Coverage and Equity

ITSU provides technical support to the Immunization Division of the Ministry of Health and Family Welfare (MoHFW), acting as an anchor between the national and State teams to achieve the goal of improving Immunization coverage and strengthening of public health system.

The Program Implementation (PI) unit within ITSU has gone through several rounds of rechristening, growing organically from being a “Program Team” to “Program Implementation-PI”, team.  Monitoring and Evaluation (M&E)  vertical handling the data of Immunization Control Room has been merged along with Programme Implementation team under the umbrella of Coverage and Equity ( C&E).

As a part of its work in assisting the Government of India in Health System Strengthening, ITSU performs functions, both within the domains of vaccine preparedness, and capacity building of immunization personnel. From planning to end stage activities, ITSU assists both the national and state level implementation teams. It supports in   formulating the immunization strategy and series of field level activities that broadly include the following:

  • Developing guidelines, strategies and documents for new vaccines
  • Providing guidance to states and Departments of Health for the various stages of vaccine roll-out- from pre-assessment to launch and post roll-out.
  • During implementation phase, it actively monitors activities and suggests mid-course correction, if required.

 

The C&E Vertical has also helped facilitate national training of trainers (ToT) for states/UTs for campaigns such as Mission Indradhanush (MI)/Intensified Mission Indradhanush (IMI) and introduction of other new vaccines and participates in the monitoring of implementation of these activities as National Monitors.

Other immunization partners were supported in preparing Operational Guidelines and FAQs for MI/IMI and new vaccines like Td vaccine, PCV, Rotavirus vaccine (RVV) and Measles Rubella (MR) vaccine etc.

Urban Immunization Strengthening: Increased urbanization has created a pressing need for innovative immunization strategies and guidelines specifically developed for urban populations. As a part of its work in the area of urban immunization, the C &E team has provided technical assistance to states for prioritization of urban areas. A pilot project was implemented in Rajkot (Gujarat) and Jabalpur (Madhya Pradesh). Strengthening urban immunization data mapping and updation for NUHM cities and generation of urban immunization dashboards is an ongoing process.

To achieve the goal of FIC, a holistic immunization package has to be considered where Adolescent immunization, Gender and equity are also covered. ITSU  developed strategies to improve adolescent immunization for Td for 10- and 16-year-olds. It has completed reviews on gender and equity in immunization in identified states.

 

Comprehensive UIP Reviews:

  • Comprehensive UIP reviews have been conducted in 2017 in the five high priority states, that include Bihar, Uttar Pradesh, Madhya Pradesh, Maharashtra and Rajasthan. All the states have been supported with their comprehensive UIP reviews especially for developing their Immunization Coverage Improvement Plans (ICIP). Tracking of implementation of ICIP by the states was done by ITSU and reports were shared with the states.
  • Self-assessment checklists were developed to enable states to do their self-assessment of UIP.

 

  • CUIP Review of all North Eastern states were conducted in year 2022 which was followed by ICIP preparation and its tracking for one year to monitor progress made.
  • In view of specific and unique challenges in Urban immunization, CUIP Review of urban immunization was conducted in year 2024 for 09 states- Andhra Pradesh, Chhattisgarh, Goa, Kerala, Madhya Pradesh, Maharashtra, Punjab and Rajasthan. Support to states were also provided in ICIP preparation.
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Monitoring and Evaluation

Another core function of the Coverage and Equity vertical is to lead and strengthen Monitoring and Evaluation (M&E) systems and processes related to immunization data. This includes the collection, collation, validation, analysis, and dissemination of data generated through platforms such as HMIS, U-WIN, Co-WIN, eVIN, and AEFI-MIS.

The objective of this M&E function is to ensure the availability of high-quality, timely, and actionable data that supports evidence-based decision-making at national, state, and district levels. This data is used by the Ministry of Health and Family Welfare (MoHFW), states  and development partners for  programmatic planning,  to monitor immunization coverage, identify equity gaps, and strengthen AEFI surveillance mechanisms.

The Monitoring and Evaluation vertical of Immunization Technical Support Unit (ITSU) plays a pivotal role in enabling these processes by: 

  • Developing data collection tools and reporting formats aligned with national guidelines.
  • Supporting capacity building of program managers and data handlers on data quality assurance (DQA) and analysis.
  • Conducting regular data reviews and triangulation to validate trends and identify underperforming geographies or populations.

Immunization Control Room

One of the most important functions of M&E vertical is managing the Immunization Control Room (ICR) which is hosted in ITSU.  The ICR provides critical information and real time data to MoHFW for decision making.

Immunization Dashboards:

The team gathers relevant data from GoI portals (HMIS, UWIN, RCH portal), reports from states/UTs for vaccination coverage of new vaccines, data from recent coverage evaluation surveys, concurrent monitoring data and communication monitoring data from partners and helps feed this information into Monthly Immunization Dashboards.

ITSU prepares Immunization Dashboards under the guidance of Immunization Division, MoHFW.  Earlier, in addition to National Immunization Dashboards, Immunization Dashboards were prepared monthly for six priority states-  Bihar, Uttar Pradesh, Rajasthan, Madhya Pradesh, Jharkhand and Maharashtra with an aim to improve quality and use of reported data on immunization to promote concrete programmatic actions for addressing challenges in strengthening UIP.

 

 

Now in addition to National Immunization Dashboard, ITSU prepares  Urban Immunization Dashboard for 1068 NUHM Cities, MR Vaccination Dashboard, Zero Dose Children Dashboard, GAVI supported 143 Districts Dashboard , which are shared with Ministry regularly .

With regard to the Mission Indradhanush (MI)/ Intensified Mission Indradhanush (IMI) portal, the team manages it for data recording and reporting of MI/IMI rounds. These  rounds are conducted from time to time for reaching out to left outs and drop outs for vaccination.   Data collection is done from states for the JE vaccination campaigns  conducted in the districts/states. Similar data collection was done from states for new vaccine introduction like PCV, RVV  till these are included in HMIS.

Support for Covid-19 Vaccination Programme

ITSU provided technical assistance to Immunization Division, MoHFW in the introduction and roll out of Covid-19 vaccine throughout the country.

The overall support was  categorised under two broad areas:

  1. Establishment of a control room to assist the Immunization Division, MoHFW for Covid-19 vaccination preparedness and roll out
  2. Management of AEFI surveillance to ensure safe rollout of Covid-19 vaccine

Technical assistance was provided to Covid-19 Support cell of Immunization Division, MoHFW. The key domain areas of support were, technical outputs for designing and launching of Covid-19 vaccines, support in streamlining CoWIN portal, training of health care professionals, tracking availability of vaccine supplies and designing and streamlining data capture and reporting mechanisms.

As ITSU hosted the Control Room for Covid-19 Vaccination coverage data, received from UNDP, was collated and compiled  daily  and Reports shared four times a day with Immunization Division, MoHFW by C&E team during the period.

Coverage and Equity