Orientation & Onsite Demonstration of Media on Routine Immunization

1. Orientation & Onsite
Demonstration of
Media on
Routine Immunization
LOK SAMVAD
SANSTHAN
Tejakavas, Kotra Block (Udaipur)
November 22, 2016
Jointly Organized by :

2. After the successful completion of first workshop in Jaipur on October 24, 2016, the venue for the
second workshop was shifted straight to a remote rural area and the event was organized in a small and
non-descript village, Teja Ka Vaas, of Kotra Block in Udaipur district on November 22, 2016. The
significant additions to the event were the hugely attended public programme and a captivating street
play on the subject, which attracted the rural men, women and children in and around the village, largely
inhabited by the tribal communities. The village is situated about 90 km away from Udaipur district
headquarters, near the Rajasthan-Gujarat border.
Lok Samvad Sansthan, a leading media advocacy based non-government organization based in Jaipur,
in partnership with the UNICEF Rajasthan Office, has launched a unique drive to orient and facilitate
the health beat reporters of various newspapers, television news channels and magazines as well media
professionals to have an improved understanding about routine immunization. The emphasis is on
understanding the prevalent conditions which make an impact on the current uptake among children
across the state of Rajasthan. This special initiative is being undertaken by organizing a series of
workshops in Jaipur and some other districts of Rajasthan.
Apart from media persons from the Udaipur district headquarters and Kotra block, the villagers evinced a
keen interest in the programme and attended it in a large number. The media and public engagement was
achieved through demonstration and direct interaction with the participants, which was followed by a street
play that served the dual purpose of entertainment and education of the tribal masses.
INTRODUCTION
Building a strong routine immunization programme as an integral part of the health system is a development
challenge that requires a systems approach. A cohesive, well-functioning immunization programme includes
many components, all of which dynamically interact to influence the accessibility, availability, acceptability,
and affordability of services, with a desired result of continuous coverage, improved service quality, equity,
and sustained disease control. Needless to say, the media plays a significant role in this entire exercise.

3. About a dozen journalists, including those from print and electronic media, from Udaipur district
headquarters and two from Gogunda block, representing Rajasthan Patrika and Dainik Bhaskar, attended
the programme. Dr Tuktak Bhanawat, senior journalist and part-time Correspondent with Press Trust of
India, came as a resource person, while Mr. Mohit Joshi, Divisional RI Coordinator, participated in the
programme to give useful information to villagers. The RCHO, Udaipur, Dr. Ashok Aditya, and Block
CMHO Dr. Shanker Lal from Kotra block, were contacted for participation. They could not attend the event
due to some other pressing commitments. The street play on the RI theme was presented by the members
of the Jan Kala Sahitya Manch.
Journalists at Udaipur district headquarters, who showed a keen interest for attending the programme,
travelled a distance of 90 km to reach Teja Ka Vaas, while the block-level media persons also came to
the venue. In all, the three events – awareness generation, street play and demonstration of the routine
immunization theme – were presented by the Jan Kala Sahitya Manch. A huge gathering of tribal men
and women as well as the curious children was present on the occasion.
PROCEEDINGS OF EVENT
The significant initiative, which will continue in other districts during the months of November and December
2016, is expected to build up a core network of media reporting on routine immunization and generate
awareness in the public at large on the subject.
A brief introduction of the RI theme was made at the beginning of the programme. There were no RI
sessions at the site and only the Auxiliary Nurse Midwives (ANMs) and health workers were present.
There was also no demonstration of the RI process.

4. The Lok Samvad Sansthan team had met Dr. Ashok Aditya, CMHO, Udaipur on November 21, 2016 and
requested him to attend the programme. Since he could not come to attend the event, the media
participation kit and complimentary pen drive were given to him. He was requested to arrange an
interaction with the BMHO, Dr. Shankar Lal of Kotra block, and the latter agreed to participate in the
programme. However, Dr. Shankar Lal later informed that he would not be able to make it because of a
court case which he was required to attend.
Thus, there was no representation of the Medical and Health Department in the programme. RI Divisional
Coordinator, Mr. Mohit Joshi, attended the event. As regards the visit of the team of media persons, the
Lok Samvad Sansthan contacted the Editors of Rajasthan Patrika, Dainik Bhaskar, Dr. Tuktak Bhanawat
of PTI and other media persons on November 21, 2016 and asked them to depute their health beat
reporters for attending the event. During discussions, Rajasthan Patrika Editor Mr. Rajesh Kasera and
Dainik Bhaskar Editor Mr. Tribhuvan evinced a great interest in covering such developmental stories and
suggested that fellowships and other encouragements should be provided to journalists for doing special
focused stories. Recognition provided to media persons in this manner will go a long way in promoting RI
and other health-related activities
Two journalists from the nearby Gogunda town
were also deputed to attend the programme.
The main programme went off well, with the
experts from UNICEF and Lok Samvad Sansthan
explaining to the audience the significance of
immunization and informing them that an
estimated four lakh children in Rajasthan were
either deprived of vaccination or were not fully
protected against the infection of some serious
diseases, which could create complications later
in the lives of children or could even be
life-threatening.
Addressing the gathering, Sarpanch Mr. Anand Ram
Garasia told the tribal people gathered on the
occasion that RI was an essential activity for keeping
the children's lives secure. ANM Ms. Roshni said she
was contacting the rural families from door to door
and encouraging them to bring their children for RI to
the primary health centres and health sub-centres.
Anganwadi activists and assistants also extend their
help regularly for ensuring success of these efforts.

5. The interactive participation of the people attending the
programme was witnessed during the street play, as the
people from among the audience came forward to
narrate their personal experiences and explained the
significance of RI from their own perspective. While
Mr. Anand Ram Garasia laid emphasis on getting full
benefits of the government's scheme in the health care
sector, Ms. Roshni felt that the health standards of
children could improve if people take a pledge to bring
their children for vaccination strictly in accordance with
the dates given on their vaccination cards.
From among the women attending the event, Ms. Sarita Devi clad in traditional attire with a long
ghoonghat (veil) said women were not bringing their children for immunization regularly. Even if some
women were willing to get their children vaccinated, they were not getting the benefit of all the vaccines
prescribed till the child's age of five years. Another woman, Ms. Fati Bai, pointed out that vaccination was
done free of cost, while it had a large number of benefits in terms of health security for children.
Children present among the audience were especially overjoyed while watching the street play with its
songs and dialogues in the local dialect. The street play's coordinators, Mr. Manish Kumar and Mr. Narendra
Mahavar, explained to the audience the details of immunization process and presented the theme in a
simple and easy language, which was followed by the villagers.
It was explained to the media persons, who were keen to know about immunization process in the rural
areas, that the current status of full immunization is 77.4%, while for the first time block-wise status has
been identified. The status of booster doses has also been recorded and the first time in national surveys,
status of booster doses is such that complete immunization (FI+ DPT 1 B+ OPV B+ Measles-2) has been
achieved in 74.1% cases.
o
All vaccines are heat sensitive and lose properties when exposed to higher temperature (less than 8 C).
There are vaccines which also lose properties when exposed to low and freezing temperature. To maintain
o o
the temperature (2 C to 8 C) of vaccine from manufacturer to beneficiaries, this process is called cold
chain. Transportation of vaccine is done by using dry ice, refrigerated vans, insulated vans, cold boxes,
ice packs.

6. According to the presentation made in the programme, the new vaccines to be introduced include rota
virus vaccine, which has already started in four states of the country, rubella virus vaccine (MR), to be
introduced soon with initial catch-up round, and PCV, which is pneumonia containing vaccine.
About the cold chain with which the vaccines are supplied to the target groups in the cities, villages and
far-off regions, it was stated that maintaining the potency of vaccines while they are carried was a big
challenge. There are 2,181 cold chain points in Rajasthan for storage of vaccine. There are contingency
plans for preservation of vaccines if power goes off at these storage points.
The department dealing with the immunization programme is facing the challenge of cutting the drop-
out rate of 19 %. Drop-outs in immunization programme are children who receive one or two vaccines,
but do not complete the course of full immunization. The full course comprises three vaccines at birth,
two each at six, 10 and 16 weeks. After nine months, a child gets the first dose of measles vaccine
and 1,00,000 international units of vitamin A. If a child gets these vaccines for BCG, hepatitis B, oral
and intravenous polio vaccines, pentavalent (a vaccine for diptheria), pertusis (whooping cough),
tetanus, hepatitis B and haemophilus influenza, then he or she is considered fully immunized.
Children who have not taken even a single vaccine are categorized as leftovers. This category is less
than 4 % of the eligible children in Rajasthan. The State Government's Medical and Health Department
is working closely with UNICEF for taking the immunization figure to 100 %. Wherever the people are
not fully aware, activities such as street plays are being taken up to popularize immunization.

7. The group of 10 media persons from Udaipur, who covered the event, utilized the opportunity of visiting
the remote Teja Ka Vaas village and stayed there throughout the day for doing coverage of at least
three other topics relating to rural economy, impact of demonetization of high value currency notes,
agricultural production and bad condition of schools in the region. Their stories on these topics
appeared prominently in addition to the news stories on routine immunization later in the newspapers
published from Udaipur.
ADDITIONAL WORK BY MEDIA PERSONS
The stories noted how the Government Primary School and the
Government Higher Secondary School in Teja Ka Vaas were
imparting a semblance of education with the staff of only
teachers despite their upgradation. The 130 children studying in
these schools study in the parallel classes run for them. In other
news stories, the impact of cash crunch on the rural populace
and the production of Sitaphal fruit, grown locally, were
highlighted. The media persons profusely thanked the
organizers of the event for providing them with the opportunity
to come to the remote rural area and interact with the villagers,
which enabled them to find other news stories as well.

8. The programme and the accompanying street play ended with a note of satisfaction, as it provided very
useful information and generated awareness among the residents of Teja Ka Vaas village. All the aspects
of the RI activity were highlighted during the event. These aspects included maximizing the reach of quality
vaccines through a well-functioning supply and cold chain system, managing programmes with strong
management support, mobilising people to generate demand through community engagement and
monitoring the programme's performance with rigorous disease surveillance, data analysis and evaluation..
CONCLUSION
It was felt at the end that the success of immunization programmes depends on their ability to be efficient
and sustainable in the long term. Programme sustainability is the capacity of country immunization
systems and processes to endure, without or with limited need of external financial and other support.
Strengthening RI system performance and monitoring, as part of a functioning health system, is the
foundation to achieving immunization goals. As with the cold chain, strengthened capacity through constant
attention, maintenance, and repair is needed for sustained, effective, and efficient performance of the entire
programme. The substantial accomplishment of routine immunization programmes in the past does not
guarantee success in the future.
Despite encouraging results in the past, the routine immunization programme must still learn to adapt in
order to overcome persistent challenges and seize new opportunities. It should engage better with broader
efforts, such as using information technology more effectively, to ensure that immunization is well-addressed.
Immunization is one of the greatest public health achievements of the 20th century. Not only does
vaccination reduce death and disability from an increasing number of diseases, studies have shown that it
also increases life expectancy and contributes to a more productive workforce.
For tackling measles, which is a challenging field in a state like Rajasthan with its feudal and traditions-bound
background, the vaccine has been in use since the 1960s. It is safe, effective and inexpensive. WHO
recommends immunization for all susceptible children and adults for whom measles vaccination is not
contraindicated. Reaching all children with 2 doses of measles vaccine, either alone, or in a measles-rubella
(MR), measles-mumps-rubella (MMR), or measles-mumps-rubella-varicella (MMRV) combination, should be
the standard for all national immunization programmes.
Evidenctly, the RI services are a cornerstone of the health system
and a basic public good that virtually all governments provide to
their populations. Routine services are the foundation of other
immunization efforts, including specific disease control initiatives,
introduction of new vaccines and periodic campaigns to improve
vaccination coverage. They are also the primary way to reach new
generations of children as early in life as possible, preventing
disease and protecting individuals and communities from
premature death and suffering.

9. MEDIA COVERAGE