The Immunization Technical Support Unit (ITSU) has been providing technical support to the Immunization Division, Ministry of Health and Family Welfare (MoHFW), Government of India (GoI) since 2012 to improve immunization coverage with equity and quality. During the first two phases ITSU was housed at the Public Health Foundation of India (2012- 2017). In its third phase, from June 1st, 2017, ITSU is housed with JSI India and continues to serve as an in-house think tank for strategic planning to innovate, demonstrate, and document best practices across the country and help in scaling-up the Universal Immunization Programme (UIP). ITSU’s broad mandate in the three year grant period is as follows:
Improving coverage with quality and equity by strengthening routine immunization (RI) programme implementation through technical support to state RI cells, conducting comprehensive UIP reviews and progress tracking, strengthening immunization supply chain, assisting in the introduction of new vaccines and their scale-up and strengthening safety surveillance and Adverse Events Following Immunization (AEFI) systems.
Strengthening data for evidence based programme management by collating, analysing and disseminating immunization data, enhancing and automating the immunization dashboards at national and state level and providing support to name-based tracking of beneficiaries through the Reproductive Child Health (RCH) portal. ITSU hosts the RI control room, which assists MoHFW collate and analyse data from Intensified Mission Indradhanush (IMI), vaccination campaigns and new vaccine introduction (NVI) coverage. ITSU also conducts data quality assessments to formulate plans for data quality improvement and using data for decision making and action. It also tracks the programme reviews, including Gavi-health system strengthening activities.
AEFI surveillance and vaccine safety: The AEFI secretariat, which manages the country’s AEFI surveillance system has been embedded within the ITSU. It monitors the performance of AEFI surveillance in states and districts, provides feedback and support for improving surveillance (reporting, investigations, causality assessment, action taking and sharing of information) through capacity building activities and coordinates with drug regulators and pharmacovigilance partners to ensure vaccines are safe. At the national level, there has been an increase in human resources, experts and institutions involved in AEFI surveillance. Since 2012, there has been a four-fold increase in AEFI reporting, results of causality assessment of more than 2000 cases are available on MoHFW website, and national level surveillance processes have been quality certified. AEFI surveillance of the country has been given a maturity rating of 4 of a possible 5 by WHO assessors in 2017. In the coming years, the focus will be on further building the capacity of states and districts by implementing Quality Management Systems, training on improved investigations, ensuring AEFI reporting through software, and universalizing AEFI registers in PHCs. At the national level the focus will be on developing capacity for signal detection and active AEFI surveillance.
Communication support for demand generation: ITSU’s Strategic Communication team leads a comprehensive communication strategy, conceptualizes, brands and executes need based and targeted framework for vaccine demand generation. It also drives communication campaigns and implements social media campaigns to increase visibility of RI, Intensified Mission Indradhanush. Under NVI the strategic communications unit develops comprehensive communication materials and communication tools for facilitating the launch of newer vaccines such as the rotavirus vaccine (RVV), the pneumococcal conjugate vaccine (PCV), inactivated polio vaccine (IPV), and the measles-rubella vaccine (MRV). The unit also supports AEFI and media crisis management.
Transition planning: Keeping in view the sustainability of ITSU’s current activities, ITSU is working with the MoHFW and other stakeholders to identify appropriate government and partner agencies where critical ITSU functions can be housed in the future. ITSU’s multi-disciplinary team of professionals are a part of several core technical and advisory groups and work closely with development partners including WHO, UNICEF, UNDP, JSI, GHS, CORE to ensure adequate coverage and address gaps in operations and demand generation for RI. ITSU continues to facilitate an enabling environment for immunization stakeholders to work towards the common target of achieving the government’s objective of 90 percent full immunization coverage by December 2018.