A child vaccination centre. (Express Photo by Anonna Dutt)
A railway crossing separates Tindli village from the nearest town of Panagar in the Jabalpur district of Madhya Pradesh, drawing a line between its forlorn life and civilization. But a quiet digital revolution is blurring that divide as ASHA worker Reena Patel uses her smartphone to fill in details of a month-old baby on U-Win, the government’s new childhood vaccination management portal.
Tindli village is part of the government’s pilot project in 64 districts to register pregnant women and children on U-Win for last mile coverage of maternal and child care. The platform, which is likely to be formally launched on August 15, will be driven by community health workers, who have already had success in polio and COVID vaccinations.
Patel, who is the first ASHA worker in India to have registered a child on the portal, goes door-to-door collecting data and uploading it on to the digital platform to ensure that no child misses their shot. Every immunisation day, the portal automatically generates a list of children due for vaccination and sends an SMS alert on their parent’s phones. Patel, who was trained last August, says, “I have registered all 55 children, between the ages of 0 and 5, in my village. The portal will send SMS alerts to their parents’ phones on the dates these are due and the nearest health centres where they can be taken. So there is no question of them missing shots and the coverage in the community goes up,” says Patel.
Advertisem*nt
A healthcare worker helps a pregnant woman get her shots. (Express Photo by Anonna Dutt)
This real-time registration of children and online record of vaccination are aimed at reducing the number of “zero-dose” children (those who do not receive their first diphtheria, pertussis, and tetanus-containing vaccine), especially among migrant workers, who can now get the children vaccinated at any centre across the country without carrying any documents. The U-Win portal is one of the important steps towards halving the number of zero-dose children by 2030.
Since August last year, ASHA workers like Patel, auxiliary nurses and midwives (ANMs) and health centres in the Jabalpur division have been registered on the U-Win portal. Her co-worker and ANM Asha Chaudhary is responsible for immunising 450 children across eight villages, including Tindli. She says that the portability of data between villages, cities and even states is the most useful feature. “When children travel to their grandparents’ homes, I tell the family to go to any vaccination centre nearby and take the shots they are due for. Mothers who might have gotten their first tetanus shot here can get the next one in their own village. There is no need to carry the vaccination booklet — all they need is their phone number to access the records at any centre,” says Chaudhary. When her centre in Jhurjhuru had its immunisation day (usually done every Tuesday and Friday) she could immediately see an update of the shots received by one of the children under her care at a centre in Narsinghpur, 107 km away. She is now in the process of updating records of older children under her care, all born before the platform was rolled out.
A healthcare worker briefs parents on vaccination. (Express Photo by Anonna Dutt)
Better data mining can improve last mile coverage. “It ensures better compliance. You can identify the exact number of children locality wise, who are unvaccinated, and the reason for it. You can then tailor the interventions accordingly ” says Dr Puneet Jaitley, professor of community medicine at AIIMS. Dr Jayaprakash Muliyil, epidemiologist and former principal of Christian Medical College-Vellore, weighs in on advantages of individual records over just numbers. “In case of a measles outbreak, we re-vaccinate people in the affected area. This might result in some children getting multiple doses and others remaining completely unvaccinated. The numbers cannot tell the difference. Now that the portal has data for individual children, it might,” he says.
How does U-Win work?
With all government delivery centres and some private hospitals in Jabalpur division registered on the portal, Chaudhary no longer needs to register newborns in her area. “The community health centre nearby logs in the data and the three shots they get at birth — polio, hepatitis B and tuberculosis. I can add the doses they receive 1.5 months onwards using the mobile number or the Aadhaar number of the parents,” she says. She can monitor better when a separate vaccine management platform — that ensures there are no stockouts and the vaccines remain temperature controlled — is linked to the U-Win portal.
Advertisem*nt
Meanwhile, the healthcare workers have devised their own method of maintaining the right temperature for the vaccines. In a one-room centre without fans or coolers, they maintain the temperature of the vaccines using a slotted thali. The vaccines that don’t spoil from freezing are placed on a silicon ice pack delivered with the vaccine. The ice pack is then placed on the steel plate with the rest of the vaccines in each slot so that they can remain cool without freezing.
However, teething troubles remain. Delivery centres still lack vaccine stores and internet connectivity is patchy. That’s why Patel maintains a physical register as back-up. As Dr Santosh Shukla, MP state immunisation officer, says: “The portal currently allows entry of data for a particular vaccination session for 24 hours. We have sought a 48-hour window so that the healthcare worker can upload information.”
