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What Is The Impact Of COVID-19 On Child Vaccinations In India?

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This post is a part of YKA’s dedicated coverage of the novel coronavirus outbreak and aims to present factual, reliable information. Read more.

In response to the COVID-19 pandemic, the Government of India (GoI) announced a nationwide lockdown from the end of March 2020 till June 2020. Access to public healthcare facilities was limited during this time, and health services were severely disrupted, including vaccinations in rural areas. This blog touches upon some aspects of the disruption.

vaccination child
Representational image

Under India’s Universal Immunisation Programme, vaccinations are done free-of-cost against 12 preventable diseases. A child is considered fully immunised if they have received all due vaccines as per the national immunisation schedule, within a year of being born. In 2020, the number of immunisation sessions planned fell from 10.58 lakh to 6.02 lakh between March and April. The number of immunisation sessions held fell from 9.81 lakh to 4 lakh during the same period (download our analyses).

The decline in the number of sessions has resulted in approximately 11 lakh fewer fully-immunised children (9-11 months) between the lockdown period of April to June, compared to the same period for the financial year (FY) 2019-20.

Even after the lockdown was lifted and restrictions were eased, the stigma around the COVID-19 virus and the fear of contracting the virus hampered the efforts of frontline workers (ASHAs, Auxiliary Nurse Midwives, and Anganwadi Workers), who are based in local communities, from effectively assisting their communities. For instance, in an interview by us, an Auxiliary Nurse Midwife in Rajasthan spoke about how workers like her were branded as ‘virus carriers’.

Moreover, immunisation services were only started in some districts by October 2020. Whether or not the decrease in immunisation coverage numbers was compensated for in the months after the lockdown remains to be determined, as data for these months was not available at the time of writing.

Before the pandemic, India had also built an Alternate Vaccine Delivery System (AVDS), which ensured the delivery of vaccines and on-site availability of logistical supplies on immunisation session days. This was used during the pandemic to provide immunisation services to children and pregnant women who missed their routine vaccines during the lockdown. But, even here, there were reports of substantial challenges.

With more-accessible routine immunisation centres either closed or people discouraged from coming to the centres, AVDS workers – who are engaged on a part-time basis and usually belong to the local community – had to undertake arduous travel (even crossing a river in one case) to source the vaccines and ensure that these reached people.

The challenges above are important to note. Not only are vaccinations lifesaving, but India has shown significant improvement in its health indicators for immunisation over the last two decades, registering an increase of 10% between 2010 and 2019 in immunisation coverage. A major part of this success can be attributed to Mission Indradhanush (MI), GoI’s immunisation campaign, which was launched in 2014 with the objective of achieving full immunisation coverage for at least 90% Indian children by 2020.

MI has been successful in fully vaccinating 255 lakh children and 69 lakh pregnant women in 2015-16, resulting in a 6.7% annual increase in full immunisation coverage two years after it was launched. This was an improvement over the previously observed 1% annual increase from 2009 to 2013. To further expand immunisation coverage, the Intensified Mission Indradhanush (IMI) and IMI 2.0 were introduced for a period of four months, in  2017-18 and 2019-20, respectively.

In February 2021, IMI 3.0 was launched. It will be carried out in two rounds, almost a year after the first lockdown was announced to curb the spread of COVID-19.  This campaign aims at vaccinating children and pregnant women who missed their vaccine doses during the pandemic and will follow COVID Appropriate Behaviour (CAB) (practices such as physical distancing, wearing a reusable face cover or mask, and regularly disinfecting frequently touched surfaces).

But since the drive is being carried out in the pandemic, its success will also depend on the fulfilment of various additional factors. These include tracking down people who have missed their vaccinations and immunisation session planning while keeping in mind the spikes and decreases in COVID-19 cases.

The pandemic has threatened to unravel the strides that India has made in immunisation coverage over the last decade. The government now has the dual challenge of achieving its objective of 90% immunisation coverage while undoing the setbacks caused by the pandemic. Launching more ‘catch-up’ sessions such as the IMI 3.0 can prove important to help India get back on track.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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