Routine Immunization: Bihar

19 Mar 2014
 Coverage: Full Immunization
– Full Immunization for Jan’13-Dec’13 is 65% (highest 79%
for Nalanda and lowest 48% for Lakhisarai, Araria & Kaimur).
• In Dec’13, full immunization of state was 69%.

–13 districts are <60% (Lakhisarai, Araria, Kaimur, Jamui,

Banka, Sheohar, Arwal, Gaya, Nawada, Begusarai, C West,
Kishanganj and Madhubani).

–Araria, C West, Gaya and Jamui are 4 district whose Full

Immunization has remained <60% for last 3 years.

–There are 119 blocks in 29 districts whose full immunization

is <55%.
 Coverage: Drop out and Left out
• Drop out: Biggest concern.
– Drop out from BCG to Full immunization is 32%.
– Banka, Lakhisarai, Arwal, Kaimur, Begusarai and Araria
has drop out rate above 40%.
– There are 387 blocks in state whose measles coverage is
<80%.

• Left out: 3% of state children comes under left out.

– Districts where left out is above 5% are Jamui (13%), Gaya
(9%), Araria (8%), Sheohar (7%), C West, Kishanganj,
Katihar and Nawada (6%).
% of Children Received doses out of Children Monitored [12-23 Months] - (All) -
(Jan'13-Dec'13)

There is a gap of 10% between

corresponding doses
Total of DPT3 and OPV3

97 95
100 91 90
90 85 83
75 76
80
70 65
60
50
40
30
20
10
0

Immunization
Measles
BCG

1 Dose of

1 Dose of
2 Doses of

3 Doses of

2 Doses of

3 Doses of
DPT

OPV
DPT

DPT

OPV

OPV

Full
Data Source : RI House to House Monitoring by WHO-NPSP & Govt.
% Measles Vaccination Status out of Children Monitored [12-23 Months] Col No.

Total

100
Cham par an West Jan'13-Dec'13 : 76 %
90 81
78 76 7778
737574 75 73 75757373 7375 75737573
80 70707172727171707071 72 72 70 71
Cham paran East Sitam arhi 69 67
Gopa lganj S heohar
Madhubani
70
S upau l Kis hanganj
Ara r ia 60
Si wa n Mu zaffar pur
Dar bhanga
50 KAIMUR
Sar an Madhepur a
Sam astipur Sahars a Pur ni a
Vaisha li 40

Bux ar Kha gari a Katihar

30
Bhojpur Patna Begus arai
20
Mung er Bhagalpu r
Arw al Nalanda
Jeha nabad La khisarai 10
Roh tas Sheikhpura
Kaimu r
0 PATNA
Ja mui Banka

Nov'11

Nov'12

Nov'13
Jul'11

Jul'12

Jul'13
Jan'11

Jun'11

Jan'12

Jun'12

Jan'13

Jun'13
PURNIA

Mar'11

Mar'13
Feb'11

Apr'11
May'11

Mar'12

May'13
Aug'11
Sep'11

Dec'11

Feb'12

Apr'12
May'12

Aug'12
Sep'12

Dec'12

Feb'13

Apr'13

Aug'13
Sep'13

Dec'13
Oct'11

Oct'12

Oct'13
Aur angaaba d Nawad a
Gaya

SARAN

0 - 20 % • Only 7 districts in state have measles

21 - 40 %
41 - 60 % coverage above 80%.
61 - 80 %
81 - 100 %
Data Not Available • To achieve a state average of FI of
80%, improvement in MCV1 coverage
is required.

Children Monitored [N]

(Jan'13-Dec'13) : 63091 Data Source : RI House to House Monitoring by WHO-NPSP & Govt.
% Children received MCV2

• From Aug’13, all 20 districts of

Col No.

Dec'13 : 36 % phase 3 started the MCV2 in RI.

Champaran West

Gopalganj
Champaran East Sitamarhi
Sheohar
• Phase 1 and Phase 2 districts
Madhubani
Supaul
Araria
Kishanganj started MCV2 in Aug’11 and Aug’12
Siwan Muzaffarpur
Darbhanga
KAIMUR
Saran Madhepura
Sam astipur Saharsa Purnia
Vaishali

Buxar Khagaria Katihar

Bhojpur Patna Begusarai

Arw al
Jehanabad
Nalanda
Lakhisarai
Munger Bhagalpur % Children received JE2 in 9
Rohtas

Districts of Bihar
Sheikhpura
Kaimur PATNA
Jamui Banka PURNIA
Aurangaabad Nawada
Gaya

SARAN
Champaran West Dec'13 : 33 %

Children Monitored (16-24 months) [N]:4392 Champaran East Sitamarhi

Sheohar
Gopalganj
Madhubani
Supaul Kishanganj
Araria
Siwan Muzaffarpur
Darbhanga
0 - 20% Saran Madhepura
Purnia
Sam astipur Saharsa
21 - 40% Vaishali

41 - 60% Buxar
Begusarai
Khagaria Katihar
Bhojpur Patna
61 - 80%
Bhagalpur
81 - 100% Arw al
Jehanabad
Nalanda
Lakhisarai
Munger

Rohtas
NA Sheikhpura
Kaimur
Jamui Banka
Aurangaabad Nawada
Gaya

Children Monitored (16-24 months) [N]:1020

 0
10
20
30
40
50
60
70
80
KHA_KHAGARIA URBAN

90 84
JBD_JEHANABAD URBAN
SKP_SHEIKHPURA URBAN
82 82
BXR_BUXAR URBAN
PRN_PURNEA URBAN
KMU_BHABUA URBAN
SAM_SAMASTIPUR URBAN
80 79 78 78

NLD_BIHAR SHARIF
MDP_MADHEPURA URBAN
AGB_AURANGABAD URBAN
SAR_CHAPRA URBAN
75 75 74 74

SIT_SITAMARHI URBAN
PTN_PATNA URBAN
State Avg. : 67 %

RTS_SASARAM URBAN
72 72 71

VSL_HAJIPUR URBAN
GYA_GAYA TOWN
GPG_GOPALGANJ URBAN
SPL_SUPAUL URBAN
BGS_BEGUSARAI URBAN
CPE_MOTIHARI URBAN
SAH_SAHARSA URBAN
69 69 68 68 67 67 67

RTS_DEHRI URBAN
MZF_MUZAFFARPUR URBAN
DBG_DARBHANGA URBAN
MUN_JAMALPUR URBAN
64 64 63 62

MDB_MADHUBANI URBAN
KTH_KATIHAR URBAN
RTS_BIKRAMGANJ URBAN
BNK_BANKA URBAN
KIS_KISHANGANJ URBAN
60 60 60 59 58

SWN_SIWAN URBAN
56

BGP_BHAGALPUR URBAN
NWD_NAWADA URBAN
53 51
There is no dedicated
Urban RI: %Full Immunization Status [12-23 Months] (Jan'13 - Dec'13)

BJR_ARA URBAN
42
the ANMs of rural PHCs

JMI_JAMUI URBAN
It is mainly being done by

LKS_LAKHISARAI URBAN
vaccinator for urban areas.

35 33

ARR_ARARIA URBAN
25
 Immunization status of monitored children –
Mar’13 to Dec’13 BIHAR

Reason for children not being fully immunized

1%2%
12% N=618
100.0% 1.0%
No Immunization 26%
2% Not aware of need
90.0% 3%

2% Aware but not knowing where & when to

36.0 1% get immunization
2%
80.0% % 1%
Fear of AEFI
Partially 7%
70.0%
Immunized Adverse media report

Child was sick care-giver did not go for

vaccination
60.0%
41%
Child was sick health worker did not vaccinate
50.0%
Session time/ location/ Long waiting time
10% 11% not convenient
40.0% 2%
5% Vaccinators behaviour unfriendly
63.0 Non-availability of vaccine at centre
30.0% %
Other
20% 13%
Fully Immunized Do not Know Why
20.0%
Data Missing
0%
10.0%
8%

0.0% 5% N=17,363
22% 1%
3%
BIHAR (n=44,667)
n=children 12 to 23 Data Source : RI House to House Monitoring by WHO-NPSP & Govt.
months of age
Tools to FLW for better tracking of beneficiaries
• To address the issue of Drop out and Incentive
distribution to ASHA – State has taken some
initiatives –

– State has supplied a tracking booklet to ASHA for children

<2 years and pregnant women.
– The Due listing and incentive distribution to ASHA has
been clubbed
– Training for this has been completed at State, District and
block.

• There is some challenges in implementation in

some of the districts and urban areas.
Due listing of beneficiaries: % Session sites where Due list Available with
mobilizer- (Jan’13-Dec’13)
Col No.

Cham par an West Jan'13-Dec'13 : 69 %

Cham paran East Sitam arhi

S heohar
Gopa lganj
Madhubani Nil
S upau l
Ara r ia
Kis hanganj 1 - 30 %
Si wa n Mu zaffar pur
Dar bhanga 31 - 59 % KAIMUR
Sar an Madhepur a
Vaisha li
Sam astipur Sahars a Pur ni a 60 - 79 %
>= 80 %
Bux ar
Bhojpur Patna Begus arai
Kha gari a Katihar
Data Not Available
Mung er Bhagalpu r
Arw al Nalanda
Jeha nabad La khisarai
Roh tas Sheikhpura
Kaimu r PATNA
Ja mui Banka PURNIA
Aur angaaba d Nawad a
Gaya

SARAN

Held [N] (Jan'13-Dec'13) : 24951 Sites

80 76
72
66
61 61
60 53
46
• State is showing gradual improvement 40 41 42 41 42 43 44 44 42
40
in due listing.
• More focus is required in Sheohar, 20
Gopalganj, Siwan, Saran, Nawada and
0
Jamui.
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
 Training of Frontline health workers
Col No.

%ANM- State Avg:79 %ASHA- State Avg:66

Champaran West Champaran West

Champaran East Sitamarhi Champaran East Sitamarhi

Gopalganj Sheohar Sheohar
Gopalganj
Madhubani Madhubani
Supaul Kishanganj Supaul Kishanganj
Araria Araria
Siwan Muzaffarpur Siwan Muzaffarpur
Darbhanga Darbhanga
KAIMUR
Saran Madhepura Saran Madhepura
Sam astipur Saharsa Purnia Sam astipur Saharsa Purnia
Vaishali Vaishali

Buxar Khagaria Katihar Buxar Khagaria

Bhojpur Patna Begusarai Begusarai Katihar
Bhojpur Patna

Munger Bhagalpur Bhagalpur

Arw al Nalanda Arw al Nalanda Munger
Jehanabad Lakhisarai Jehanabad Lakhisarai
Rohtas Sheikhpura Rohtas Sheikhpura
Kaimur Kaimur PATNA
Jamui Banka PURNIA Jamui Banka
Aurangaabad Nawada Aurangaabad Nawada
Gaya Gaya

SARAN

Training of 34% ASHAs and 39%

Col No.

AWWs is still pending.

Champaran West
%AWW- State Avg:61

Champaran East Sitamarhi

• Districts which are lagging are
Gopalganj Sheohar
Madhubani
Supaul Kishanganj
Araria, Banka, Aurangabad,
Siwan

Saran
Muzaffarpur
Darbhanga
Araria
Muzaffarpur and Nawada. KAIMUR
Madhepura
Sam astipur Saharsa Purnia
Vaishali

Buxar Khagaria Katihar

Bhojpur Patna Begusarai

Munger Bhagalpur
Arw al Nalanda
Jehanabad Lakhisarai
Rohtas Sheikhpura
Kaimur PATNA
Jamui Banka PURNIA
Aurangaabad Nawada
Gaya

SARAN
%Sessions with Paracetamol available
Col No.
Total

100
8989899087
Cham par an West Jan'13-Dec'13 : 83 % 90 83
86
80 82
818180 8181 817979 81
767874 77787876 7678
80 7273 72 72
Cham paran East Sitam arhi 66676868 67
S heohar 70
Gopa lganj
Madhubani
S upau l Kis hanganj
60
Ara r ia
Si wa n Mu zaffar pur
Dar bhanga 50
KAIMUR
Sar an Madhepur a
Sam astipur Sahars a Pur ni a 40
Vaisha li
30
Bux ar Kha gari a Katihar
Bhojpur Patna Begus arai
20
Mung er Bhagalpu r
Arw al Nalanda
Jeha nabad La khisarai 10
Roh tas Sheikhpura
Kaimu r 0 PATNA

OCT'1
Jan'11
Feb'11
Mar'11

May'11
Jun'11
Jul'11

Oct'11
Nov'11
Dec'11
Jan'12
Feb'12
Mar'12

May'12
Jun'12
Jul'12

Oct'12
Nov'12
Dec'12
Jan'13
Feb'13
Mar'13

May'13
Jun'13
Jul'13

Nov'13
Dec'13
Sep'11

Sep'12

Sep'13
Banka

Apr'11

Aug'11

Apr'12

Aug'12

Apr'13

Aug'13
Aur angaaba d Ja mui PURNIA
Nawad a
Gaya

SARAN

Nil
1 - 30 % Dec'13 : 87 %
31 - 59 % Cham par an West

60 - 79 %
>= 80 % Cham paran East Sitam arhi
S heohar
Data Not Available Gopa lganj
Madhubani
S upau l Kis hanganj
Ara r ia
Si wa n Mu zaffar pur
Dar bhanga

Provision of Paracetamol to alleviate Sar an

Vaisha li
Sam astipur
Madhepur a
Sahars a Pur ni a

the fever concern following DPT has Bux ar

Bhojpur Patna Begus arai
Kha gari a Katihar

improved. Arw al
Jeha nabad
Nalanda
La khisarai
Mung er Bhagalpu r

Roh tas Sheikhpura

Kaimu r
Ja mui Banka
Aur angaaba d Nawad a
Gaya
Held [N] (Jan'13-Dec'13) : 24951 Sites

(Dec'13) : 3395 Sites

Data Source : RI Session Site Monitoring by WHO-NPSP & Govt.
 Mobilization by AWW
– Before 2013, more than 50% beneficiaries were
mobilized to session site by AWW.

– In 2013, only 25% parents acknowledge that they

were mobilized by AWW.
• This is even less than 10% in Araria, Arwal, Banka, C
West, Katihar and Sheikhpura.

– This dip in mobilization effort is mainly following

withdrawal of incentive money for AWW from
2012.
 10
20
30
40
60
70
80
90
100

0
10
20
30
40
50
60
70
80
90

0
Nov'11

50 42
Dec'11

62
Jan'11
Feb'11
Jan'12

67
Mar'11
Feb'12 Apr'11

71
May'11
Mar'12

65
Jun'11
Apr'12 Jul'11

76
Aug'11
May'12 Sep'11 100 9393929292949494
Jun'12 Oct'11
Nov'11
Jul'12

72 72 71
Dec'11
90 929290

Jan'12
85

Aug'12

86
Feb'12 67
Sep'12

90
Mar'12 62
Oct'12 Apr'12

93
May'12
65
Total

Nov'12

87
Jun'12
70 68

Jul'12
71

Dec'12
Aug'12
Jan'13

68 70
Sep'12
8483

Oct'12
81

Feb'13

81
Nov'12
Mar'13 Dec'12

90
Jan'13
Apr'13

85
%HepB Availability
Feb'13
72
%BCG Availability

May'13 Mar'13

90
Apr'13
Jun'13 May'13
787780 79 7677

Jul'13 Jun'13
Jul'13
70

Aug'13 Aug'13
Sep'13
73 7274

Sep'13
OCT'1
OCT'13 Nov'13
51

Dec'13
57 58

Nov'13
Dec'13

94 95 97 95 94 94 93
10
20
30
40
50
60
70
80
90
100

Jan'11
91

Feb'11

10
20
30
40
50
60
70
80
90
100

0
Mar'11
Jan'11
81

Apr'11
Feb'11 May'11
81 81

Mar'11 Jun'11
84 84 85

Apr'11
Jul'11
69

May'11
70 72

Aug'11
57

Jun'11
75 76 75

Sep'11
44

Jul'11
62

Oct'11
52

Aug'11
52

Nov'11
66

Sep'11
39

Oct'11 Dec'11
47

Nov'11 Jan'12
7776

27

Dec'11 Feb'12
60

Jan'12
4648

Mar'12
71

Feb'12 Apr'12
58

Mar'12 May'12
63

Apr'12
343535
Total

Jun'12
50

May'12
37

Jul'12
69

Total

Jun'12
31

Aug'12
79

Jul'12
45

Sep'12
86

Aug'12
Sep'12 Oct'12
67

Nov'12
8079

Oct'12
63 63

Dec'12
86

Nov'12
59
%tOPV Availability

Dec'12 Jan'13
89

Jan'13 Feb'13
4849

Feb'13
39

Mar'13
Mar'13
72

Apr'13
Apr'13 May'13
May'13
70

Jun'13
Jun'13
Jul'13
Status of availability of Vaccines at session sites (Jan’11 –Dec’13)

Jul'13
65 6665

Aug'13
Aug'13
Sep'13 Sep'13
6869

OCT'1 OCT'1
Nov'13
9393 9192939395959595

Nov'13
49

Dec'13
96

Dec'13
53 53
%All RI Vaccines & A D Syringes available with HepB
 BCG Shortage: % of Children received BCG Within 45 Days of their birth Col No.

Total

100
Cham par an West Jan'13-Dec'13 : 81 % 8684878787868485 868585
90 82 83 82838182 81808481818584818481
78 80 79 77 7877
80
75 75 74
Cham paran East Sitam arhi
Gopa lganj S heohar
Madhubani
70
S upau l Kis hanganj
Ara r ia 60
Si wa n Mu zaffar pur
Dar bhanga
50 KAIMUR
Sar an Madhepur a
Sam astipur Sahars a Pur ni a
Vaisha li 40

Bux ar Kha gari a Katihar

30
Bhojpur Patna Begus arai
20
Mung er Bhagalpu r
Arw al Nalanda
Jeha nabad La khisarai 10
Roh tas Sheikhpura
Kaimu r
0 PATNA
Ja mui Banka

Nov'11

Nov'12

Nov'13
Jul'11

Jul'12

Jul'13
Jan'11

Jun'11

Jan'12

Jun'12

Jan'13

Jun'13
PURNIA

Mar'11

Mar'12

Mar'13
Feb'11

Apr'11
May'11

Aug'11
Sep'11

Dec'11

Feb'12

Apr'12
May'12

Aug'12
Sep'12

Dec'12

Feb'13

Apr'13
May'13

Aug'13
Sep'13

Dec'13
Oct'11

Oct'12

Oct'13
Aur angaaba d Nawad a
Gaya

SARAN

0 - 20 % Dec'13 : 77 %
Cham par an West
21 - 40 %
41 - 60 %
Cham paran East Sitam arhi
61 - 80 % Gopa lganj S heohar
Madhubani
81 - 100 % S upau l Kis hanganj
Ara r ia
Data Not Available Si wa n Mu zaffar pur
Dar bhanga
Sar an Madhepur a
Sam astipur Sahars a Pur ni a
Vaisha li

Bux ar Kha gari a Katihar

Bhojpur Patna Begus arai

Mung er Bhagalpu r
Children Monitored (1-44 Days) [N] Roh tas
Arw al
Jeha nabad
Nalanda
La khisarai
Sheikhpura
(Jan'13-Dec'13) : 10402 Kaimu r
Ja mui Banka
Aur angaaba d
(Dec'13) : 1476 Gaya
Nawad a

Data Source : RI House to House Monitoring by WHO-NPSP & Govt.

 %Session sites where any Supervisor Visited Today
Col No.

Cham par an West Mar'13-Dec'13 : 8 %

• State has introduced new
monitoring formats from Jan’14.
Cham paran East Sitam arhi
Gopa lganj S heohar
Madhubani

Si wa n Mu zaffar pur
S upau l
Ara r ia
Kis hanganj
• Detailed guidelines with expected
Dar bhanga
Sar an

Vaisha li
Sam astipur
Madhepur a
Sahars a Pur ni a
number of format filling by different KAIMUR

Bux ar
Bhojpur Patna Begus arai
Kha gari a Katihar
health staff has been mentioned.
Mung er Bhagalpu r
Arw al Nalanda
Jeha nabad La khisarai
Roh tas Sheikhpura
Kaimu r PATNA
Ja mui Banka PURNIA
Aur angaaba d Nawad a
Gaya

SARAN

Nil
1 - 30 % Dec'13 : 6 %
31 - 59 % Cham par an West

60 - 79 %
>= 80 % Cham paran East Sitam arhi
S heohar
Data Not Available Gopa lganj
Madhubani
S upau l Kis hanganj
Ara r ia
Si wa n Mu zaffar pur
Dar bhanga
Sar an Madhepur a
Sam astipur Sahars a Pur ni a
Vaisha li

Bux ar Kha gari a Katihar

Bhojpur Patna Begus arai

Mung er Bhagalpu r
Held [N] (Mar'13-Dec'13) : 19855 Sites Arw al
Jeha nabad
Nalanda
La khisarai
Roh tas Sheikhpura
(Dec'13) : 3395 Sites Kaimu r
Banka
Aur angaaba d Ja mui
Nawad a
Gaya

Data Source : RI Session Site Monitoring by WHO-NPSP & Govt.

%Sessions where ASHA received the payment for Previous RI Session
Col No.

Cham par an West Mar'13-Dec'13 : 15 %

State has developed a new template –
Gopa lganj
Cham paran East Sitam arhi
S heohar
• Due list cum dava prapatra
• It will be prepared in two copies at
Madhubani
S upau l Kis hanganj
Ara r ia
Si wa n Mu zaffar pur

Sar an
Dar bhanga

Sam astipur
Madhepur a
Sahars a Pur ni a
session site. KAIMUR

• One copy will reach to PHC on same

Vaisha li

Bux ar Kha gari a Katihar

Bhojpur Patna Begus arai

Arw al Nalanda Mung er Bhagalpu r evening to Accounts Manager

• Every month PHC will ensure the
Jeha nabad La khisarai
Roh tas Sheikhpura
Kaimu r PATNA
Ja mui Banka PURNIA
Aur angaaba d
Gaya
Nawad a
timely disbursement of incentive.
SARAN

% Session where :ASHA

Held [N] (Mar'13-Nov'13) 13983 Sitesreceived the payment for FI & CI of Last Month
Col No.

Cham par an West Mar'13-Dec'13 : 10 %

Cham paran East Sitam arhi

Gopa lganj S heohar
Madhubani
S upau l Kis hanganj
Nil
Ara r ia
Si wa n Mu zaffar pur
Dar bhanga
1 - 30 %
Sar an Madhepur a 31 - 59 % KAIMUR
Sam astipur Sahars a Pur ni a
Vaisha li 60 - 79 %
Bux ar
Bhojpur Patna Begus arai
Kha gari a Katihar >= 80 %
Data Not Available
Mung er Bhagalpu r
Arw al Nalanda
Jeha nabad La khisarai
Roh tas Sheikhpura
Kaimu r PATNA
Ja mui Banka PURNIA
Aur angaaba d Nawad a
Gaya

SARAN

Data Source : RI Session Site Monitoring by WHO-NPSP & Govt.

 Status of RI Task Force
District Task force Status Mar-
• State has conducted 13 to Feb-14
Champaran West

2 State Task Force Champaran East Sitamarhi

Meetings: in Oct’13
Gopalganj Sheohar
Madhubani
Supaul Kishanganj
Araria
Siwan Muzaffarpur
Darbhanga
Saran

and Dec’13.
Madhepura
Sam astipur Saharsa Purnia
Vaishali

Buxar Khagaria Katihar

Bhojpur Patna Begusarai

Munger Bhagalpur
Arw al Nalanda
Jehanabad Lakhisarai
Rohtas Sheikhpura
Kaimur
Jamui Banka
Aurangaabad Nawada
Gaya

DM Presence in DTF
Mar-13 to Feb-14

Champaran West

Champaran East Sitamarhi

Gopalganj Sheohar
Madhubani
Supaul Kishanganj
Araria
Siwan Muzaffarpur
Darbhanga
Saran Madhepura
Sam astipur Saharsa Purnia
Vaishali

Buxar Khagaria Katihar

Bhojpur Patna Begusarai

Munger Bhagalpur
Arw al Nalanda
Jehanabad Lakhisarai
Rohtas Sheikhpura
Kaimur
Jamui Banka
Aurangaabad Nawada
Gaya
RI District Control Room & DIO Presence in the meeting -
Jan’14-Mar’14* *Wk no. 10

DCR meetings to be Held DCR Actually Held DIO Presence SIA Rounds
10
9 10 10 10 10 10 10
8
8 9 9 9 9 9 9 9 9 9 9 9
7 8 8 8
6 7 7 7 7 7
5 6 6 6
4 5
3 4 4
2 3 3 3 3
1 2 2
0

GAYA
BANKA

ARARIA
PATNA

SAHARSA
NAWADA
NALANDA

PURNIA
KHAGARIA
MADHEPURA

DARBHANGA
SHEIKHPURA

SARAN
SIWAN

CHAMPARAN

CHAMPARAN
ROHTAS
BUXAR
MUNGER

KAIMUR
KATIHAR

SHEOHAR

BHOJPUR
SAMASTIPUR
MUZAFFARPUR

BHAGALPUR
JAMUI
VAISHALI
BEGUSARAI

SITAMARHI
LAKHISARAI

JEHANABAD
MADHUBANI
AURANGABAD

ARWAL
SUPAUL
GOPALGANJ

KISHANGANJ
Weekly RI DCR is being done in state from 2011. Still we are working to
improve its overall quality.
Special Immunization Weeks in HRA/HRG
– 4 Special Immunization Weeks were done in 2013.

–During each SIW about 21000 HRA/HRGs were

covered.

– From 8th March’14 state conducted the Special

Immunization week.
•3 more SIWs to be done in April, May and July’14.
 Human Resource/Infrastructure
– District Immunization Officer:
• In whole state only 4 DIOs were notified till Nov’13.
• In Dec’13, state issued notification for DIOs of 27 districts.

– ANM vacancy: As against 10000 HSCs, there are 17000

ANMs in whole state.
• There are 9% HSCs which are vacant but RI is being done by
ANM of other HSC.
• The districts with high number of vacant HSCs are Madhepura, C
East, Madhubani, Supaul, Saran and Siwan.
• State has initiated the process of recruitment of ANMs. On a fixed
day ANMs interview is done in all the districts.

– Supervisory Cadre: Inadequate and sub optimally used

– Currently 1 PHC is catering a population of1.75 lakhs
– 1 Health sub centre is catering a population of 10000.
 Cold Chain
• State requires both electrical and non electrical
(Vaccine carrier and Ice Packs) cold chain
equipments.

• ILR points needs to be expanded beyond PHC i.e.

to APHCs
• There are approx 1300 APHCs but none have electrical cold
chain equipments
Thanks