Enhancing Vaccine Delivery to the Urban Poor

With the plethora of vaccine and immunization programs currently underway in all countries across the globe, we would expect the contraction rate to be extremely less. The current scenario however, is overwhelmingly different. Statistics given by the World Health Organisation in 2016 suggest that a staggering 46% of the population of the world, is currently suffering from a disease, the level ranging from mild to chronic.

So with all the immunisation plans underway, why are we not being able to address one of the most rudimentary aspects of prevention of disease of infections? Another figure from the World Health Organisation suggests that only 30 percent of the population of India has received all three doses of the Hepatitis B vaccine. The problem is quite simple: as we have more and more immunisation programs underway, coherence of these programs into a single unified structure becomes a matter of significant importance and has been continuously overlooked. One of the major problems that plagues the urban poor is the lack of a data record that will be key in unifying all such programs that are currently underway.

The local governments have established a multitude of Primary Healthcare Centres (PHCs) across districts. These are main points of contact for the distribution as well as the administering of vaccines, particularly to children below the age of 18 months. Primary Healthcare Centres distribute immunisation cards to the families of newborns of the local community they are serving. Now one of the major problems with such a system is that tracking of what vaccine has been administered is of a major concern, especially when it looked at in the perspective of a migrant population.

Often, this standard leaflet is lost or is not updated, leading to a child not being given the stipulated 18 month vaccines, or either being administered a particular dose more than once. If this card is lost, there is no way to recover the details of the vaccines previously administered since there is no server integrating community healthcare standards and practices. So where does the solution come into play?

While brainstorming about a viable and easily implementable solution to this particular problem, we have come up with a three prong fail-safe system that will easily allow the proper and timely administering of an immunisation schedule to children of the urban poor, from the time when they are born, till the age of eighteen months. The first part of this system partakes to a standardised immunisation card that should be used by the government, as well as other community medicine programs operating in the region. This card will be equipped with a unique identification number, along with key details for identification, including but not limited to: the number of dependents, previous vaccine administered, date of birth, family name, et cetera.

The second step of this system is a visual cue in the form of beads. Every child, at the time of birth will be given a bracelet that may be tied around the wrist or the ankle. This bracelet will contain unique beads, corresponding to a particular vaccine that has been administered to the child. Every new bead will be attached only at the time of administering the vaccine. At the end of the cycle, for the child to be completely vaccinated, he/she should have eighteen beads corresponding to different vaccines, and different doses of each vaccine, on the bracelet. Such a device would be a visual cue for the parent to get the child vaccinated on time, regardless of the level of literacy. It would also be easier for multiple community medicine programs to act in coherence with such a localised form of data entry and visualisation.

The last element to the three prong approach entails the use of NFC tags, embedded in a bead, and placed on the bracelet. This NFC tag may also be worn by the mother in the form of a ring or a pendant. The purpose of this NFC tag would be to store whatever vaccine information is already on the card that has been administered, and further keep an up to date entry system with regard to when each dosage was given. The contents of the tag may be read from any NFC capable device, however reading and writing of the data may only take place with an app that will be put on a smartphone and given to community workers. The entire database of an area may be stored on a smartphone, and the community worker will also receive constant alerts for vaccines due in a particular area.

Such a system promotes coherence of multiple programs, and even helps in the establishment of a data entry scheme, while achieving its primary objective: ensuring the timely delivery and enforcement of an immunisation schedule for the urban poor.

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