Contd from previous issue
Other reasons include side-effects immediately after vaccination (such as a fever), misinformation about vaccines, migration of families, refusal to get vaccinated and shortcomings in the implementation of the scheme, he added.
Thirty-four-year-old Vinita, who uses only one name, has been working as an auxiliary nurse midwife in Sambhal block of UP’s Moradabad district for five years. She faces difficulty in explaining the benefits of immunisation, Vinita told IndiaSpend. “Women do not get their children vaccinated without permission from their mother-in-law or husband,” Vinita said. “We have to convince the entire family. Many people argue that since they themselves did not get vaccinated, there is no need to get their children or grandchildren immunised.”
“People agree to administer the BCG vaccine, but since other vaccines are stronger and may cause a fever, people think the vaccine causes ill health,” she added. “Still, people agree to one or two vaccines. When I visited one home for the fourth vaccine, the mother chased me out with a shoe.”
Fiza Parveen, 40, working as auxiliary nurse midwife in Moradabad’s Sirsi village for eight years, concurred, adding that her biggest challenge is convincing Muslims. “Less-educated Muslims living in backward areas believe that if they get vaccinated, their children will not be able to bear progeny,” she told IndiaSpend. “They argue that religious scriptures do not say vaccination is required when children do not have a disease.”
There is a need to use new methods to spread awareness, Prakash of the National Health Mission told IndiaSpend. “We have started identifying areas where children do not get vaccinated and where families are prone to refuse vaccination,” he said. “At the local level, we organise awareness meets in which we praise children who have received full immunisation.”
He added: “This has been happening since a long time. Now, we have trained accredited social health activists and anganwadi workers for social mobilisation. Along with this, street plays are performed in some districts, and information is written on walls and other spaces. We have also started using social media for spreading awareness.”
The focus of awareness campaigns has shifted to explaining the dangers of disease, Prakash said. It is necessary for information and awareness of new vaccines to reach people, he added. “It is important to tell people that there are new vaccines, not only for BCG but also for diarrhoea and pneumonia.”
Costs expected to rise
Between 2018 and 2022, India’s immunisation drive will cost Rs 52,220 crore, according to the comprehensive multi-year plan released by the Ministry of Health and Family Welfare. This is 52% more than the Rs 34,336 crore the country had spent between 2013 and 2017.
Between 2000 and 2018, the Global Alliance for Vaccines and Immunisation, a public-private collaboration of the Bill & Melinda Gates Foundation, the World Health Organisation, UNICEF and the World Bank, provided Rs 5,318 crore to India to introduce new vaccines and strengthen India’s health system. Global Alliance for Vaccines and Immunisation is ending its financial support to India after 2020.
In 2017-’18, India spent Rs 6,864 crore on its immunisation programme. Of this, the government spent 79% while the remaining 21% was funded by partners and donors, data show. Global Alliance for Vaccines and Immunisation contributed about 14%.
Compared to 2017, India’s immunisation programme is expected to cost 80% more by 2022, when the country would need to spend Rs 12,364 crore on vaccines and shared personnel costs.
This article first appeared on HealthCheck.in, a publication of the data-driven public-interest journalism non-profit IndiaSpend.