by Ishwar Nath Jha & Raman Pandit
Najeeta Begum, an ANM
worker in Karnataka’s Lingsugur taluk, walked home to home post lockdown to
ensure that children who were not vaccinate for preventable infections due to
the COVID-19 lockdown, are covered under routine immunization services while 60-year-old Rameshwar Prasad, an alternate
vaccine delivery person in Bihar’s Gaya District, had to wade across the
river during monsoon to ensure that vaccines reach their destination on time.
Both Begum and Prasad
are among around two lakh vaccine warriors who travel several kilometres to
deliver life saving vaccine doses to children and pregnant women at reach
remote immunization sites. They brave tough
terrain and hard-to-reach areas, often by cycling or motor bike and then
walking, to prevent the vaccines from falling through the cracks.
“We have been asked by
villagers not to venture. I had to answer and convince them to vaccinate their children
and pregnant women,” said Begum. Begum traveled to
remote villages and visited the homes on foot to request families to not to
miss their child vaccination schedule and visit the sub-centre to get
vaccinated. 26-year-old Begum said
that she managed to cover every child and mother who could have missed their
vaccination schedule.
Prasad on the other
hand, cycled, walked and even waded through rivers to deliver vaccines to
remote villages of his district. “When I have to go to
Bentanawadhi village, I have to park my cycle in a neighbouring village. Then I
had to walk two kilometres during the lockdown period to reach there as there is
no proper road. During rainy season, I wade across the river to ensure that
vaccines reach on time," he said. "If I don’t go,
it will affect so many women and children. So, I have continued to do it with
all precautions like wearing a face mask, washing my hands regularly and
maintaining physical distance during collection and distribution of vaccine
carrier,” he said.
Since vaccines need to
be stored and transported at a certain temperature (+2 to +8 degrees Celsius)
to ensure their potency and efficacy, women and men spearheading the Alternate
Vaccine Delivery system, are given specific training. The UNICEF supported
training of 674 cold chain handlers, 36 cold chain technicians and almost
45,000 AVD personnel before the re-introduction of outreach immunization
sessions as soon immunization was put under essential services during covid
lockdown. .
A senior government
official from the ministry of health said:
"There were some gaps in coverage because of the pandemic due
to restriction in movement of man and material to contain the spread. However,
the government came up with guidelines to ensure access to essential
services in mid April that resulted in guiding the states on how to conduct
vaccination sessions by taking due precautions. The states too worked on
innovative ideas and the services have now been restored,"
Elaborating on the
process of alternate vaccine delivery systems, UNICEF said the states have
different vaccine delivery mechanisms depending on the topography of the state
ranging from motocycle, cycle, boats and by foot.
"During and after
the lockdown; when the regular road transport mechanism was affected, the AVD
system was functional and it supported in vaccine delivery and resumption of
Routine Immunization services. The AVDs are based on local need and depending
upon local support and means for transport," the official said. The government
along with partners ensured supportive supervision visits to the outreach
sessions and hand holding of the ANM and ASHA workers for house to house
surveys to identify children who may have missed routine immunization.
Luigi d’Aquino, Chief
of Health, UNICEF India, said vaccination is one of the most effective and
cost-effective ways to protect children’s lives and futures, and for building
healthier and safer communities.
Till August 2020, over
12 million children were vaccinated, a coverage of 68.5% in eight months,
according to data from the Union health ministry.