3) Universal Immunisation programme

Immunisation is the most cost effective/ health intervention to reduce morbidity and mortality due to vaccine preventable disease such as TB, Diphtheria, Pertusis, Tetanus, Poliomyelitis, Measles.  Immunisation session now a days is called as Health & Nutrition Day, is held in every village once in a month.  If population of village is more than 4000, health and nutrition day is organized on weekly basis.  In a subcenter village health day is organised in subcenter building otherwise it is held in anganwadi center (AWC). 

     Following is the schedule of Immunisation and Vitamin A supplementation

Beneficiary	Age	Vaccine
Pregnant Women	PrimGravida - at registration preferably after 16 weeks of pregnancy	Tetanus Toxoid - 1 Tetanus Toxoid - 2 ( 4 weeks after the first dose)
	Multigravidae	TT booster
Infants	At Birth	BCG & '0' OPV in case of institutional deliveries. OR BCG upto 6 weeks
	At 6 weeks	DPT - 1 & OPV 1, Hepatits B1
	At 10 weeks	DPT 2 & OPV 2 , Hepatits B2
	At 14 weeks	DPT 3 & OPV 3 , Hepatits B3
	After 9 month upto 12 months	Measles, Vit- A First Dose
Children	At 18 months	DPT & OPV Booster, Vit- A Second Dose
	At 24 months	Vit- A Third Dose
	At 30 months	Vit- A Fourth Dose
	At 36 months	Vit- A Fifth Dose
	At 42 months	Vit- A Sixth Dose
	At 48 months	Vit- A Seventh Dose
	At 54 months	Vit- A Eighth Dose
	At 60 months	Vit- A Nineth Dose
	At 5  years	DT
	At 10 years	TT
	At 16  years	TT

 

Now a days AD (Auto Disable) syringes are used for vaccinating beneficiaries.  The beneficiaries are provided maternal and child protection cards. The entries with regard to vaccination are recorded into mother and child protection card (immunisation card).The growth chart of child is also ploted onmother and child protection card by taking weight in anganwadi center every month.

 

Integrated Management of Neonatal & Childhood Illness (IMNCI) - Latur district is one of the district for implementation of WHO & UNICEF collaborated IMNCI programme.  All MOPHC, CDPOs, Health Workers ICDS & AWWs are trained in IMNCI. 

Objective of IMNCI strategy - To reduce deaths frequency & severity of illness & disability & to contribute to improved growth & development of neonates/children through primary health care approach  

IMNCI interventions -

IMNCI intervention is integrated case management of 5 most important cases of childhood of deaths

       Acute Respiratory Infections

       Diarrhea 

       Measles

       Malaria

       Malnutrition

IMNCI case management process includes assessment for major symptoms & examination for danger signs & treatment as per IMNCI protocols counseling to mother/caretaker about food/fluids referred to health facility.   

Integrated Child Development Scheme is implemented with close co-ordination with women & child welfare Dept of Zilla Parishad.  There are 1700 AWC in rural area each AWC catering to approximately 1000 pop.  Service delivery in ICDS is the joint responsibility of ICDS & health dept of Z.P. Latur.  There are 208193 beneficiaries of 0-6 year age group throughout the district. 

Objectives of ICD scheme -

To improve nutritional & health status of preschool children in 0-6 year age group. 

• To lay foundation of proper psychological development of the child. 
• To reduce incidences of mortality, morbidity, malnutrition and school dropout.
• To import health & malnutrition education of women between 15-45 years age especially ANC, PNC & adolescent girls.

ICDS Services -

Sr No.	Services	Beneficiaries
1	Supplementary Nutrition	ANC, PNC, children below 6 year
2	Immunisation	ANC, PNC, children below 6 year
3	Health check up	ANC, children below 6 year
4	Referral services	High risk ANC/PNC, severely malnourished and seriously ill children
5	Health Education & Nutrition Education.	Women between 15-45 yrs age group esp. ANC, PNC and Adolescent girls
6	Informal preschool education	Children 3-6 years.

Out of 6 services under ICDS Scheme, 4 services i.e. Immunisation, Health checkup, Referral services, Health and Nutrition Education are offered by PHC staff in co-ordination with AWW.  All these services are provided during health and nutrition day ( Immunisation session) organized in AWC.  Health checkup of all children is done by MO PHC once in three months  ( i.e. once in each quarter ).  While children in grade III and IV and seriously and chronically ill are examined once in a month.  While children in grade III and IV and seriously and chronically ill children are examined by pediatrician at RH level periodically.  0-6 year children with learning disability are treated if needed surgery under Sarva Shiksha Abhiyan.  While those with need for cardiac surgery are investigated and operated under Jivan Dai scheme, School Health Scheme at higher centers. 

            The Child Development Centers/ Nutritional Rehabilitation centers were established in 20 PHCs in first round.  The names of those PHCs are - Chikurda, Bori, Nivali, Kharola, Karepur, Shirur T., Kingaon, Hadolti, Aurad Sh., Panchincholi, Belkund, Matola, Janwal, Chapoli, Kasar B., Atnoor, Sakol, Walandi, Her and Wadhavana. During second round CDCs were established at all of above PHCs excepting Panchincholi and Walandi .The children in the grades of III and IV of PEM were admitted for 21 days at these CDCs.  They were provided energy dence high protein diet and supplementary medicines such as multivitamin, Multi Minerals, Iron and folic Acid, K-RESOMOL, KESOL for 21 days as per Dr. Bhan's protocol under of Rajmata Jijau Maternal and child health Mission.  The 82 children were upgraded at the time of discharge while total 112 showed conversion of grade IV to III, III to II on 8 th day of discharge.  The children are provided diet and medicine as per Dr. Bhan's protocol under close supervision of AWW/ANM/MPW/ICDS supervisor/CDPO/MO PHC.  The encouraging results have motivated the district health authority to establish CDCs at all 46 PHCs in Latur District.