Initiatives to improve immunization in priority countries

These are some of the specific initiatives to improve immunization in priority countries:

• India: India launched “Mission Indradhanush” from 2015-2017 to improve routine immunization. This equity focused mission applied a range of polio strategies and assets to focus on identified high-risk populations in traditionally low-coverage or underserved areas with insufficient health services; 6.7 million children were fully immunized while 6.8 million pregnant women received the vaccine during this intensification effort. India reassessed the achievements and targeted 173 districts and 17 cities through the “Intensified Mission Indradanush” in 2017–2018; 1.4 million children were fully immunized and 1.2 million pregnant women were vaccinated during this effort.
• Indonesia: Eighty districts are being targeted for intensification of routine immunization through various strategies such as sustained outreach strategy and dropout follow-up and sweepings. Indonesia has declared 2018 as the “immunization acceleration year”.
• Myanmar: New approaches such as providing immunization service through 98 major hospitals, developing township-level operational annual workplans, improvement of cold chain capacity and data management capacity by using modern information technologies have contributed to improved coverage in Myanmar.
• Nepal introduced the concept of achieving fully immunized districts through the Full Immunization Declaration (FID) initiative in 2012. The initiative aimed to increase community ownership and commitment through positive behavioral reinforcement of individuals and groups. Heath workers followed a rigorous method of line listing target children and immunizing them, followed by a validation by the district team. A full immunization declaration of the district was done only after all sub-district level units had been validated. As of April 2018, 42 districts in the country have been declared fully immunized.
• Timor Leste ensured strong advocacy for adequate funding for outreach immunization services, and rapidly built capacity of the immunization workforce with close monitoring by external consultants at the subnational level. The country has increased the number of vaccine storage cold chain points from 68 (community health centre level) to 127 (health post-level). A twining programme has been initiated with the EPI programme in Sri Lanka to strengthen the technical capacity of the national and subnational programme managers.