Vitamin-A supplementation program in Bihar

JOINT PROGRAM OF STATE HEALTH SOCIETY,BIHAR & UNICEF
Vitamin 'A'
In 1997-98 Vitamin 'A' program had been started with the help of World Health
Organization and Indian Council of Medical Report (ICMR). As per the survey report of
NFHS II the objective was to strengthen both Vitamin 'A' and routine Immunization in
complementary way. Therefore looking at the need of the time it was decided to initiate
the process with UNICEF in the year 2000-2001 under the Netra Jyoti Campaigns. Since
the merger of Vitamin-A and Routine immunization in the State it is still continuing with
the coordination of UNICEF and State Health Society, Bihar.
Objectives of the Programme
As per the Programme policy led by GOI Department of Health, Ministry of Health and
family welfare Department of family Welfare child health Division it has been decided to
administer Vitamin A supplement to all children Nine month to Five Years of age vide
letter no Z.28020/30/2003-CH dated: 2nd November 2006.
State Health Society and Government of Bihar has been successfully undertaking
Vitamin 'A' supplementation Programme for preschool children. It has therefore been
decided to undertake the respective programmes for the children of the age group 9
Months to 5 Years in all the 38 District of state following the biannual fixed day strategy
linked with Routine Immunization. Children of 9 months to 5 Years of age would be
covered with six monthly doses of Vitamin A syrup.
Regular Vaccination Program of Vitamin 'A'
− In all the States in India 'Wednesday' and 'Saturday' is marked as a regular
vaccination day.
− During this schedule Micro plans were cultivated.
− Strengthening this regular vaccination program various meetings were organized
with Primary health centers (PHC), Health Sub Centers (HSC) and Aangan wari
centers (AWC).
− While the way of Jaccha Baccha Card and M.C.H.N register, society
dependent orientation had been started. For the age group of 9m-36m child Jaccha
Baccha Cards were spread upto HSCs.
− District Field Monitors (DFM) were appointed with the help of State Health
Society and UNICEF which included different groups of people, who were
trained at State Level. The roles of DFMS varied from strengthening the program
to assisting the State level employees.
SHSB
Vitamin 'A'

Vitamin 'A' Supplementation Program in Bihar
Vitamin 'A' first and second catch up round was scheduled from 19th to 21st April 06 and
28th Nov to 1st Dec '06 in all the 38 Districts of Bihar as a result of which 77 Lakhs and
79 Lakhs children were benefited by Vitamin 'A' Syrup respectively. The aggregate
percentage of which accounts to 89.94 for first and 95.10 for the second catch up round .
In order to execute the Works related to Vitamin 'A' Program in the District to the grass
root level the services of District Field Monitors (DFM) are being taken, who render their
services on short-term assignment by UNICEF. They have been stationed in the allotted
District to strengthen the program since the very beginning till the finalization of the
Reports and UC and SOE.
Activities before the catch up round
• Different types of IEC materials were developed for Advocacy and propagation of
information regarding the Vitamin 'A' catch up Round.
• The meetings at all the levels were organized ranging from Primary Health Center
to the Health Sub centers with the coordination of District Field Monitors, District
Level Officials and Block Level Officials.
• Special Mobile Drive campaign was launched for covering the children of hard to
reach areas so that no child could be left out.
Following Strategies were followed during the Second Catch Up Round with Mobile
Van approach for Hard-to-Reach areas:
Date Day Centre Approach Mobile Van Approach
28.11.06 Tuesday Advocacy and Communication of
Messages through Mobile Van
-
29.11.06 Wednesday Administering Vitamin Syrup to the
Children with the help of Anganwadi
Workers
Advocacy and
Communication of
Messages through
Mobile Van
30.11.06 Thursday With the help of Door to Door approach
administering the syrup to the left out
children
Administering Vitamin
Syrup to the Children
with the help of Mobile
vans
01.11.06 Friday To go to each and every House with the
help of the workers
Administering Vitamin
Syrup to the Children
with the help of Mobile
vans
SHSB
Vitamin 'A'

Role and Responsibility of (District Field Monitors) DFM
1. Assisting in Conducting Vitamin ‘A’ Catch Up round Biannually in their District.
2. Support in monitoring of PHC’s (Primary Health Center) during the Catch Up
round.
3. Organizing meetings in District, PHCs, HSCs with CS (Civil Surgeon), DIO
(District Immunization Officer), DEO (District Education Officials), MOIC (MO
Incharg), MO (Medical Officers), AWC (Angan Wari Centers), HS (Health
Supervisor), AWW (Angan wari workers) and Others supportive person.
4. Preparation of Coverage Reports on the basis of Census data.
5. Preparing reports on UC (Utilization Certificate) and SOE (Statement of
Expenditure Certificate) of their funds.
6. Monitoring of Population of PHC given by District, Account of Coverage Report.
7. Training and Sensitization.
Importance of Catch Up round Coverage Report:
• Coverage report reflects the radiant beauty of your hard work over the catch
up round.
• Coverage reports of the round are the most important aspect, which shows the
achievement of your district.
• It also shows the percentage coverage of PHC’s as per district.
• It represents, number of targeted beneficiaries covered during the round and
number of children who were administered.

Some points to be viewed while making Coverage Reports of Catch Up
rounds:
• While checking coverage reports given by districts, we found that they made
silly mistakes which make their exceptional coverage reports vulnerable.
• There are variations in calculation of Target Beneficiaries made by various
districts.
• As we know The Target Beneficiaries is fixed as 8.5% for 9m-36m and 5.7%
for 37m-60m of the Total Population of PHC.
• But different district made different calculation for Target Beneficiaries.
• Some says that they would not be able to change the Target Beneficiaries on
8.5% it is fixed as per District.
• Some district gives their Target beneficiaries 2.5% for 9m-12m and 6% for
13m-36m and accounts their percentage of achievement according to them.
• Some other complained that the coverage report made by "Computer Babu"
and the mistake is done by them not by him.
• Some Covering Letters came here with the sign of DFM it self instead signed
by CS (Civil Surgeon).
SHSB
Vitamin 'A'

Achievement

YEAR Percntage of Coverage %
2004 73.93
2005 84.55
2006 95.10

Looking at the previously mentioned table, we say that our Vitamin 'A' Supplementation
has been rising above and now it shows all time highest 95.10% coverage.
Practical Notes
− Preparation of Coverage report must be on the basis of above mentioned points.
− Coverage reports should be accompanied with the covering letter duly signed by
civil surgeon.
− The correct Coverage reports were prepared on the basis of originals only