Addressing Immunization Inequity-What Have the International Community and India Learned over 35 Years?

Abstract

Countries around the world established immunization programs over 40 years ago to reach all infants. The maturity of these preventive health programs offers some useful learning on the importance of, and components needed for, population-based services to reach all communities. A public health success, ensuring equity in immunization, requires a multi-faceted approach that includes sustained government and partner commitment and human, financial, and program operational resources. Evidence from India's Universal Immunization Program (UIP) across stabilizing vaccine supply and services, enhancing access, and generating demand for vaccines in the community provides a useful case study. The political leadership in India took advantage of the two decades of learning from polio eradication and focused initiatives, such as the National Health Mission and Intensified Mission Indradhanush, to reach populations with immunization services. With a goal of leaving no one behind, India's UIP and partners are bringing essential rotavirus and pneumococcal vaccines nationwide, upgrading vaccine cold chain and supply systems with technologies, such as the electronic Vaccine Intelligence Network (eVIN), and optimizing funding for local needs through the Program Implementation Plan (PIP) budgetary processes and building health worker capacities through training, awareness, and e-learning.

Keywords: India; equity; immunization; inequity.

Figure 1

Percent of Fully Immunized Children (National Family Health Surveys—NFHS).

Figure 2

Person-centered immunization service experience graphic.