GOOD VACCINES FOR CHILDREN IN INDIA   Dr. Abdul Kalu

Challenge:

Fewer than 44% of Indian young children receive the full schedule of immunization.

This states that around 56% of children have no immunization. General health diseased

conditions can be prevented when proper vaccines can be given at the proper time and a

proper form of recommendation in which the system can deliver the proper form of

immunization. The nature of primary health care challenges in the last two decades, has had

better delivery but more will have to be done to be able to promote or increase the survival

rate of children in India. The survival rate improved by about 200 % but more than half of the

children still die without good or complete vaccination at the proper time. In India, a record

number of children of about 27 million children are born which is the highest in the world.

But immunization process is low and generally incomplete in many communities.

Some conditions are highlighted such as in case of diarrhoeas due to rotavirus which

takes about 1,22,000 to 1,53,000 lives every year and a record number of 4,57 ,000 to

8,84,000 children are hospitalized under the age of 5. Polio has had a successful

immunisation process which has dropped the case of events significantly due to improved

and better programs of vaccinations which is not implemented in other health conditions.

There have been about 4 to 10 reported cases of polio in the last few years. Pneumonia is the

leading cause of children’s death in India. About 3,71,605 children under the age of 5 years

die due to pneumonia. Pneumococcal pneumonia is not being contained due to the nature of

its transmission which has continued to be a major challenge due to improper vaccination. It

is noted that 2 out of 3 children who died of pneumonia would have survived if proper

vaccination was given. This shows that in design thinking the ‘what is’ question can be asked

in the area of vaccination through the method of mind mapping and will create the proper

avenue and will continue into the ‘what if’ process.

Selection:

In the ‘what if’ stage of design thinking, all parameters, data and values are being

evaluated in order to see what the further outcomes in this process could be. In the design

thinking process, you can identify life-threatening challenges which come up due to lack of

access to vaccinations, improper vaccinations or no vaccinations. In order to understand the

process, we must develop a chain in order to observe the process of vaccination.

a) From the level of WHO, the National Coordinator to the state and district health

vaccine providers

GOOD VACCINES FOR CHILDREN IN INDIA   Dr. Abdul Kalu

b) To the primary health providers who are responsible for this process

The issue to be reviewed are transportation and logistics. In design thinking, logistics can

be approached in view of what is available. Design thinking is not a substitute to other forms

of management but is an efficient tool in management. There should be understanding of the

logistical process since most of the vaccines are donated by the WHO and other healthcare

providers. The gap between the collection and delivery has been a major challenge in this

process. Lots of work on approach to this system must be done in order to carry out the

process of immunization. Logistics alone is the major challenge for the available vaccine but

is not remedy if the vaccines are not available to begin with.

Vaccine availability will be determined early in the system if there is a proper census of

pregnant women before delivery. The infrastructural challenges of vaccination and

immunization for children in India is also reviewed by ‘what wows’ and ‘what works.’

Application:

In the application of design thinking, a good teaching model shows how there was an

interaction between the teaching workers, the nature of meals, seasons and the choice of old

people who eat the food from the Danish Government. It is noted that relationships between

the primary health care and the receiver (parents and the child) can also be a factor to

investigate.

What could be accessible and utilized in the full manifestation in the various manner

of vaccine delivery, could be a registration system of pregnant women from 5 months

gestation in order to be able to track of where, how to and who needs the vaccines. It is

interesting that many people at the time of pregnancies have no knowledge of vaccination

program. The primary health centre board should be responsible for educating women and

giving them confidence in the process which is of paramount importance, so that the death,

disability and hospitalisation ratio will reduce. In the area of logistics, technology should be

used to close the gap between availability and actual delivery. A lot of vaccine vials have

optimum temperature for dispensation. If the temperature is not adequate the vaccine spoils.

So, there should be mobile refrigerators, closer distribution centres and increased manpower.

In ‘what wows’ process of design thinking, it allows us to see potential possibilities. Door to

door vaccination of children should be considered. This will help create the relationships

between the health workers and the people. In understanding of the people and culture, it is

best that the people from the local community are trained to administer the vaccine. This

GOOD VACCINES FOR CHILDREN IN INDIA   Dr. Abdul Kalu

creates a continuous awareness in families, schools and communities at large from generation

to generation. It is also a possibility that doctors emphasize on vaccination proofs on annual

check-up of children under the age of 5 years.

Insight:

Education of the people will determine response to vaccines. The mapping process is

better off done when a community is well educated directly resulting in increase in

vaccination. Religious flexibility will be important to the news to reach out for more children.

It can be used when all mediums are being placed and available at disposal.

In India, in educational system, children tend to start under the age of 5 years which is

also important that the educational system asks for proofs for vaccination before admitting

children to school, to prevent further spread of diseases.

Approach:

It is a total repackaging or reorientation of people from the central to the district level

of how the administering of the vaccine is done. It is through increased education of people,

registration of women and increased manpower. When all these things are improved there

will be a radical improvement in the number of children taking vaccines every year resulting

in decrease in the deaths, disabilities and hospitalizations. There should be gifts or incentives

to parents who take their children for immunization which will promote and encourage

people to take part in this process of immunization.

Registration of women is important to track those who did not bring their children to

the proper course of immunization. In order to ensure the proper immunization, giving

financial penalty to people who fail to bring their children for immunization can be done.

This will create a sense of responsibility of the parents to the Society.

