.06 crore children and 1.25 crore pregnant women have been cumulatively vaccinated under the campaign.

The Ministry is being technically supported by WHO, UNICEF, Rotary International and other donor partners. Mass media, interpersonal communication, and sturdy mechanisms of monitoring and evaluating the scheme are crucial components of Mission Indradhanush.

Areas Under Focus

The following areas are targeted through special immunization campaigns:

1. High risk areas identified by the polio eradication programme. These include populations living in areas such as:
• Urban slums with migration
• Nomads
• Brick kilns
• Construction sites
• Other migrants (fisherman villages, riverine areas with shifting populations etc.) and
• Underserved and hard to reach populations (forested and tribal populations etc.)
2. Areas with low routine immunization (RI) coverage (pockets with Measles/vaccine preventable disease (VPD) outbreaks).
3. Areas with vacant sub-centers: No ANM posted for more than three months.
4. Areas with missed Routine Immunisation (RI) sessions: ANMs on long leave and similar reasons
5. Small villages, hamlets, dhanis or purbas clubbed with another village for RI sessions and not having independent RI sessions.

Mission Indhradhanush - Districts covered

Phase V

All districts across the country

Phase V - 190 low performing districts

Phase IV - The fourth phase of Mission Indradhanush covered North-eastern states - Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura from 7th February 2017. It was rolled out in rest of the country in April 2017.

Phase III - 216 districts

Phase II - 352 districts

Phase I - 201 districts

Strategy for Mission Indradhanush

Mission Indradhanush will be a national immunization drive to strengthen the key functional areas of immunization for ensuring high coverage throughout the country with special attention to districts with low immunization coverage.

The broad strategy, based on evidence and best practices, will include four basic elements-

Meticulous planning of campaigns/sessions at all levels: Ensure revision of microplans in all blocks and urban areas in each district to ensure availability of sufficient vaccinators and all vaccines during routine immunization sessions. Develop special plans to reach the unreached children in more than 400,000 high risk settlements such as urban slums, construction sites, brick kilns, nomadic sites and hard-to-reach areas.

Effective communication and social mobilization efforts: Generate awareness and demand for immunization services through need-based communication strategies and social mobilization activities to enhance participation of the community in the routine immunization programme through mass media, mid media, interpersonal communication (IPC), school and youth networks and corporates.

Intensive training of the health officials and frontline workers: Build the capacity of health officials and workers in routine immunization activities for quality immunization services.

Establish accountability framework through task forces: Enhance involvement and accountability/ownership of the district administrative and health machinery by strengthening the district task forces for immunization in all districts of India and ensuring the use of concurrent session monitoring data to plug the gaps in implementation on a real time basis.

The Ministry of Health and Family Welfare will establish collaboration with other Ministries, ongoing programmes and international partners to promote a coordinated and synergistic approach to improve routine immunization coverage in the country.

Intensified Mission Indradhanush (IMI)

The Intensified Mission Indradhanush (IMI) has been launched by the Government of India to reach each and every child under two years of age and all those pregnant women who have been left uncovered under the routine immunisation programme. The special drive focuses on improving immunization coverage in select districts and cities to ensure full immunization to more than 90% by December 2018.

With a sharpened focus on high priority districts and urban areas, under IMI, four consecutive immunization rounds were conducted for 7 days in 173 districts - 121 districts and 17 cities in 16 states and 52 districts in 8 north eastern states - every month between October 2017 and January 2018. Intensified Mission Indradhanush covers low performing areas in the selected districts and urban areas. These areas have been selected through triangulation of data available under national surveys, Health Management Information System data and World Health Organization concurrent monitoring data. Special attention will be given to unserved/low coverage pockets in sub-centre and urban slums with migratory population. The focus is also on the urban settlements and cities identified under National Urban Health Mission (NUHM).

Intensified Mission Indradhanush will have inter-ministerial and inter-departmental coordination, action-based review mechanism and intensified monitoring and accountability framework for effective implementation of targeted rapid interventions to improve the routine immunization coverage. IMI is supported by 11 other ministries and departments, such as Ministry of Women and Child Development, Panchayati Raj, Ministry of Urban Development, Ministry of Youth Affairs among others. The convergence of ground level workers of various departments like ASHA, ANMs, Anganwadi workers, Zila preraks under National Urban Livelihood Mission (NULM), self-help groups will be ensured for better coordination and effective implementation of the programme.

Intensified Mission Indradhanush would be closely monitored at the district, state and central level at regular intervals. Further, it would be reviewed by the Cabinet Secretary at the National level and will continue to be monitored at the highest level under a special initiative ‘Proactive Governance and Timely Implementation (PRAGATI)’.

This Intensified Mission is driven based on the information received from gap assessment, supervision through government, concurrent monitoring by partners, and end-line surveys. Under IMI, special strategies are devised for rigorous monitoring of the programme. States and districts have developed coverage improvement plans based on gap self-assessment. These plans are reviewed from state to central level with an aim to reach 90% coverage by December 2018.

An appreciation and awards mechanism is also conceived to recognize the districts reaching more than 90% coverage. The criteria includes best practices and media management during crisis. To acknowledge the contribution of the partners/Civil Society Organization (CSOs) and others, Certificate of Appreciation will be given.

Intensified Mission Indradhanush (IMI) 3.0

The Government of India is committed to improve immunization coverage and achieve full immunization coverage of 90 percent. Launch of massive routine immunization campaigns, such as Mission Indradhanush (MI) and Intensified Mission Indradhanush (IMI), in part, reflects government’s efforts under Universal Immunization Program to reduce child mortality and morbidity. To boost the RI coverage in the country, Government is planning to introduce Intensified Mission Indradhanush 3.0 to ensure reaching the unreached with all available vaccines and accelerate the coverage of children and pregnant women in the identified districts and blocks from February 2021-March 2021. 

The Intensified Mission Indradhanush 3.0 will have two rounds starting from February 22 and March 22, 2021 and will be conducted in pre-identified 250 districts/urban areas across 29 States/UTs in the country. As per the Guidelines released for IMI 3.0, the districts have been classified to reflect 313 low risk; 152 as medium risk; and 250 as high risk districts.

Focus of the IMI 3.0 will be the children and pregnant women who have missed their vaccine doses during the COVID-19 pandemic. They will be identified and vaccinated during the two rounds of IMI 3.0. Each round will be for 15 days each.  Beneficiaries from migration areas and hard to reach areas will be targeted as they may have missed their vaccine doses during COVID19.

The present eighth campaign will target achieving 90% Full Immunization Coverage (FIC) in all districts of the country and sustain the coverage through immunization system strengthening and foster India’s march towards the Sustainable Development Goals.

List of districts (250) selected for Mission Indradhanush 2021

Intensified Mission Indradhanush 4.0

Intensified Mission Indradhanush 4.0 launched during Febraury 2022 had three rounds and was conducted in 416 districts (including 75 districts identified for Azadi ka Amrit Mahotsav) across 33 States/UTs in the country.

• In the first round (Feb-April 2022), 11 states conducted IMI 4.0. These are Assam, Uttarakhand, Gujarat, Jammu & Kashmir, Meghalaya, Mizoram, Nagaland, Rajasthan, Sikkim, Tripura and Chhattisgarh.
• The others (22 states) conducted the rounds from April to May 2022. These states/UTs include Himachal Pradesh, Maharashtra, Andhra Pradesh, Manipur, Arunachal Pradesh, Odisha, Bihar, Puducherry, Delhi, Punjab, Goa, Tamil Nadu, Haryana, Telangana, Jharkhand, Dadra & Nagar Haveli and Daman & Diu, Karnataka, Uttar Pradesh, Kerala, West Bengal, Madhya Pradesh, A & N Islands.

Intensified Mission Indradhanush 5.0

• IMI 5.0 ensures that routine immunization services reach the missed-out and dropped out children and pregnant women across the country.
• For the first time the campaign is being conducted across all the districts in the country and includes children up to 5 years of age (Previous campaigns included children up to 2 years of age).
• IMI 5.0 campaign aims to enhance immunization coverage for all vaccines provided under the Universal Immunization Programme (UIP) as per the National Immunization Schedule (NIS). Special focus is on improvement of Measles and Rubella vaccination coverage with the aim of Measles & Rubella elimination by 2023 and use of U-WIN digital platform for Routine Immunization in pilot mode across all districts in the country.
• IMI 5.0 was conducted in three rounds i.e., 7 -12 August, 11-16 September, and 9-14 October 2023 i.e., 6 days in a month with the inclusion of a Routine Immunization Day. All States/UTs except Bihar, Chhattisgarh, Odisha and Punjab concluded all the three rounds of IMI 5.0 campaign by 14th October 2023. These four states could not start the IMI 5.0 campaign in August due to some inevitable circumstances. These states would complete by  November 2023.

Source: Ministry of Health and Family Welfare