U-WIN PORTAL
Source: IndianExpress
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Context
- The U-WIN portal, the digital platform to record vaccinations, is poised for a nationwide launch by the end of August.
- This portal, modelled after the Covid-19 vaccine management system Co-WIN, aims to create an electronic registry of routine immunisations for pregnant women and children under the Universal Immunisation Programme (UIP).
Details
- U-WIN is part of India’s Universal Immunisation Programme (UIP), which falls under the Reproductive and Child Health (RCH) Program of the National Health Mission (NHM).
- During the interim Budget for 2024-2025 in February, Finance Minister Nirmala Sitharaman emphasised the expeditious rollout of the newly designed U-WIN platform to manage immunisations and support Mission Indradhanush.
Key Features of U-WIN
- Electronic Registry: Captures every vaccination event for pregnant women and children, ensuring accurate and complete records.
- Digital Vaccination Certificates: Generates QR-based, digitally verifiable e-vaccination certificates accessible anytime by citizens.
- Self-Registration and Scheduling: Citizens can self-register via the U-WIN web portal or mobile app, select vaccination centers, and schedule appointments.
- Automated Alerts: Sends SMS alerts for registration confirmations, dose administration, and reminders for upcoming doses.
- Frontline Worker Support: Enables frontline workers to digitally record vaccination events, facilitating accurate and easy record maintenance.
- Ayushman Bharat Health Account (ABHA) IDs: Aids in creating ABHA IDs for comprehensive health record maintenance.
- Reducing Zero-Dose and Left-Out Children: Uses a name-based tracking mechanism to ensure no child is left unvaccinated, particularly benefiting migratory populations.
How U-WIN Works
- Registration: Children up to the age of six years and pregnant mothers are registered using government ID like Aadhaar and their mobile phone numbers.
- Vaccination Records: Records of all 25 shots given to a child and two given to pregnant mothers are added. The platform generates a checkered vaccination certificate that color-codes all vaccines.
- Vaccination Tracking: After each shot is administered and recorded on U-WIN, its date gets added to the card, showing the due date for the next set of vaccines.
- Reminder System: SMS reminders are sent to parents before their children are due for the next dose.
- Portability: The digital vaccine certificate can be downloaded by parents using their registered mobile numbers, allowing for vaccination anywhere in the country.
- Health Worker Support: The platform can automatically generate a due-list of children in their respective areas, allowing health workers to track and ensure vaccination compliance.
- Data Integration: U-WIN will eventually connect all digital records through ABHA (Ayushman Bharat Health Account) ID, integrating data from various government programs.
Pilot Project and Feedback
- The U-WIN platform is currently in a pilot phase in 64 districts.
- ASHA workers and other community health workers have been instrumental in its implementation, going door-to-door to collect data and register children and pregnant women on the portal.
- Feedback indicates that while the portal is beneficial, challenges such as lack of vaccine storage facilities and patchy internet connectivity remain. Physical registers are maintained as a backup, and workers have requested to extend the data entry window from 24 hours to 48 hours.
Future Implications for Healthcare
- Individual Tracking: Establishes a mechanism for individual tracking of immunizations, ensuring comprehensive coverage.
- Enhanced Awareness and Accessibility: Improves awareness among beneficiaries about session locations and dates, particularly in urban areas, and addresses inequities in immunization coverage.
- Comprehensive Information Source: Serves as the single source of information for immunization services, including pregnancy details, newborn registration, immunization status, and delivery outcomes in real-time.
- Digitization of Records: Eliminates the need for manual record-keeping, streamlining session planning and updating vaccination statuses in real-time, thus reducing administrative burdens and improving efficiency.
Immunization in India
Universal Immunisation Programme (UIP)
- The Universal Immunisation Programme (UIP) is one of the largest public health programs globally, launched in 1985.
- It aims to provide free vaccines against 12 vaccine-preventable diseases to all children and pregnant women across India.
Target Groups:
- Annually targets 2.9 crore pregnant women and 2.6 crore infants (0-1 years).
- Provides more than 1.2 crore vaccination sessions annually.
Vaccines Administered:
- Under UIP, 11 vaccines are administered to protect against 12 diseases, including:
- Tuberculosis
- Diphtheria
- Pertussis (Whooping Cough)
- Tetanus
- Poliomyelitis
- Measles
- Hepatitis B
- Haemophilus influenzae type b (Hib)
- Rotavirus
- Pneumococcal diseases
- Japanese Encephalitis (in endemic districts)
- Rubella
Immunization Coverage:
- According to the National Family Health Survey (NFHS-5) 2019-21:
- Full immunization coverage (FIC) for children aged 12-23 months has increased to 76.4% from 62% in NFHS-4 (2015-16).
- States with high FIC: Punjab (89.7%), West Bengal (90.5%), Himachal Pradesh (89.9%).
- States with lower FIC: Nagaland (57.6%), Arunachal Pradesh (59.7%), Uttar Pradesh (68.6%).
Challenges:
- High dropout rates between DPT1 (Diphtheria, Pertussis, and Tetanus first dose) and DPT3.
- Geographic and socio-economic disparities in immunization coverage.
- Resistance to vaccination in certain communities due to myths and misinformation.
Zero-Dose Children:
- Zero-dose children are those who have not received any vaccination.
- According to the WHO and UNICEF, India had 1.6 million zero-dose children in 2023.
- Significant in states with lower immunization coverage and higher instances of vaccine-preventable diseases like measles.
CAG Audit Report on the Reproductive and Child Health (RCH) Programme (2011-12 to 2015-16)The Comptroller and Auditor General of India (CAG) released an audit report on July 21, 2017, scrutinizing the Reproductive and Child Health (RCH) programme under the National Rural Health Mission (NRHM). The NRHM, launched in April 2005, aims to provide accessible, affordable, and quality healthcare to the rural population. The RCH programme, a sub-component of NRHM, focuses on maternal and child health, immunization, and family planning. Key Findings of the Audit Report:1. Financial ManagementUnspent Balances:
Delays in Fund Transfer: Delays were noted in the transfer of funds from state treasuries to State Health Societies, ranging from 50 to 271 days. Diversion of Funds: About ₹36 crore was diverted to other schemes. Recommendations: Proper fund flow management was recommended, considering the absorptive capacity of State Health Societies. 2. Physical InfrastructureShortfall in Health Facilities:
Issues with Existing Infrastructure:
Non-functional Completed Works: In 20 states, 1,285 works were completed but not made functional. Recommendations: A review of civil works by the concerned authorities was recommended to ensure faster completion and commissioning of buildings. 3. Availability of Human ResourcesShortage of Staff:
Unutilized Medical Equipment: Medical equipment in some states was lying unutilized due to the non-availability of doctors and manpower to operate them. Recommendations: The Ministry of Health and Family Welfare should ensure that sanctioned posts of healthcare professionals are filled up. 4. Availability of Medical Equipment and MedicinesLack of Basic Equipment: Selected health facilities across 29 states/UTs lacked basic equipment required for RCH services. Non-availability of Essential Drugs:
5. Quality of HealthcareNational Quality Assurance Programme (NQAP):
6. Reproductive and Child Health Services and OutcomesJanani Suraksha Yojana (JSY): Deficiencies were noted in the implementation of JSY, such as non-payment or delayed payment of incentive amounts to beneficiaries. Millennium Development Goal (MDG) Targets:
The CAG report underscores significant challenges in financial management, infrastructure, human resources, availability of medical equipment and medicines, quality of healthcare, and overall outcomes of the RCH programme. Addressing these issues is crucial for enhancing the effectiveness of the programme and achieving its objectives. Interventions for improving Maternal Mortality Rate (MMR)
Interventions for improving Infant Mortality Rate (IMR)
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PRACTICE QUESTION Q: With reference to the U-WIN portal, consider the following statements:
Which of the statements given above is/are correct? (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (d) 1, 2, and 3 Answer: (d) |