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APHA Scientific Session and Event Listing

Vijaya Kiran, MD and Tasnim Partapuri. IMMUNIZATIONbasics, 30, Hauz Khas Village, New Delhi, 110016, India, 91-11- 55702887, vijay@immbasics.org

As a signatory to the Convention of the Rights of the Child, the Indian Government is committed to ensuring child survival, (Article 6) including the provision of quality and timely immunization services. However, strengthening of Routine Immunization services in India continues to be perceived through a technocratic lens, with near exclusive focus on "outcomes"- improving coverage and the attendant debate over the difference between evaluated and recorded coverage. In a rights-based framework, this outcome-focused approach has sought to increase access to immunization services in hitherto un-reached and under-served populations. Such a focus neglects another key issue that impacts on rights- the quality of the "process", including sustainability and community participation.

Using a comprehensive rights-based strategy that combines focus on both outcomes and processes, USAID/IMMUNIZATIONbasics is reinforcing the "Reaching Every District" approach in three populous north Indian states of Uttar Pradesh, Jharkhand and Rajasthan. USAID-supported NGOs such as CARE, CORE and UHRC work closely with health and other government departments and CBOs to improve coverage (outcomes) by identifying left out and hard to reach areas and re-establishing outreach vaccination. They also initiate supportive supervision and establish links between community and service providers in an effort to improve quality, participation and sustainability (processes). Field-level NGO staff, CBO representatives and service-providers are trained in key concepts of immunization and supportive supervision. These stakeholders then jointly assess the various facets of the program through the use of simple monitoring tools, identify problems and initiate corrective actions. Early results using quantitative and qualitative progress indicators from a piloting of this strategy in one district each of these states indicates significant improvement in both outcomes (coverage) and process (quality).

Learning Objectives: