Behind the Scenes of PPI, Pulse Polio Immunization Programme – Part 1

Being the Medical Officer at a primary health centre (PHC) implementation of national level health programmes is not just a part of my job, it is something much more than that. In this article, I’d like to give you my perspective of such a national programme, the very famous pulse polio immunization. If you’re keen to learn what all stuff goes behind the scenes of conducting a national health programme like PPI, you’ve reached the right page.

Interesting Reading: Healthcare in India

Overview

• Polio is a viral disease that can make you paralysed and handicapped for a lifetime. Find out more about the disease by visiting this page.
• The only effective method to prevent polio is through vaccines. There are two types of polio vaccines, namely the oral polio vaccine (OPV) and inactivated polio vaccine (IPV). Learn more about polio vaccines in this page.
• Pulse polio immunization is a special vaccination method wherein all children below the age of 5 years are given two drops of OPV irrespective of their previous vaccination history. The first round of PPI was conducted this year in January 29 and the second round is due on April 2. For more details on the PPI, kindly follow this link.
• India was declared a “polio-free” country in 2014 as a result of the hard work done by the thousands of healthcare workers all around the country in conducting the routine and special vaccination programmes. The last case of polio detected in our country was in 2011.
• It’ll be a good idea to know a bit about the cold chain system which is responsible for maintaining the potency of all vaccines throughout it’s transport and storage from the manufacturing unit to the dispensing centre.

Now that you are familiar with polio and PPI, let’s get started. I’ll tell you the arrangement process, fund distribution, trainings and everything else that goes in before every PPI day.

The Trainings

Except for this year, the first and second round of PPI are usually conducted in the months of January and February respectively. District level trainings for all categories of healthcare workers in Kerala are conducted one or two months prior to the first round of PPI. I remember attending a routine training for PPI in December of 2016. The district level trainings are intended to make the healthcare workers familiar with the new forms, new guidelines, safety precautions ahead of the PPI.

After attending the district level training, the medical officer has to conduct training sessions for the volunteers who are supposed to be handling the PPI booths. ASHAs and anganwadi teachers are volunteers of the PPI programme by default and they are also invited to the PHC where the training is conducted. It is made sure that all volunteers for the PPI are trained at least at the PHC level.

The Vehicle

Conducting a PPI programme without a vehicle is practically unimaginable. Vehicle is a must for transporting vaccines from the PHC to the booths on the days of PPI and for the monitoring duty. Off-record, vehicles are also used to distribute the lunch for the volunteers!

Usually, the panchayat vehicle is used for the PPI days. But, things get messed up when the panchayat vehicle is off-road. In that situation, we have to request for another government department vehicle and that requires the order from the district collector. Whether the allotted department vehicle is off-road or not depends entirely on our luck. There have been instances when we had to hire a vehicle simply because all the allotted vehicles were unavailable!

I still remember receiving a reply letter from the Block Secretary stating that the Block panchayat vehicle cannot be sent to the PHC for PPI duty as the Block President had some important function to attend to on the same day! The district collector’s order was not even in their consideration while writing that letter, I reckon. It would have been appreciated if they could arrange an alternate vehicle for us, but they really didn’t care.

There was this one time when after repeated letters and phone calls, our RCH officer finally managed to arrange a department vehicle for us on the last day just ahead of the PPI. Brilliant work from them, I should admit.

The Vaccines

It was today, the 31 March that we received the OPV to be given on the PPI day. Every PHC receives an additional amount of OPV based on the number of under five year old children in that particular panchayat. The vaccine is the same 20 dose vials that’s being used in the routine immunization programme. Ice packs are prepared well in advance keeping in mind the need to transport the vaccines and for the booths. There is a shortage of vaccine carriers and cold boxes which are usually addressed to by borrowing from the higher or neighbouring centres.

If you haven’t already read about the cold chain system and vaccine vial monitoring system, now would be a good time. Here’s the link.

Along with the vaccines, the markers, banners and forms are also delivered to the PHC that are to be used on the PPI.

Still here? Well, this post is getting a bit longer than I had expected. The interesting part of the PPI is coming up in Part 2 of the post. In the meantime, here are some good articles on vaccines that you might like:

• Why Vaccinate your Child?
• The Free Vaccination programme
• Does Vaccines contain Harmful Mercury?
• The Immune-Walk programme