Objective of this roadmap

This document aims to provide a roadmap to attain 90% Full Immunization Coverage (FIC) in India’s Universal
Immunization Programme (UIP).
The document is intended to be used by the state and district programme managers to improve and sustain high
immunization coverage in their respective states and districts.
Contents
Background 1
1. Improving immunization coverage 2
2. Introduction of new vaccines 3
3. Increased funding of UIP 3
4. Health system strengthening using innovative technological interventions 3

Underlying principles of action: Data-Decision-Delivery 5

Steps to improve coverage in districts with less than 50% FIC (Category III) 7
1. Mission Indradhanush 7
2. Gap assessment & immunization coverage improvement plans 8
3. Building vaccine confidence and community engagement 8
4. Health system strengthening 8
5. Monitoring for action 9

Steps to improve coverage in districts with 50 to 90% FIC (Category II) 10

1. Prioritizing & focusing 10
2. Improving RI plans 10
3. Gap assessment & iCIP 11
4. Demand generation - addressing vaccine hesitancy and mitigating fear of AEFI 11
5. Health system strengthening 12
6. Monitoring for action 13
Steps to improve or sustain coverage in districts with 90% or higher FIC (Category I) 13
1. Sustaining gains 13
2. Incorporating MI sessions in RI microplans 13
3. Monitoring and review 14
4. Improving HMIS data quality 14
National-level support across all districts 15
Way Forward 16
Performance matrix-roadmap for achieving 90% FIC 17
Annexure 19
Acronyms
AAA ANM, ASHA and Anganwadi worker
AEFI Adverse Event Following Immunization
ANM Auxiliary Nurse Midwife
ANMOL ANM Online
ASHA Accredited Social Health Activist
AYUSH Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy
BRIDGE Boosting Routine Immunization and Demand Generation
CES Coverage Evaluation Survey
CRS Congenital Rubella Syndrome
DIO District Immunization Officer
DTFI District Task Force for Immunization
eGSA extended Gram Swaraj Abhiyan
eVIN electronic Vaccine Intelligence Network
FIC Full Immunization Coverage
GoI Government of India
GSA Gram Swaraj Abhiyan
HMIS Health Management Information System
INCHIS Integrated Child Health & Immunization Survey
iCIP Immunization Coverage Improvement Plan
IFV Immunization Field Volunteer
IMI Intensified Mission Indradhanush
MCTS Mother and Child Tracking System
MR Measles Rubella
MI Mission Indradhanush
MoHFW Ministry of Health & Family Welfare
NCC National Cadet Corps
NCCMIS National Cold Chain Management Information System
NFHS National Family Health Survey
NSS National Service Scheme
NUHM National Urban Health Mission
NYK Nehru Yuva Kendra
ORS Oral Rehydration Solution
PCV Pneumococcal Conjugate Vaccine
PHC Primary Health Centre
PIP Programme Implementation Plan
PRAGATI Pro-Active Governance and Timely Implementation
RBSK Rashtriya Bal Swasthya Karyakram
RCH Reproductive and Child Health
RI Routine Immunization
RVV Rotavirus Vaccine
SMNet Social Mobilization Network
STFI State Task Force for Immunization
UIP Universal Immunization Programme
UNDP United Nations Development Programme
VAEIMS Vaccine Adverse Event Information Management System
WASH Water, Sanitation and Hygiene
WHO World Health Organization
(i)
 Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

Together, MI and IMI resulted in 3.14 crore children being vaccinated in 537 districts across the country,
of which, 80.58 lakh children achieved full immunization status. In addition, 80.64 lakh pregnant women
received tetanus toxoid vaccine through this initiative.
ii
ROAD MAP FOR
ACHIEVING 90%
FULL IMMUNIZATION
COVERAGE IN INDIA
Background

I
ndia’s Universal Immunization Programme (UIP) is the largest in the world. Every
year the programme targets around 26.7 million infants and 29 million pregnant
women. Around nine million sessions are held every year to deliver vaccines
to the target population. However, over the past many years, immunization
coverage among children aged 12-23 months in the country has increased
at a very slow pace of around 1% each year (from 35% in 1992-93 to 62% in
2015-16).1
To address this slow progress in immunization coverage, Ministry of Health &
Family Welfare (MoHFW) demonstrated highest political commitment to this cause
and launched a massive routine immunization (RI) intensification campaign called
Mission Indradhanush (MI) in December 2014, which was targeted to reach 90%
full immunization coverage (FIC) by 2020. MI was further intensified when the
Honorable Prime Minister advanced the timeline for reaching the goal of 90% FIC
to December 2018.
Mission Indradhanush intended to reach out to unvaccinated and partially
vaccinated children, with a focus on hard-to-reach and high-risk populations.
The first two phases of MI contributed to an increase of 6.7 percentage points in
FIC according to the Integrated Child Health and Immunization Survey (INCHIS).
Analysing the coverage trend and progress, it was clearly understood that MI alone
will be inadequate to reach the target of 90% FIC by December 2018. An Intensified
Mission Indradhanush (IMI) was launched by the Honorable Prime Minister in
October 2017 to accelerate vaccination coverage and meet current gaps.
A critical component of IMI is participation and coordination of multiple ministries
and government bodies towards a common goal of 90% FIC by 2018. Regular
review of this programme is conducted under Pro-Active Governance and Timely
Implementation (PRAGATI).
Following the launch of IMI in 2017, four rounds have been conducted between
October 2017 and January 2018 in the identified geographic areas.
An independent survey conducted by UNDP and WHO has shown an average
improvement of 18.5 percentage points in the full immunization coverage in 190
IMI districts.
Mission Indradhanush is also a part of seven leading Central Government schemes
under Gram Swaraj Abhiyan (GSA) and extended GSA. An additional 9.59 lakh
children and 2.49 lakh pregnant women have been vaccinated under GSA and
EGSA.

1
International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey (NFHS-4), 2015-16: India.
Mumbai: IIPS.
*A fully immunized child is one who at 12-23 months of age has received one dose of BCG, 3 doses of Penta or DPT, 3 doses
of OPV and one dose of measles containing vaccine.
1
 Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

Actions taken so far

I
n the last four years, many steps have been taken to points in FIC, in comparison with the National Family Health
strengthen UIP. A strong political commitment in the country Survey-4 (NFHS-4) (2015-16). High momentum has been
exists today to achieve high coverage and equity in UIP reached by conducting MI and IMI across states.
in addition to adding critical vaccines in the programme to
protect lives of children from vaccine preventable diseases Figure 1: Trend in full immunization coverage among
like rotavirus caused diarrhoea, childhood pneumonia and children aged 12-23 months
rubella/CRS. MI & IMI rounds

1. Improving immunization coverage 80

Average 1% increase every year from 1992 to 2014

70.8

Despite being implemented for more than 30 years, 70

61.0
65.0 64.1

immunization coverage among children aged 12-23 months 60

54.5
6.7% increase within a year
Percentage

in the country has increased at a slow pace of almost 1% 50

42.0 43.5

each year (from 35% in 1992-93 to 62% in 2015-16). With 40

35.4

focus on strengthening RI services and recent initiatives (MI 30

and IMI) to meet existing gaps rapidly, the coverage trend 20

has now increased to more than 6% FIC in one year. 10

0
A recent survey (2018) that was conducted in 190 IMI NFHS-1
1992-93
NFHS-2
1998-99
NFHS-3
2005-06
DLHS
2007-08
CES 2009 RSOC
2012-14
INCHIS-1
March
INCHIS -
2&3
2015 combined
districts has shown an average increase of 18.5 percentage 2015-16

Recent survey in 190 IMI districts has shown an average increase of 18.5 percentage points in
FIC from NFHS-4

2
2. Introduction of new vaccines health data recording and reporting system, in addition
to generating real time beneficiaries’ records. The tablet
Since 2014, five new vaccines have been introduced in UIP,
allows them to enter and update the service records of
which includes Rotavirus vaccine, Japanese encephalitis
beneficiaries on real time basis, which ensures prompt
vaccine for adults, Inactivated Poliovirus Vaccine (IPV);
entry and updating of data. Since it is a completely
Measles Rubella vaccine (MR) and, Pneumococcal
digitalized process, high quality of data and accountability
Conjugate Vaccine (PCV) in a phased manner. The health
is maintained. Paperless recording of health data is also
ministry will soon replace the existing Tetanus Toxoid (TT)
more convenient for ANMs.
vaccine for pregnant women and 10 & 16 year children,
with Td (tetanus, diphtheria) vaccine. c) Vaccine Adverse Event Information
Management System (VAEIMS)
Many of these vaccines were already available through
private practitioners and could be bought by those who The Vaccine Adverse Event Information Management
were able to afford them. Introduction of these new System (VAEIMS) was conceptualized to speed-up the
lifesaving vaccines in UIP provides an opportunity to processes of recording, reporting and investigation of
children everywhere in the country to lead a healthy and cases of Adverse Event Following Immunization (AEFI)
more productive life. from the districts. The software will fast track the
response time following AEFIs, will reduce data and time
loss while transmitting AEFI data and will strengthen
Figure 2: New vaccine introduction in the Universal causality assessment. Data related to reporting and
Immunization Programme investigation of AEFI cases will be entered at the district
6
IPV, JE (adult), level while the causality assessment results of each
RVV, MR, PCV
5 case will be entered at the state level. The system has
Number of vaccines

5
provision for generation of line lists, alerts on reporting of
4 new cases and reminders of deadlines for investigations
3 and causality assessments. The system will provide
analyses of current AEFI surveillance status in the form of
2 Hep B JE Penta
1 1 1
dashboards and graphs.
1
0 0 0
d) Kilkari
0
98
9
99
4 99 04 09 01
4
01
8 ‘Kilkari’, is an audio-based mobile service that delivers
-1 -1 19 20 20 -2 -2
86 90 5- 0- 5- 10 15
19 19 19
9
20
0
20
0 20 20 weekly audio messages to pregnant women and infant’s
mothers registered on MCTS, about pregnancy, child
3. Increased funding of UIP birth and child care. Seventy-two different messages
To ensure availability of these lifesaving vaccines for reach the targeted beneficiaries from the 4th month
all sections of society, the Government of India (GoI) has of pregnancy until the child is one year old. It intends
increased the immunization budget significantly in 2017-18 to adopt healthier behaviours through increasing their
as compared to the earlier budgetary allocations. knowledge, shifting attitudes and empower women. The
objective is to improve family health – including family
4. Health system strengthening using innovative
planning, reproductive, maternal, neonatal and child
technological interventions
health, nutrition, sanitation and hygiene, by generating
a) electronic Vaccine Intelligence Network (eVIN) demand for healthy practices.
In 2015, the Ministry introduced an indigenously developed e) Augmenting cold chain space
IT system/ application called eVIN for real time tracking
To address existing gaps and meet the additional
of vaccine stocks and tracking of storage temperature. It
requirement due to new vaccines being added to the
is planned that eVIN will be scaled-up across all states by
UIP, GoI purchased significant numbers of cold chain
2020. After introduction of eVIN, vaccine stock-out events
equipment after 2014.
have reduced by 80% as compared to past years.
In the last four years (2014-2017), 28,340 cold chain
b) ANM Online (ANMOL)
equipment were purchased and distributed to various
A tablet-based ANM Online (ANMOL) system has been states/districts.
piloted by the GoI in two states. It aims to improve the

3
4
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states
Approach to 90%
full immunization
coverage
The following key steps in planning, managing and monitoring immunization services, if
carried out appropriately, will improve immunization coverage.
Underlying principles of action: Data-Decision-Delivery
States need to conduct comprehensive UIP reviews for each district to diagnose gaps
in the immunization programme around human resources, fund utilization, training,
governance, review process etc. These gaps are to be discussed with all stakeholders
and decisions must be undertaken to bridge them accordingly in the programme. States
and districts need to develop an Immunization Coverage Improvement Plan (iCIP) for all
districts wih <90% FIC based on these decisions. States and districts must also ensure
effective implementation/service delivery and regular monitoring of plans to ensure
midcourse corrections.
This document categorizes all districts in the country based on their FIC status. The
categorization is based on latest IMI survey (2018) for 120 IMI districts conducted by
UNDP and 70 districts by WHO and NFHS-4 data for remaining districts.
UNICEF is conducting a state-wise coverage evaluation survey (CES 2019) across
the country, reports from which will be available by January 2019. Henceforth a re-
categorization will be undertaken after this report is available.
This document categorizes districts in three categories based on their FIC status:

Table 1: Categorization of districts in three categories based on their FIC status

Category Criteria
I FIC ≥ 90%
II FIC between 50% and 90%
III FIC less than 50%

To achieve 90 percent FIC nationally, these districts will need to adopt different
approaches. Four common underlying actions across all districts to accomplish and
sustain 90% FIC will be:
1. Highest political commitment at all levels
2. A robust review mechanism at multiple levels with clear accountability for action
3. Prompt action to meet any gaps identified in the review
4. Building community participation by effective social mobilization

5
 Figure 3: Three broad categories based on FIC status
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

Figure 4: Strategies at different levels of full immunization coverage

Key Strategy: Key Strategy: Key Strategy:
Mission Indradhanush Prioritizing & focusing on Sustaining gains
Districts with 50-90% FIC

District with greater than or equal to 90% FIC

Districts with less than 50% FIC

in districts with less than poor performing areas Incorporating MI areas in RI

50% FIC Urban & tribal areas microplans
Tracking of children Improving RI plans Other Strategies:
covered in MI
Other Strategies: Monitoring and review
Other Strategies:
Gap assessment & iCIP Improving HMIS data quality
Building Vaccine
Confidence Demand generation

Gap assessment & Addressing vaccine

immunization coverage hesitancy and mitigating
improvement plan (iCIP) fear of AEFI
formulation Health System
Health System Strengthening
Strengthening Monitoring for Action
Monitoring for Action
Category III Category II Category I

6
Table 2: Activities proposed for districts in different categories:
Activity Districts with Districts with Districts with Districts with
< 50% FIC 50-70% FIC 70-90% FIC >90% FIC
National level review Monthly Monthly Quarterly Quarterly
Monthly by Principal Monthly by Principal
Quarterly by Principal Quarterly by Principal
State level review Secretary Secretary
Secretary Secretary
and MD NHM and MD NHM
District self-gap assessment Yes Yes Yes No
DTFI meetings Fortnightly Monthly Monthly Monthly
Lead partner Assign Assign State to manage State to manage
Prototypes and PIP Prototypes and PIP Prototypes and PIP
Demand generation National support
support support support
Crisis communication support
From National level From National level From National level State to manage
to states
Data quality assessments No Yes Yes
National, state and district,
Monitoring support hiring of immunization field State to monitor State to monitor State to monitor
volunteers (IFV)

Steps to improve coverage in districts with less than 50% FIC (Category III)
These districts have a high proportion of unimmunized and demand. There are total 91 districts (annexed) in the country
partially immunized children and need intensified efforts by with less than 50% FIC based on NFHS 4 and IMI survey
all stakeholders to improve both immunization services and data. The recommended activities are:

Figure 5: Actions to improve coverage in districts with less than 50% FIC

Mission Gap Assessment Building Vaccine Health System Monitoring for

Indradhanush & Immunization confidence Strengthening action
Coverage & community
Improvement Plans engagement

1. Mission Indradhanush Figure 6: Key activities under Mission Indradhanush

Pockets with unreached or under-reached populations
need to be identified and innovative strategies formulated
to reach them and children covered under MI need to be
tracked for routine immunization. Also, additional need-
based funds may be proposed in the supplementary
Programme Implementation Plan (PIP) for approval by GoI
as per PIP norms.
Of the 91 districts with <50% FIC, 16 districts have already
implemented MI under extended GSA (eGSA) during July-
September 2018.
Three rounds of MI during the period October to December
2018 will be critical for coverage improvement in the
remaining 75 districts.

7
 school children as ambassadors for immunization;
Key Performance Indicators
interpersonal communication skills training for frontline
workers to address community queries related to vaccines
and immunization programme;
Total number of children immunized during MI campaign
formal media briefings to encourage positive messaging
Percent children found fully immunized during MI survey
for the community to access the vaccine;
2. Gap assessment & immunization coverage orientation of the state and district level spokesperson to
improvement plans (iCIPs) answer queries raised by media on immunization and to
handle crisis in case of AEFI;
These districts need to conduct gap assessment to identify
the issues in key processes like microplanning, headcount communication plans to clearly identify the key
survey, due-list preparation, recruitment against vacancies, spokesperson during the crisis. As part of the plan,
fund utilization, comprehensive monitoring and regular prepare few editorials for mainstream (English) and
feedback mechanism. District level self-assessment checklist vernacular media, addressing specific fears created by
must be utilized for these UIP reviews and gap analysis. the anti-vaccine lobby; and
The Secretary, MoHFW, GoI has sent directives to states ensure regular media monitoring (including social media)
to undertake district level gap analysis in all the districts and tracking before, during and after the expansion/
and to formulate iCIP to achieve 90% FIC, which must be introduction.
further sustained thereafter. Few activities in the action districts like Mewat and Palwal which have social
plan formulated by the states may require projection of mobilization challenges will need to formulate need
additional activities in the PIP, which will be reviewed by based communication strategies
GoI for need-based approvals. Utilization of funds for these
activities will be tracked at all levels.
Key Performance Indicators
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

Key Performance Indicators

Percent districts & planning units with communication plan
prepared
Total number of districts reviewed by the state team
Percent districts conducted media briefing on routine
Percent districts with immunization coverage improvement immunization in last six months
plan (iCIP) prepared
Percent monitored sessions with IEC visibility
3. Building vaccine confidence and community Percent districts with social media plan
engagement Percent sessions where ANM giving all four key messages
To reach all eligible women and children, community
leaders and different community-based groups must be 4. Health system strengthening
engaged in planning, organizing and generating demand for A comprehensive health system strengthening approach
immunization services. It is important to generate high level will help to successfully move towards achieving the goal of
of vaccine awareness and build vaccine confidence among 90% FIC. The districts must conduct following activities to
communities to achieve 90% FIC. strengthen the immunization system in their districts.
Health staff ought to partner with communities in managing Proposed actions
and implementing immunization and other health services
through regular Village Health and Sanitation Committee Health workforce
meetings and village health days. District health teams and improve vacancy situation of ANMs and ASHAs,
health facility staff should engage with communities to make timebound recruitment drives;
sure immunization and other health services meet their needs. track status of training of various health staff cadres;
Regular communication activities like media workshops and enhance convergence with Women and Child
informal media briefings are required to help in building Development department; ANM, ASHA and Anganwadi
vaccine confidence. Availability of detailed communication worker; through AAA convergence by using AAA
plan needs to be ensured at the sub-center, planning unit incentives and triangulation of beneficiary data of health
and district level for better implementation of various and WCD departments; and
communication activities.
rationalise infrastructure and manpower required as
Proposed actions many ANMs/Sub centres cater to population much more
communication planning for mass media, mid-media and than set norms.
social mobilization activities;

8
Infrastructure Additional interventions for urban areas
opportunity of recent promotion of health and wellness ensure deployment of an Urban Nodal RI Officer and
centres (HWCs) institutionalize an urban task force for immunization;
Vaccines & technology conduct need-based hiring/recruitment of vaccinators
coordinate use of eVIN and NCCMIS for monitoring of using NUHM funds;
supply chain processes. convert all urban PHCs as fixed vaccination sites;
Immunization financing: need based inclusion of activities involve private sector providers and NGOs for giving
in PIP immunization services and submit coverage reports, with
plan mobile teams for RI; clear segregation of such areas;

hire alternate vaccinators; reach and immunize migrant populations like slum
population and construction workers on their monthly
plan and conduct appropriate social mobilization holiday (eg. Amavasya in parts of northern India);
activities;
strengthen RCH/MCTS portal data entry; and
document successful innovations and build mechanisms
for cross learning; involve urban local bodies and municipal corporations.
Also, coordinate between all stakeholders at all levels like
provide mobility allowance to ANMs for covering vacant the National Urban Livelihood Mission for mobilisation of
sub-centres; beneficiaries.
depute and position immunization field volunteers; and Key Performance Indicators
finalize proposals for urban areas under the National
Urban Health Mission’s (NUHM) PIP with justifications.
Strengthening governance Percent vacant sub centres in the district
facilitate coordination of different Government Percent health workers trained on health worker module
departments, National Cadet Corps (NCC), Nehru Yuva (new) in last three years
Kendra (NYK), National Service Scheme (NSS) and
Percent immunization funds utilized by the district
partners at State Level Steering Committee and Task
Force for Immunization (STFI) meetings; Percent sessions with support from NYK, NCC & NSS
articulate iCIPs with timelines; and empower Panchayati Percent urban areas with urban nodal officer assigned
Raj Institutions to improve immunization coverage.
Strengthening supervision and concurrent monitoring 5. Monitoring for action

improve methodology of concurrent monitoring to

District health teams and health facility staff need
generate quality data
continuous flow of information that keeps them updated on
whether health services are of high quality and accessible
ensure significant quantum of data to guide policy to target population. It also lets them know as to who is
decisions and is not being reached, whether resources are being used
enhance government participation for monitoring and efficiently and if strategies are meeting objectives.
supervision “Monitoring for Action” is needed to analyse and utilize
using mobile based technology for real time monitoring data at all levels. This will help direct the programme in
data measuring progress, identifying areas needing specific
interventions and making practical revisions to plans.
Data systems
The review of roadmap at district level should be done
strengthen name-based tracking of beneficiaries – mother
regularly under the chairmanship of District Magistrate.
and child tracking system (MCTS) or RCH portal, link with
Each district should ensure the conduct of fortnightly
incentives;
District Task Force for Immunization (DTFI) meeting to
update and utilize mobile numbers in MCTS portal to send review progress based on identified indicators. District
message alerts or reminder calls through Kilkari initiative; Immunization Officers (DIOs) and partners should ensure
and that data on all these identified indicators (given in this
share regular feedback on reported, concurrent monitoring roadmap) are collected, compiled and shared during the
and survey data with districts in the form of immunization DTFI meetings. The State and National task force must
dashboards. review progress on a monthly basis.

9
 Proposed actions partners and create a systematic feedback mechanism;
strengthen the State and District Task Force review invove medical colleges in supervision/monitoring;
mechanism to conduct structured comprehensive RI work with partners for joint concurrent monitoring, and
programme reviews, including human resource status, ensure corrective actions based on monitoring feedback; and
fund allocation and utilization and to take timely corrective
measures; establish reward and recognition mechanism for good
performing districts.
Chief Secretary/Principal Secretary will undertake regular
review of districts through video conferencing with the Key Performance Indicators
District Magistrates;
ensure regular monitoring and review of progress using
monthly reports, monitoring charts, monthly & quarterly Percent districts with atleast 1 DTFI meeting held per month
reviews and supportive supervisory visits; Percent DTFI meetings chaired by District Magistrate
assign lead partner for each district for coordination of Number of review meetings held at state level with all DIOs
partner efforts in strengthening RI. Prepare standard
Number of review meetings held at National level with SEPIOs
operating protocols, roles and responsibilities of lead
Steps to improve coverage in districts with 50 to 90% FIC (Category II)
A total of 555 districts (annexed) in India are between may be stable in immunization coverage for many years or
50-90% FIC. Of these, 288 districts have an FIC of 50-70% might have increasing or decreasing trends for the same. It
while 267 districts have an FIC of 70-90%. Activities to be is important to diagnose the reason behind these trends to
implemented in these two sub-groups are slightly different, develop their iCIPs and although some of the districts may
and are outlined in Table 2 (page 7). It is important to be close to reaching 90%, a thorough analysis and review is
understand trends of FIC among these districts, as they required to move forward to achieve this target.
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

Figure 7: Actions to improve coverage in districts with 50-90% FIC

Prioritizing & Improving RI Gap Demand Health System Monitoring for

focusing plans assessment & generation- Strengthening action
iCIP based on Addressing
3D approach vaccine
hesitancy and
mitigating fear
of AEFI

1. Prioritizing & focusing would be required, as also progress to be reviewed by DTFI

Prioritization will be the key to success in these districts. on a monthly basis.
The districts with FIC levels of 50-90% need to identify State may consider Mission Indradhanush activities in
pockets of poor performance. A focused strategy to improve selected pockets, especially in districts with 50-70% FIC,
coverage in these areas will help to achieve 90% FIC. States based on need.
and districts need to identify high priority blocks and low
coverage areas based on various immunization indicators. Key Performance Indicators
Partners are expected to support in the identification of such
areas based on indicators that include low FIC, low Penta
3 coverage, high levels of dropouts, left-out pockets, hard- Number of districts completed prioritization of blocks and
to-reach population, vacant sub centres; resistance pockets, villages
tribal areas, urban slums, nomadic groups, construction sites, Number of these areas monitored by state and district
brick kilns, factory areas and other migratory settlements. level monitors
After prioritization, these areas should be focused by state
2. Improving RI plans
and district authorities. Appointment of nodal officers for
these blocks and ensuring intensive monitoring by state Bi-annual revision of RI microplans is required. All
and district level monitors in these identified high-risk areas additional sessions planned during the MI campaigns must

10
get included in RI microplans. States and districts need of the magnitude and setting of the problem. It also calls
to monitor this activity stringently. For non-MI districts, for diagnosis of root causes, tailoring evidence-based
programme managers should identify areas with no RI strategies to address causes and undertaking monitoring
sessions planned (missed areas). Vacant subcentres and evaluation to determine the impact of the intervention.
must be identified/targeted and appropriate plans Ongoing monitoring for possible recurrence of the problem
developed to cover them. Additionally, districts shall must be ensured. The interventions should address specific
identify areas currently tagged with existing sessions determinants underlying vaccine hesitancy.
but needing separate immunization sessions. To ensure Proposed actions
no missed areas, an extensive mapping exercise needs
to be undertaken at all levels. NIC maps should be used provide other health services along with immunization
to prepare microplans for urban cities. like oral rehydration solution (ORS) & Zinc, water,
sanitation and hygiene (WASH), etc for better acceptance
Key Performance Indicators of immunization services;
engage religious and/or other influential leaders to
promote vaccination in the community;
MI districts-Percent MI sessions incorporated in RI micro school children as ambassadors
plans
undertake advocacy and social mobilization;
Non-MI districts- Number of new sessions planned in
improve access to vaccination;
districts to cover missed or low coverage pockets
employ reminder and follow-up;
3. Gap assessment & iCIP
use 104 call center for mobilization of reluctant families
States should conduct a gap assessment in these districts by outbound calling;
to identify bottlenecks in key processes like microplanning,
conduct communications training for healthcare workers;
headcount survey, duelist preparation, filling of human
resource vacancies, fund utilization, comprehensive provide non-financial incentives to beneficiaries; and
monitoring and regular feedback mechanisms. It is important increase knowledge and awareness on vaccination.
to analyse trends among these districts to identify reasons
behind these declining and/or increasing trends, if any. This Mitigating fear of Adverse Event Following
data will be utilized to formulate and implement iCIP as per 3D Immunization (AEFI): Health workers and mobilizers
approach (Data-Decision-Delivery). should communicate four key messages to all beneficiaries
including whom to contact in case of any problems/concerns
Secretary, MoHFW has sent directives to the states for
following vaccinations. The caregiver must be reassured
undertaking district level gap analysis in all districts and
that giving multiple vaccines during the same session is
formulating immunization coverage improvement action
safe. The following day the beneficiary should be visited by
plans for achieving 90% FIC and sustaining it thereafter.
community mobilizers for ensuring well being.
Few activities in the action plan formulated by states may
require projection of additional activities in the PIP, which On being informed of any problem, the frontline worker/
will be reviewed by GoI for need-based approvals. Utilization vaccinator should be able to manage minor AEFIs and
of funds for these activities will be tracked at all levels. refer all serious/severe AEFIs to nearest health facility
for further treatment. ANMs should be trained for proper
Key Performance Indicators use of adrenaline kit which should be available during all
vaccination sessions. All AEFI cases should be managed,
reported, and investigated properly as per guidelines.
Total number of districts reviewed by the state team The results of the investigations should be communicated
appropriately within the community to maintain the
Percent districts with immunization coverage improvement confidence in the vaccination programme. AEFI committees
plan (iCIP) prepared at all levels should review AEFI surveillance, support to
tackle vaccine hesitancy due to AEFIs and dispel any myths
4. Demand generation - addressing vaccine and misconceptions that exist regarding AEFIs.
hesitancy and mitigating fear of AEFI
Generating demand and building vaccine confidence will Key Performance Indicators
be an important strategy in these areas. There might be
pockets of vaccine hesitancy, where identification and
proper strategy to address these issues will be key to reach
Numbers of serious AEFI cases reported and investigated
90% FIC in these areas.
Percent sessions with influencers identified in micro plan
Addressing vaccine hesitancy requires an understanding

11
 5. Health system strengthening document successful innovations and build mechanisms
for cross learning;
A comprehensive health systems approach will help these
districts to successfully move towards achieving the goal provide mobility allowance to ANMs for covering vacant
of 90% FIC. These districts should conduct the following sub centres;
activities to strengthen immunization system. deploy immunization field volunteers; and
Proposed actions prepare proposals for urban areas under NUHM PIP with
Health workforce justifications.
improve vacancy situation of ANMs and ASHAs; Strengthen governance
track status of training of various health staff cadres; facilitate coordination of different Government
departments, NCC, NSS, NYK and partners at the state
enhance convergence with Women and Child
level and conduct Steering Committee and STFI meetings;
Development department; ANM, ASHA and Anganwadi
worker; through AAA convergence by using AAA articulate iCIPs with timelines; and
incentives and triangulation of beneficiary data of health empower and incentivize PRIs to improve immunization
and WCD departments; and coverage.
rationalisation of infrastructure and manpower required Strengthening supervision and concurrent monitoring
as many ANMs/sub centres cater to population much
more than set norms. improve methodology of concurrent monitoring to
generate quality data
Infrastructure
ensure significant quantum of data to guide policy
opportunity of recent promotion of health and wellness decisions
centres (HWCs)
enhance government participation for monitoring and
Vaccines & technology supervision
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

coordinate use of eVIN and NCCMIS for monitoring of

supply chain processes. using mobile based technology for real time monitoring data

Data systems Additional interventions for urban areas

strengthen name-based tracking of beneficiaries – mother ensure deployment of an Urban Nodal RI Officer and
and child tracking system (MCTS) or RCH portal, link with institutionalize the Urban Task Force for Immunization
incentives; complete the need-based hiring/ recruitment of
update and utilize mobile numbers in MCTS portal to send vaccinators using NUHM funds;
message alerts or reminder calls through Kilkari initiative; convert all urban PHCs as fixed vaccination sites;
and involve private sector providers and NGOs to provide
share regular feedback on reported, concurrent monitoring immunization services and submit coverage reports, with
and survey data with districts in the form of immunization clear segregation of such areas;
dashboards. reach and immunize migrant populations like slum
Demand generation population and construction workers on their monthly
holiday (eg Amavasya in parts of northern India);
prepare a need-based underserved strategy to improve
strengthen RCH/ MCTS portal data entry; and
coverage;
involve urban local bodies and municipal corporations in
coordinate with relevant government departments for
seven metro/cities; and coordinate between all stakeholders
social mobilization;
at all levels like NUHM for mobilization of beneficiaries.
cascade Boosting Routine Immunization and Demand
Generation (BRIDGE) training to enhance interpersonal
Key Performance Indicators
communication skills of frontline workers; and
support microplanning for communication activities using
standard guidelines and formats. Percent vacant sub-centres in the district
Immunization financing: Need based inclusion of activities Percent health workers trained on health worker module
in PIP (new) in last three years
Percent immunization funds utilized by the district
plan need - based mobile teams for RI;
Percent sessions with support from NYK, NCC & NSS
hire alternate vaccinators;
Percent urban areas with urban nodal officer assigned
conduct social mobilization activities;

12
6. Monitoring for action regular monitoring and review of UIP progress in these
districts;
The review of roadmap at district level should be done
regularly under the chairmanship of District Magistrate. establish reward and recognition mechanism for good
Each district should conduct monthly district task force performing districts;
meeting to review progress based on identified indicators. ensure corrective actions on monthly feedback provided
The District Immunization Officers (DIO) and partners should through immunization dashboards; and
ensure that data on all these identified indicators (given in
this roadmap) are collected and compiled and shared during depute district and state monitors and task them with
DTFI meetings. The State and National task force should focusing on high priority blocks and villages/ urban areas
also review progress on quarterly basis with districts and during monitoring visits and reviews.
states respectively.
Key Performance Indicators
Proposed actions
strengthen the State and District Task Force review
mechanism to conduct structured comprehensive RI
Percent districts with DTFI held every month
programme reviews, including human resource status, fund
allocation and utilization and take timely corrective measures; Percent DTFI meetings chaired by District Magistrate
Number of review meetings held at state level with all DIOs
state should hold regular review with districts through
video conferences with District Magistrates and conduct Number of SEPIO review meetings held at National level

Steps to improve or sustain coverage in districts with 90% or higher

FIC (Category I)
Districts that have achieved 90% FIC will need to prepare Districts must identify areas currently tagged with existing
plans for sustaining coverage by identifying key processes sessions but needing separate immunization sessions.
and geographies that need strengthening to sustain Prepare maps at all levels to ensure there are no missed
achieved immunization coverage. There are only 54 districts areas. NIC maps can be used to prepare microplans for
(annexed) having coverage more than or equal to 90% based urban cities.
on the National Family Health Survey 4 (NFHS) and IMI survey done
by United Nations Development Programme (UNDP) and WHO.
Figure 8: Actions to improve or sustain coverage in districts with greater than equal to 90% FIC

Sustaining Incorporating Monitoring Improving

gains MI areas in and reviews HMIS data
RI microplans Quality
1. Sustaining gains 2. Incorporating MI areas in RI microplans
These districts have achieved desired coverage and they States and districts should ensure bi-annual revision of
should ensure that they sustain this coverage. They are highly RI microplans. All additional sessions planned during MI
prone to decline in coverage due to complacency. However, campaigns should be included in the RI microplans. States
they must make sure that their health systems are robust and districts should also monitor this activity stringently.
and strong governance and leadership is maintained at all
times. Gains achieved through MI should be maintained by
RI system strengthening while continuously targeting low Key Performance Indicators
coverage and high priority areas.
Key Performance Indicators

MI districts- Percent MI sessions incorporated in RI

micro plans
Number of districts with more than 90% FIC
Non-MI districts- Number of new sessions planned in
Number of districts with less than 1% unimmunized districts to cover missed or low immunization pockets
children

13
 3. Monitoring and review ØØ strengthen name-based tracking of beneficiaries
(mother and child tracking system or RCH portal) and
The DIOs and Chief Medical Officers would need to
utilize mobile numbers in the portal to send SMS alerts
monitor progress in RI and ensure that the monthly district
and reminder calls;
task force meetings diligently review progress based on
identified indicators. The DIOs and partners should ensure ØØ ensure training of data handlers at all levels;
that immunization data is collected, compiled and shared ØØ conduct data quality assessments in these districts
during DTFI meetings. State and National task force should and develop data quality improvement plans;
also review progress on quarterly basis with districts and
states respectively. Supportive supervision visits will be ØØ ensure timely availability of reliable data on key
key component of these districts, focusing on promoting processes, immunization coverage and vaccine
quality provision of services by periodically assessing preventable disease burden;
and strengthening service providers’ skills, attitudes and ØØ states to share regular feedback on reported,
working conditions. It includes regular onsite training, concurrent monitoring and survey data with districts in
feedback and follow-up with staff to ensure that routine form of immunization dashboards;
and newly-introduced action points are being addressed ØØ enhance quantum of concurrent monitoring by
correctly. deployment of “Immunization Field Volunteers”
Key Performance Indicators through PIP funding; and
ØØ engage medical colleges, public health institutes,
Rashtriya Bal Swasthya Karyakram (RBSK) and
the Ministry of Ayurveda, Yoga and Naturopathy,
Percent districts with DTFI held every month
Unani, Siddha and Homoeopathy (AYUSH) workforce
Percent DTFI meetings chaired by District Magistrate in states.
Number of review meetings held at state level with all
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

DIOs
Key Performance Indicators
4. Improving HMIS data quality
Since these districts have high coverage, there is an
opportunity to improve their HMIS and RCH portal data
Number of districts conducted data quality self-
quality. This will help in having a real time progress update
assessment
on the performance of the immunization programme.
Additionally, states and districts should conduct the Percent data handlers trained in data management
following activities to improve data quality:

Incentives for performance

Incentives should be provided at village, district and state levels for achieving 90% FIC the targets.

14
 National-level support across all districts
1. System strengthening
ØØ support for prioritization of poor performing districts;
ØØ develop training modules for data handlers;
ØØ availability of adequate cold chain space and need based expansion of cold chain network;
ØØ phased nation-wide roll-out of eVIN, ANMOL and VAEIMS; and
ØØ share innovations and best practices across the country through workshops and meetings.
2. Vaccine supply
ØØ steady supply of all vaccines; and
ØØ phased roll-out of Rotavirus (RVV), Measles Rubella (MR) and Pneumococcal Conjugate Vaccine (PCV).
3. Demand generation
ØØ converge with all relevant line ministries for support to social mobilization (mobilization of beneficiaries, SMNet support,
ownership to panchayats by incentivization of FIC); regular meetings of inter-ministerial committees at national level;
ØØ train the trainers for BRIDGE training to enhance interpersonal communication skills of frontline workers;
ØØ update microplanning guidelines and formats for planning communication activities;
ØØ crisis communication in response to AEFIs; and
ØØ engagement of celebrities from minority/underserved communities.
4. Monitoring and supervision
ØØ regular review of UIP in priority states (Bihar, Madhya Pradesh, Maharashtra, Rajasthan, Uttar Pradesh);
ØØ finalise checklist for state and district level UIP self-assessment & gap analysis;
ØØ capacity building of state officials to conduct district self assessments;
ØØ monthly feedback to states on immunization data through immunization dashboards;
ØØ undertake regular reviews with states and priority districts through video conferences and review meetings;
ØØ assign senior MoHFW officials as national mentors for states;
ØØ implement technological interventions like real time, user defined dashboards; and
ØØ establish reward and recognition mechanism for good performing states.
5. Financial support
ØØ incentives under NHM subject to achieving 90% FIC
ØØ adequate funding for nation wide roll-out of rotavirus (RVV), measles rubella (MR) and pneumococcal conjugate vaccines;
and
ØØ review innovations proposed in state PIPs for need-based approvals.

Figure 9: Mechanism for review of progress on Roadmap

National Level Sub-National Level

Regular review at highest level with states- The UIP self assessment checklists
PRAGATI must be filled for all districts with less
than 90% FIC. WHO, UNICEF, UNDP and
Key performance indicators of this roadmap
ITSU will assess key components of the
will be tracked through a web-based tool and
checklists
will be updated monthly
Review visits by National mentors
States will put in place a mechanism
for third party review of immunization
ITSU and immunization partners will submit
coverage through medical colleges/
a report on progress made on roadmap to JS
public health institutions
(RCH) on monthly basis

MoHFW will conduct regular review meetings Review visits by state officials in poor
with all states and UTs to review progress and performing districts
decide future strategy.

15
 Way Forward
State level estiamtes

States with FIC States with FIC

less than 70% more than 70%

Entire state will conduct MI Categorization of districts based

on available data sources
1. Concurrent monitoring data by partners in sizeable beneficiary survey,
2. IMI Survey

FIC less than 70% FIC between 70 and 90% FIC more than 90%
Mission Indradhanush Intensive monitoring Sustaining gains
Prioritizing & focussing
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

States with less than 70% coverage as per CES 2019 will monitoring data. Districts having FIC less than 70% will
be kept in category 3, and all districts of these states will undertake three rounds of Mission Indradhanush, districts
undertake 3 rounds of Mission Indradhanush. For states between 70-90% will undertake intensive monitoring along
with coverage of 70% or more in CES 2019, districts will be with prioritizing and focusing strategies while districts
re-categorized based on IMI survey (2018) and concurrent having FIC>90% will strive to sustain the gains.

16
 Table 3: Performance matrix-roadmap for achieving 90% FIC
Baseline/
No. Indicator Data source Target Frequency
criterion
Performance matrix for review at national, state and district level
Percent districts with more Survey data /
1 15.4% 100% Quarterly
than 85% FIC Concurrent monitoring
Percent children found fully Monitoring data – Monthly, after
2 NA 90%
immunized during MI survey NPSP every round
Total number of districts Gap analysis by the
All districts below
3 reviewed (gap assessment) by State teams, reported 0 Monthly
90% coverage
state team by NPSP
Percent districts with iCIP after gap
immunization coverage assessment by the All districts below
4 0 Monthly
improvement plan (iCIP) state teams, reported 90% coverage
prepared by NPSP
Only for MI districts- Percent
Monitoring data - Monthly after
5 MI sessions incorporated in RI NA 100%
NPSP every round
micro plans
Performance matrix for review at state and district level
Percent districts & planning Monitoring data,
Data not
1. units with communication reported by UNICEF & 100% Monthly
available
plans prepared NPSP
Monitoring data,
Percent districts with social
2. reported by UNICEF & NA 80% Monthly
media plans prepared
NPSP
Percent vacant sub centres in
3. State Report NA <2% Quarterly
the district
Percent health workers trained
Training report- state
4. on health worker module (new) NA 80% Monthly
& NPSP
in last three years
Percent immunization funds
5. State PIPs NA 90% Annually
utilized by the district
Percent urban areas with urban
6. State reports NA 100% Annually
nodal officer assigned
2 meetings per month
for district with <50%
Percent districts with DTFI held Monitoring data,
7. NA FIC and 1 meeting Monthly
every month reported by NPSP
per month for other
districts
Every meeting
Percent DTFI meetings chaired Monitoring data, to be chaired
8. 90% Monthly
by District Magistrate reported by NPSP by District
Magistrate
One monthly meeting
Number of review meetings Monitoring data, for <50% FIC districts
9. Quarterly Monthly
held at state level with all DIOs reported by NPSP Quarterly for other
districts
Each district
Number of districts completed
Monitoring data - to complete
10. prioritization of blocks and 90% Monthly
comprehensive review prioritization in
villages
category II

17
 Baseline/
No. Indicator Data source Target Frequency
criterion
Performance matrix for review at district level
Monitoring data,
Percent sessions where ANM Monthly after
1. reported by UNICEF & NA 90%
giving all four key messages every round
NPSP
Percent data handlers trained District training 80% for category 1
2. 0 Monthly
in data management reports districts
States and districts should ensure that these targets should be achieved as early as possible. They should prepare a timeline for these targets and share with MoHFW for tracking.
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

18
Annexure:
Table A: List of districts with < 50% FIC as per NFHS-4 /IMI Survey

State District Less than 50%

A&N ISLANDS Nicobar 45.5
ANDHRA PRADESH Vizianagaram 49.3
ARUNACHAL PR. West Kameng 25.0
ARUNACHAL PR. Tawang 27.8
ARUNACHAL PR. Longding 32.0
ARUNACHAL PR. West Siang 34.4
ARUNACHAL PR. Upper Subansiri 35.1
ARUNACHAL PR. Lower Dibang Valley 37.3
ARUNACHAL PR. Siang** 40.0
ARUNACHAL PR. Lower Subansiri 40.1
ARUNACHAL PR. Dibang Valley 40.8
ASSAM Barpeta 34.1
ASSAM Kamrup R 35.7
ASSAM Hailakandi 39.2
ASSAM Bongaigaon 42.4
ASSAM Marigaon 44.4
ASSAM Sonitpur 45.3
ASSAM Cachar 45.4
ASSAM Dhemaji 47.0
ASSAM Nalbari 48.8
D&N HAVELI Dadra & Nagar Haveli 43.2
GUJARAT Mahisagar* 30.2
GUJARAT Panch Mahals 30.2
GUJARAT Patan 30.7
GUJARAT Dahod 33.0
GUJARAT Surendranagar 37.5
GUJARAT Kheda 39.5
GUJARAT The Dangs 44.3
GUJARAT Morbi** 44.5
GUJARAT Surat 48.0
GUJARAT Ahmedabad 49.0
GUJARAT Botad* 49.0
GUJARAT Aravalli* 49.1
GUJARAT Sabar Kantha 49.1
HARYANA Mewat 40.8
HARYANA Rewari 41.2
HIMACHAL PRADESH Hamirpur 45.9
JAMMU & KASHMIR Doda 43.2
JAMMU & KASHMIR Rajouri 44.5
JHARKHAND Chatra 42.0
JHARKHAND Pashchimi Singhbhum 49.7
KARNATAKA Chikmagalur 41.2

19
 State District Less than 50%
KARNATAKA Shimoga 45.5
KARNATAKA Gadag 46.7
KARNATAKA Mysore 46.7
KARNATAKA Chitradurga 48.7
MADHYA PRADESH Ashok Nagar 37.2
MADHYA PRADESH Barwani 41.8
MADHYA PRADESH Rajgarh 42.7
MADHYA PRADESH Burhanpur 43.3
MADHYA PRADESH Mandsaur 43.5
MADHYA PRADESH Ratlam 45.2
MADHYA PRADESH Katni 46.7
MADHYA PRADESH Neemuch 47.0
MADHYA PRADESH Harda 48.6
MADHYA PRADESH Dindori 49.4
MADHYA PRADESH Hoshangabad 49.5
MAHARASHTRA Dhule 40.0
MAHARASHTRA Palghar* 40.9
MAHARASHTRA Sangli 43.4
MAHARASHTRA Kolhapur 46.9
MAHARASHTRA Raigarh 47.6
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

MAHARASHTRA Jalgaon 48.1

MEGHALAYA East Garo Hills 41.2
MIZORAM Champhai 48.3
ODISHA Gajapati 46.4
RAJASTHAN Jaisalmer 38.6
RAJASTHAN Chittaurgarh 42.4
RAJASTHAN Nagaur 44.4
RAJASTHAN Barmer 45.2
RAJASTHAN Banswara 46.1
RAJASTHAN Sirohi 47.1
RAJASTHAN Sawai Madhopur 49.8
TAMIL NADU Nagapattinam 39.0
TAMIL NADU Toothukudi 47.7
TAMIL NADU Tirunelveli 49.8
TELANGANA Jogulamba Gadwal* 45.0
TELANGANA Mahbubnagar 45.0
TELANGANA Nagarkurnool* 45.0
TELANGANA Wanaparthy* 45.0
UTTAR PRADESH Farrukhabad 40.3
UTTAR PRADESH Bahraich 41.4
UTTAR PRADESH Auraiya 43.7
UTTAR PRADESH Sonbhadra 44.0
UTTAR PRADESH Azamgarh 45.2
UTTAR PRADESH Allahabad 45.4
UTTAR PRADESH Kashi Ram Nagar 47.2
UTTAR PRADESH Faizabad 48.5

20
State District Less than 50%
UTTAR PRADESH Kannauj 48.9
UTTAR PRADESH Balrampur 49.1
UTTARAKHAND Udham Singh Nagar 47.4
Total Districts = 91
*FIC for these districts is that of parent district from which they were carved out
**FIC of these districts is mean of the parent districts from which they were carved out
Data is from IMI Survey

21
 Table B: List of districts with 50-90% FIC as per NFHS-4 / IMI Survey
State District 50-90%
A&N ISLANDS South Andaman 69.1
A&N ISLANDS North and Middle Andaman 89.1
ANDHRA PRADESH Srikakulam 59.2
ANDHRA PRADESH Guntuet 61.7
ANDHRA PRADESH Prakasam 64.0
ANDHRA PRADESH Cuddapah 65.3
ANDHRA PRADESH Vishakapatnam 66.0
ANDHRA PRADESH Kurnool 66.1
ANDHRA PRADESH Chittoor 67.7
ANDHRA PRADESH Krishna 74.1
ANDHRA PRADESH Anantapur 76.3
ANDHRA PRADESH West Godavari 77.7
ARUNACHAL PR. Anjaw 55.3
ARUNACHAL PR. Namsai 58.2
ARUNACHAL PR. East Kameng 59.8
ARUNACHAL PR. Tirap 64.6
ARUNACHAL PR. Papum Pare 69.0
ARUNACHAL PR. Kra Daadi 72.4
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

ARUNACHAL PR. Lohit 77.9

ARUNACHAL PR. Changlang 81.3
ARUNACHAL PR. Kurung Kumey 84.6
ARUNACHAL PR. East Siang 85.3
ARUNACHAL PR. Upper Siang 85.4
ASSAM Goalpara 51.1
ASSAM Udalguri 52.8
ASSAM Karimganj 53.9
ASSAM Lakhimpur 54.0
ASSAM Kokrajhar 55.4
ASSAM Baksa 59.1
ASSAM North Cachar Hills 59.8
ASSAM Darrang 60.3
ASSAM Tinsukia 64.0
ASSAM Jorhat 64.8
ASSAM Dhubri 65.2
ASSAM Golaghat 67.9
ASSAM Karbi Anglong 70.5
ASSAM Dibrugarh 71.1
ASSAM Kamrup M 72.8
ASSAM Sibsagar 73.0
ASSAM Nagaon 79.0
ASSAM Chirang 85.4
BIHAR Jamui 55.5
BIHAR Samastipur 57.4
BIHAR Sheohar 59.2
BIHAR Muzaffarpur 62.0

22
State District 50-90%
BIHAR Madhepura 62.2
BIHAR Siwan 63.3
BIHAR Munger 63.7
BIHAR Buxar 63.9
BIHAR Gopalganj 64.3
BIHAR Sitamarhi 64.6
BIHAR Banka 64.9
BIHAR Nalanda 65.2
BIHAR Madhubani 65.4
BIHAR Purnia 65.8
BIHAR Khagaria 65.9
BIHAR Supaul 65.9
BIHAR Bhagalpur 66.7
BIHAR Saran 67.0
BIHAR Jehanabad 67.5
BIHAR Gaya 68.9
BIHAR Katihar 69.1
BIHAR Lakhisarai 69.1
BIHAR Vaishali 70.2
BIHAR Kaimur (Bhabua) 70.5
BIHAR Darbhanga 71.1
BIHAR Bhojpur 71.9
BIHAR Araria 72.6
BIHAR East Champaran 73.2
BIHAR Arwal 74.1
BIHAR Rohtas 75.6
BIHAR Patna 75.8
BIHAR Begusarai 77.1
BIHAR Aurangabad 77.6
BIHAR Saharsa 78.0
BIHAR Nawada 80.2
BIHAR Kishanganj 80.5
BIHAR West Champaran 83.7
BIHAR Sheikhpura 88.3
CHANDIGARH Chandigarh 79.5
CHHATTISGARH Jashpur 50.4
CHHATTISGARH Kawardha 61.5
CHHATTISGARH Narayanpur 62.4
CHHATTISGARH Balrampur* 64.3
CHHATTISGARH Surajpur* 64.3
CHHATTISGARH Surguja 64.3
CHHATTISGARH Dantewada 66.1
CHHATTISGARH Sukma* 66.1
CHHATTISGARH Raigarh 68.5
CHHATTISGARH Janjgir Champa 70.5
CHHATTISGARH Bastar 71.6
CHHATTISGARH Kondagaon* 71.6

23
 State District 50-90%
CHHATTISGARH Koriya 74.6
CHHATTISGARH Mahasamund 74.8
CHHATTISGARH Baloda Bazar* 80.1
CHHATTISGARH Gariyaband* 80.1
CHHATTISGARH Raipur 80.1
CHHATTISGARH Korba 80.8
CHHATTISGARH Bilaspur 82.0
CHHATTISGARH Kanker 82.0
CHHATTISGARH Mungeli* 82.0
CHHATTISGARH Bijapur 83.7
CHHATTISGARH Rajnandgaon 87.1
CHHATTISGARH Dhamtari 88.2
DAMAN & DIU Daman 62.8
DAMAN & DIU Diu 81.4
DELHI South 51.1
DELHI North East 55.2
DELHI East 64.0
DELHI Central 69.5
DELHI North West 74.2
DELHI New Delhi** 84.4
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

DELHI South West 84.4

DELHI North 85.7
GOA North Goa 87.3
GOA South Goa 89.5
GUJARAT Rajkot 51.4
GUJARAT Valsad 52.9
GUJARAT Mahesana 55.1
GUJARAT Gir Somnath* 56.5
GUJARAT Junagadh 56.5
GUJARAT Bharuch 56.9
GUJARAT Amreli 59.9
GUJARAT Anand 61.4
GUJARAT Chhotaudepur* 63.3
GUJARAT Vadodara 63.3
GUJARAT Gandhinagar 66.1
GUJARAT Porbandar 68.8
GUJARAT Narmada 69.3
GUJARAT Devbhumi Dwarka* 71.4
GUJARAT Jamnagar 71.4
GUJARAT Tapi 72.9
GUJARAT Kachchh 77.7
GUJARAT Navsari 78.5
GUJARAT Banas Kantha 80.7
GUJARAT Bhavnagar 87.6
HARYANA Jhajjar 50.0
HARYANA Rohtak 64.1
HARYANA Sonipat 64.1

24
State District 50-90%
HARYANA Bhiwani 66.1
HARYANA Panipat 68.4
HARYANA Mahendragarh 73.0
HARYANA Sirsa 75.2
HARYANA Hisar 75.3
HARYANA Palwal 77.2
HARYANA Gurgaon 83.8
HARYANA Faridabad 84.9
HARYANA Fatehabad 87.6
HARYANA Yamunanagar 87.9
HARYANA Kurukshetra 88.2
HARYANA Jind 89.0
HIMACHAL PRADESH Bilaspur 58.3
HIMACHAL PRADESH Lahul & Spiti 58.9
HIMACHAL PRADESH Una 59.1
HIMACHAL PRADESH Chamba 64.6
HIMACHAL PRADESH Kullu 65.7
HIMACHAL PRADESH Kangra 68.6
HIMACHAL PRADESH Sirmaur 70.6
HIMACHAL PRADESH Mandi 78.8
HIMACHAL PRADESH Solan 79.8
HIMACHAL PRADESH Kinnaur 82.0
HIMACHAL PRADESH Shimla 87.3
JAMMU & KASHMIR Ramban 57.5
JAMMU & KASHMIR Bandipora 68.0
JAMMU & KASHMIR Samba 68.7
JAMMU & KASHMIR Shopian 69.9
JAMMU & KASHMIR Anantnag 72.7
JAMMU & KASHMIR Reasi 73.1
JAMMU & KASHMIR Kishtwar 74.4
JAMMU & KASHMIR Kupwara 77.8
JAMMU & KASHMIR Baramula 78.6
JAMMU & KASHMIR Kargil 81.9
JAMMU & KASHMIR Leh (Ladakh) 82.0
JAMMU & KASHMIR Kathua 82.5
JAMMU & KASHMIR Udhampur 82.7
JAMMU & KASHMIR Ganderbal 82.9
JAMMU & KASHMIR Kulgam 83.0
JAMMU & KASHMIR Poonch 84.2
JAMMU & KASHMIR Srinagar 85.5
JAMMU & KASHMIR Badgam 87.5
JAMMU & KASHMIR Pulwama 89.9
JHARKHAND Latehar 52.7
JHARKHAND Garhwa 54.2
JHARKHAND Simdega 56.9
JHARKHAND Palamu 57.7
JHARKHAND Gumla 58.8

25
 State District 50-90%
JHARKHAND Lohardaga 60.0
JHARKHAND Godda 60.1
JHARKHAND Sahibganj 62.2
JHARKHAND Jamtara 62.4
JHARKHAND Deoghar 64.2
JHARKHAND Saraikela 65.1
JHARKHAND Ramgarh 66.1
JHARKHAND Bokaro 66.2
JHARKHAND Giridih 66.6
JHARKHAND Ranchi 67.7
JHARKHAND Purbi Singhbhum 68.9
JHARKHAND Kodarma 70.9
JHARKHAND Hazaribagh 72.5
JHARKHAND Khunti 72.7
JHARKHAND Dhanbad 73.5
JHARKHAND Dumka 76.0
JHARKHAND Pakaur 77.1
KARNATAKA Dharwad 54.9
KARNATAKA Bijapur 58.1
KARNATAKA Ramanagar 58.8
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

KARNATAKA Chamrajnagar 59.5

KARNATAKA Bidar 59.6
KARNATAKA Mandya 61.0
KARNATAKA Chikkaballapur 63.7
KARNATAKA Bangalore Rural 64.1
KARNATAKA Udupi 64.6
KARNATAKA Tumkur 64.8
KARNATAKA Raichur 65.4
KARNATAKA Uttara Kannada 67.7
KARNATAKA Hassan 68.1
KARNATAKA Kodagu 68.2
KARNATAKA Haveri 69.3
KARNATAKA Bellary 71.1
KARNATAKA Koppal 72.8
KARNATAKA Davanagere 75.2
KARNATAKA Kolar 76.4
KARNATAKA Dakshina Kannada 77.3
KARNATAKA Yadgir 80.2
KERALA Kozhikkode 70.0
KERALA Wayanad 72.8
KERALA Ernakulam 75.9
KERALA Pathanamthitta 78.0
KERALA Malappuram 78.6
KERALA Thiruvananthapuram 81.9
KERALA Kannur 87.1
KERALA Kollam 87.3
KERALA Palakkad 88.1

26
State District 50-90%
KERALA Thrissur 88.3
LAKSHADWEEP Lakshadweep 86.9
MADHYA PRADESH Bhind 51.0
MADHYA PRADESH Satna 52.4
MADHYA PRADESH Gwalior 52.5
MADHYA PRADESH Datia 53.2
MADHYA PRADESH Narsinghpur 54.2
MADHYA PRADESH Mandla 55.1
MADHYA PRADESH Damoh 55.9
MADHYA PRADESH Chhatarpur 56.3
MADHYA PRADESH Jhabua 56.6
MADHYA PRADESH Ujjain 56.8
MADHYA PRADESH Seoni 57.1
MADHYA PRADESH Anuppur 57.8
MADHYA PRADESH Khandwa 58.7
MADHYA PRADESH Sehore 60.0
MADHYA PRADESH Dewas 60.3
MADHYA PRADESH Morena 60.6
MADHYA PRADESH Bhopal 62.3
MADHYA PRADESH Shivpuri 63.1
MADHYA PRADESH Khargone 64.2
MADHYA PRADESH Chhindwada 64.3
MADHYA PRADESH Balaghat 64.6
MADHYA PRADESH Guna 65.1
MADHYA PRADESH Dhar 65.6
MADHYA PRADESH Alirajpur 66.0
MADHYA PRADESH Singroli 66.7
MADHYA PRADESH Umaria 67.1
MADHYA PRADESH Jabalpur 67.5
MADHYA PRADESH Sidhi 67.8
MADHYA PRADESH Tikamgarh 68.7
MADHYA PRADESH Betul 69.1
MADHYA PRADESH Agar Malwa* 71.7
MADHYA PRADESH Shajapur 71.7
MADHYA PRADESH Panna 71.8
MADHYA PRADESH Shahdol 73.4
MADHYA PRADESH Sheopur 74.1
MADHYA PRADESH Indore 76.1
MADHYA PRADESH Vidisha 78.5
MADHYA PRADESH Rewa 82.0
MADHYA PRADESH Raisen 83.5
MADHYA PRADESH Sagar 87.9
MAHARASHTRA Akola 50.8
MAHARASHTRA Parbhani 51.5
MAHARASHTRA Thane 57.5
MAHARASHTRA Satara 59.2
MAHARASHTRA Aurangabad 59.3

27
 State District 50-90%
MAHARASHTRA Latur 59.4
MAHARASHTRA Chandrapur 60.5
MAHARASHTRA Bid 61.3
MAHARASHTRA Osmanabad 62.7
MAHARASHTRA Buldana 64.2
MAHARASHTRA Amravati 64.7
MAHARASHTRA Mumbai 65.0
MAHARASHTRA Hingoli 65.9
MAHARASHTRA Washim 67.9
MAHARASHTRA Nandurbar 69.4
MAHARASHTRA Jalna 70.0
MAHARASHTRA Ratnagiri 73.1
MAHARASHTRA Gondiya 74.4
MAHARASHTRA Nagpur 76.5
MAHARASHTRA Wardha 76.5
MAHARASHTRA Ahmednagar 77.4
MAHARASHTRA Yavatmal 78.2
MAHARASHTRA Solapur 78.6
MAHARASHTRA Nashik 79.4
MAHARASHTRA Sindhudurg 80.3
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

MAHARASHTRA Pune 81.0

MAHARASHTRA Bhandara 81.1
MAHARASHTRA Gadchiroli 84.8
MAHARASHTRA Nanded 86.2
MANIPUR Senapati 58.7
MANIPUR Tamenglong 61.0
MANIPUR Ukhrul 61.6
MANIPUR Thoubal 65.4
MANIPUR Churachandpur 66.2
MANIPUR Imphal East 72.7
MANIPUR Chandel 74.4
MANIPUR Bishnupur 77.2
MANIPUR Imphal West 82.8
MEGHALAYA Ri Bhoi 55.7
MEGHALAYA North Garo Hills 70.9
MEGHALAYA East Khasi Hills 73.9
MEGHALAYA West Khasi Hills 74.2
MEGHALAYA South West Khasi Hills 80.2
MEGHALAYA West Garo Hills 80.9
MEGHALAYA South Garo Hills 83.0
MEGHALAYA South West Garo Hills 87.1
MEGHALAYA West Jaintia Hills 89.8
MIZORAM Kolasib 51.5
MIZORAM Saiha 55.0
MIZORAM Aizawl East 55.3
MIZORAM Aizawl West 55.3
MIZORAM Serchhip 60.9

28
State District 50-90%
MIZORAM Mamit 67.7
MIZORAM Lawngtlai 68.5
MIZORAM Lunglei 79.2
NAGALAND Kiphrie 60.2
NAGALAND Pheren 60.5
NAGALAND Mon 61.9
NAGALAND Wokha 61.9
NAGALAND Longleng 62.3
NAGALAND Tuensang 65.0
NAGALAND Zunheboto 71.1
NAGALAND Phek 71.6
NAGALAND Dimapur 82.8
NAGALAND Kohima 83.2
NAGALAND Mokokchung 84.9
ODISHA Koraput 67.1
ODISHA Deogarh 68.4
ODISHA Rayagada 71.2
ODISHA Nabarangapur 71.5
ODISHA Mayurbhanj 72.7
ODISHA Kandhamal 73.5
ODISHA Sambalpur 74.4
ODISHA Kendrapara 76.8
ODISHA Malkangiri 76.9
ODISHA Keonjhar 77.6
ODISHA Baleshwar 79.0
ODISHA Jharsuguda 79.1
ODISHA Cuttack 79.2
ODISHA Bargarh 81.4
ODISHA Nuapada 83.8
ODISHA Sundargarh 85.4
ODISHA Jagatsinghpur 85.7
ODISHA Nayagarh 85.9
ODISHA Dhenkanal 87.0
ODISHA Kalahandi 88.2
ODISHA Puri 88.2
ODISHA Bhadrak 88.4
ODISHA Anugul 88.9
PONDICHERRY Yanam 88.3
PONDICHERRY Karaikal 89.6
PUNJAB Ludhiana 72.3
PUNJAB Sangrur 79.0
PUNJAB Nawanshahr 86.1
PUNJAB Fazilka* 87.0
PUNJAB Firozpur 87.0
PUNJAB Fatehgarh Sahib 87.8
PUNJAB Gurdaspur 89.2
PUNJAB Pathankot* 89.2

29
 State District 50-90%
RAJASTHAN Bharatpur 50.5
RAJASTHAN Udaipur 52.8
RAJASTHAN Sikar 56.8
RAJASTHAN Dausa 57.0
RAJASTHAN Churu 57.4
RAJASTHAN Jodhpur 57.8
RAJASTHAN Alwar 58.0
RAJASTHAN Rajsamand 60.0
RAJASTHAN Pali 60.2
RAJASTHAN Jaipur 61.3
RAJASTHAN Hanumangarh 62.1
RAJASTHAN Bundi 63.0
RAJASTHAN Bikaner 64.1
RAJASTHAN Jhunjhunun 65.1
RAJASTHAN Dungarpur 65.8
RAJASTHAN Bhilwara 66.5
RAJASTHAN Dhaulpur 66.7
RAJASTHAN Ajmer 67.1
RAJASTHAN Pratapgarh 67.7
RAJASTHAN Baran 68.0
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

RAJASTHAN Karauli 71.2

RAJASTHAN Kota 71.2
RAJASTHAN Jalor 73.5
RAJASTHAN Jhalawar 75.4
RAJASTHAN Tonk 75.9
RAJASTHAN Ganganagar 79.9
SIKKIM East 83.6
SIKKIM North 89.9
TAMIL NADU Dharmapuri 51.6
TAMIL NADU Pudukkottai 54.3
TAMIL NADU Virudhunagar 54.4
TAMIL NADU Kanniyakumari 55.1
TAMIL NADU Kancheepuram 56.8
TAMIL NADU Theni 56.8
TAMIL NADU Namakkal 57.3
TAMIL NADU Ramanathapuram 59.0
TAMIL NADU Ariyalur 60.6
TAMIL NADU Madurai 61.0
TAMIL NADU Tiruvanamalai 62.1
TAMIL NADU Cuddalore 64.2
TAMIL NADU Sivaganga 69.9
TAMIL NADU Tiruchirappalli 70.0
TAMIL NADU Perambalur 70.4
TAMIL NADU Thiruvarur 72.0
TAMIL NADU Viluppuram 72.1
TAMIL NADU Salem 73.6
TAMIL NADU Vellore 74.0

30
State District 50-90%
TAMIL NADU Thanjavur 74.6
TAMIL NADU Nilgiris 78.7
TAMIL NADU Thiruvallur 78.9
TAMIL NADU Dindigul 80.0
TAMIL NADU Coimbatore 80.7
TAMIL NADU Krishnagiri 81.6
TAMIL NADU Erode 81.9
TAMIL NADU Chennai 86.1
TAMIL NADU Karur 87.4
TELANGANA Bhadradri Kothagudem* 62.4
TELANGANA Khammam 62.4
TELANGANA Kamareddy* 64.2
TELANGANA Nizamabad 64.2
TELANGANA Jayashankar Bhupalpally* 67.0
TELANGANA Mahabubabad* 67.0
TELANGANA Warangal Rural 67.0
TELANGANA Warangal Urban 67.0
TELANGANA Jangoan** 68.0
TELANGANA Medchal Malkajgiri* 68.1
TELANGANA Ranga Reddy 68.1
TELANGANA Vikarabad* 68.1
TELANGANA Nalgonda 69.0
TELANGANA Suryapet* 69.0
TELANGANA Yadadri Bhonagiri* 69.0
TELANGANA Adilabad 70.0
TELANGANA Komaram Bheem* 70.0
TELANGANA Mancherial* 70.0
TELANGANA Nirmal* 70.0
TELANGANA Hyderabad 71.3
TELANGANA Medak 81.4
TELANGANA Sangareddy* 81.4
TELANGANA Siddipet* 81.4
TELANGANA Jagitial* 84.3
TELANGANA Karim Nagar 84.3
TELANGANA Peddapalli* 84.3
TELANGANA Rajanna Sircilla* 84.3
TRIPURA Gomati* 54.7
TRIPURA Khowai* 56.7
TRIPURA Sipahijala* 56.7
TRIPURA Dhalai 73.8
TRIPURA North Tripura 74.5
TRIPURA Unakoti 74.5
UTTAR PRADESH Etah 50.5
UTTAR PRADESH Sitapur 51.3
UTTAR PRADESH Fatehpur 52.5
UTTAR PRADESH Hamirpur 52.5
UTTAR PRADESH Sultanpur 53.7

31
 State District 50-90%
UTTAR PRADESH Etawah 53.8
UTTAR PRADESH Gonda 54.0
UTTAR PRADESH Barabanki 54.3
UTTAR PRADESH Mirzapur 54.3
UTTAR PRADESH Jalaun 54.7
UTTAR PRADESH C S M Nagar (Amethi)** 55.4
UTTAR PRADESH Kanpur Nagar 55.9
UTTAR PRADESH Kaushambi 56.5
UTTAR PRADESH Chandauli 58.5
UTTAR PRADESH Lucknow 58.5
UTTAR PRADESH Unnav 59.9
UTTAR PRADESH Sambhal 60.1
UTTAR PRADESH Mainpuri 60.6
UTTAR PRADESH Hathras 61.2
UTTAR PRADESH Budaun 62.0
UTTAR PRADESH Kanpur Dehat 62.1
UTTAR PRADESH Kushinagar 62.3
UTTAR PRADESH Jhansi 62.7
UTTAR PRADESH Saharanpur 63.1
UTTAR PRADESH Shamli* 63.7
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

UTTAR PRADESH Mahoba 64.5

UTTAR PRADESH Gautam Buddha Nagar 65.5
UTTAR PRADESH Lakhimpur Kheri 65.7
UTTAR PRADESH Maharajganj 65.7
UTTAR PRADESH Hardoi 65.9
UTTAR PRADESH Varanasi 66.4
UTTAR PRADESH Ghazipur 66.8
UTTAR PRADESH Ambedkar Nagar 67.5
UTTAR PRADESH Banda 67.8
UTTAR PRADESH Muzaffarnagar 67.8
UTTAR PRADESH Maunathbhanjan 67.9
UTTAR PRADESH Ghaziabad 68.7
UTTAR PRADESH Pratapgarh 68.9
UTTAR PRADESH Sant Kabir Nagar 69.7
UTTAR PRADESH Bagpat 69.8
UTTAR PRADESH Shrawasti 70.2
UTTAR PRADESH Shahjahanpur 70.7
UTTAR PRADESH Rae Bareli 70.9
UTTAR PRADESH Pilibhit 71.0
UTTAR PRADESH Bareilly 71.2
UTTAR PRADESH Meerut 71.3
UTTAR PRADESH Moradabad 71.6
UTTAR PRADESH Firozabad 71.9
UTTAR PRADESH Sant Ravidas Nagar 72.0
UTTAR PRADESH Aligarh 72.4
UTTAR PRADESH Basti 73.4
UTTAR PRADESH Jyotiba Phule Nagar 74.2

32
State District 50-90%
UTTAR PRADESH Deoria 74.5
UTTAR PRADESH Bijnor 76.7
UTTAR PRADESH Bulandshahar 76.8
UTTAR PRADESH Siddharth Nagar 78.6
UTTAR PRADESH Lalitpur 78.7
UTTAR PRADESH Agra 80.1
UTTAR PRADESH Jaunpur 81.4
UTTAR PRADESH Mathura 81.7
UTTAR PRADESH Hapur 83.1
UTTAR PRADESH Chitrakoot 83.2
UTTAR PRADESH Ballia 85.4
UTTAR PRADESH Rampur 86.7
UTTAR PRADESH Gorakhpur 87.8
UTTARAKHAND Tehri Garhwal 51.1
UTTARAKHAND Nainital 59.0
UTTARAKHAND Bageshwar 60.2
UTTARAKHAND Almora 60.6
UTTARAKHAND Dehradun 60.7
UTTARAKHAND Garhwal 61.2
UTTARAKHAND Chamoli 62.2
UTTARAKHAND Champawat 68.4
UTTARAKHAND Rudraprayag 70.3
UTTARAKHAND Uttarkashi 72.0
UTTARAKHAND Pithoragarh 74.2
UTTARAKHAND Hardwar 84.4
WEST BENGAL Uttar Dinajpur 66.0
WEST BENGAL Kolkata 66.7
WEST BENGAL Malda 69.5
WEST BENGAL Haora 73.8
WEST BENGAL Koch Bihar 76.6
WEST BENGAL Murshidabad 78.9
WEST BENGAL Alipurduar* 81.7
WEST BENGAL Jalpaiguri 81.7
WEST BENGAL Bardhaman 82.3
WEST BENGAL Paschim Barddhaman* 82.3
WEST BENGAL Dakshin Dinajpur 83.2
WEST BENGAL Darjeeling 84.2
WEST BENGAL Kalimpong* 84.2
WEST BENGAL Puruliya 87.4
WEST BENGAL Hooghly 88.4
Total Districts = 555
*FIC for these districts is that of parent district from which they were carved out
**FIC of these districts is mean of the parent districts from which they were carved out
Data is from IMI Survey

33
 Table C: List of districts with >90% FIC as per NFHS-4 / IMI Survey
State District More Than 90%
ANDHRA PRADESH Nellore 93.0
ANDHRA PRADESH East Godavari 94.1
CHHATTISGARH Balod* 90.4
CHHATTISGARH Bemetra* 90.4
CHHATTISGARH Durg 90.4
DELHI South East 91.1
DELHI Shahadara 92.3
HARYANA Kaithal 90.5
HARYANA Karnal 91.0
HARYANA Panchkula 96.9
HARYANA Ambala 97.4
JAMMU & KASHMIR Jammu 97.9
KARNATAKA Gulbarga 90.1
KARNATAKA Bangalore Urban 93.3
KARNATAKA Bagalkote 94.5
KARNATAKA Belgaum 94.9
KERALA Kasaragod 91.8
KERALA Kottayam 95.2
Roadmap for achieving 90% full immunization coverage in India - A guidance document for the states

MEGHALAYA East Jaintia Hills 92.6

ODISHA Jajapur 90.0
ODISHA Sonapur 91.9
ODISHA Khordha 92.7
ODISHA Balangir 93.0
ODISHA Ganjam 93.5
ODISHA Baudh 94.2
PONDICHERRY Mahe 90.6
PONDICHERRY Pondicherry 91.9
PUNJAB Mohali (SAS Nagar) 90.1
PUNJAB Barnala 90.9
PUNJAB Jalandhar 91.0
PUNJAB Amritsar 91.9
PUNJAB Mansa 91.9
PUNJAB Bathinda 92.6
PUNJAB Hoshiarpur 92.7
PUNJAB Rupnagar 93.1
PUNJAB Moga 94.0
PUNJAB Patiala 95.3
PUNJAB Tarn Taran 96.5
PUNJAB Muktsar 96.9
PUNJAB Faridkot 97.8
PUNJAB Kapurthala 100.0
SIKKIM South 92.3
SIKKIM West 96.3
TAMIL NADU Tirupur 93.2
TRIPURA South Tripura 90.1
TRIPURA West Tripura 91.0

34
State District More Than 90%
WEST BENGAL Birbhum 91.4
WEST BENGAL Jhargram* 92.2
WEST BENGAL Medinipur West 92.2
WEST BENGAL Medinipur East 92.6
WEST BENGAL Nadia 93.2
WEST BENGAL South 24 Parganas 94.8
WEST BENGAL Bankura 96.2
WEST BENGAL North 24 Parganas 96.9
Total Districts = 54
*FIC for these districts is that of parent district from which they were carved out
Data is from IMI Survey

State District
DELHI West
KERALA Alappuzha
KERALA Idukki
Total Districts = 3
Data not available due to less sample size of NFHS-4 survey

35