Cluster RI Lead, Routine Immunization Access, Uttar Pradesh
The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving lives and reducing the burden of disease in low-and middle-income countries, while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance. For more information, please visit: http://www.clintonhealthaccess.org
CHAI, in partnership with its India affiliate William J Clinton Foundation (WJCF), works in close partnership with and under the guidance of the Ministry of Health and Family Welfare (MoHFW) at the Central and States' levels on an array of high priority initiatives aimed at improving health outcomes. Currently, CHAI works across projects to expand access to quality care and treatment for HIV/AIDS, Hepatitis-C (HCV), tuberculosis, cancer, and immunization.
Through the prioritized implementation of high impact public health interventions like immunization, access to safe drinking water, improved neo-natal and infant care and access to effective treatment for pneumonia and diarrhea, India has reduced its infant mortality rate (IMR) from 89 in 1990 to 32 in 2017 and Under-five Mortality Rate (U5MR) from 126 in 1990 to 39 in 2017(1). India’s Universal Immunization Program (UIP) is one of the largest public immunization programs in the world. It caters to 26.3 million infants and 30 million pregnant women annually through 9 million planned sessions. The program provides access to vaccines against 11 Vaccine Preventable Diseases (VPDs)(2) at the national level and against two VPDs vaccines at the sub-national level(3).
Under the strong leadership of the Ministry of Health & Family Welfare (MoHFW) and state governments, the entire immunization ecosystem has demonstrated proactive commitment for achieving universal immunization coverage in the country in recent years. Strategic projects in this direction include but are not limited to introduction of new vaccines(4), rolling out of data systems(5), strengthening of national immunization centres such as Immunization Technical Support Unit (ITSU) and National Cold Chain & Vaccines Management Resource Centre (NCCVMRC) and successful piloting of initiatives for bolstering health worker capacity building(6). Coupled with these initiatives, MoHFW launched Mission Indradhanush (MI) in 2014 and Intensified Mission Indradhanush (iMI) in 2017: catch up and system strengthening campaigns to target underserved, vulnerable, resistant, and inaccessible populations. iMI has resulted in an increase of 6.7% in full immunization coverage (FIC) after the first two phases in prioritized districts(7). However, the government and partners recognize the need for further efforts in this direction to reduce the 802,000 infant deaths and 989,000 under-five deaths that occur annually in the country(8).
Uttar Pradesh (UP), the most populous state of India, contributes more than 20% (5.7 million) to India’s annual birth cohort. UP has the highest infant mortality (64 deaths per 1,000 live births) and under five mortality rates (78 death per 1,000 live births) in the country(9). UP’s FIC went up from 51.1% in 2015-16, to 65.3% in 2018 through concentrated efforts and catch up campaigns (MI and iMI) in 60 out of 75 districts. However, wide variations in coverage exist across regional and social categories. In 2018, UP accounted for 25% of under-immunized children in India & 9.5% of world’s under-immunized children. Improvements in UP’s FIC are essential to national and global improvements in immunization coverage, as an increase in UP’s FIC from 65 to 90% could increase India’s FIC by 6 percentage points, and the global FIC by 1%. The government of Uttar Pradesh (GoUP) is currently rapidly implementing a new strategic roadmap for holistic improvement of immunization outcomes in the state.
CHAI operates an immunization program in India to support the MoHFW’s UIP at the national level and in the focus states of Madhya Pradesh and Uttar Pradesh. CHAI provides catalytic support to the NCCVMRC, which is based out of National Institute of Health and Family Welfare (NIHFW), on national projects for improving availability and efficacy of vaccines and efficiency of vaccines systems by strengthening cold chain management and vaccines delivery & logistics. CHAI also supports national and state governments on broader operational aspects such as planning, capacity building and systems improvements for immunization service delivery. Supporting GoUP since 2013, the Uttar Pradesh Technical Support Unit (UP-TSU) works closely with the Department of Health & Family Welfare and the Department of Child Welfare of GoUP to improve the availability, quality and utilization of critical reproductive, maternal, natal, child and adolescent health (RMNCH+A) interventions and services and has a deep understanding of UP’s health systems, geography and demographics and opportunities.
Recognizing the vision and ambition of the GoUP on improving immunization coverage and equity outcomes in the state, CHAI and UP-TSU are undertaking a transformative project to provide support to GoUP at the state and district levels and in prioritized blocks. A purposely-formulated immunization project management unit (PMU) nestled within the UP-TSU will anchor this support to GoUP. The PMU will design and deploy catalytic support to GoUP based on the guiding principles of impact, integration, investment, and innovation. The PMU will support GoUP on the state’s plans for strengthening evidence-informed decision-making, enhancing state capacity to manage and govern immunization service delivery and augmenting immunization systems in prioritized blocks of the state.
CHAI seeks a highly motivated and entrepreneurial individual with outstanding credentials for the key role of Cluster RI Lead. The Cluster RI Lead will report to the Implementation Lead, within the Immunization PMU. The role would entail leading the immunization system strengthening & coverage improvement activities in a cluster of priority districts and blocks within UP, through a multi-functional cluster team. The candidate will lead efforts to diagnose area specific challenges and drive intensive efforts for RI improvement. The ideal candidate would have rich implementation experience in Immunization, excellent stakeholder management abilities, and have demonstrated excellence in leading high caliber teams for impact. CHAI places great value on relevant personal qualities: resourcefulness, responsibility, tenacity, independence, energy, and work ethic.
(1) Unicef on behalf of UN IGME (2018). Level and Trends in Child Mortality Report 2018 Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York
(2) diphtheria, pertussis, tetanus, polio, measles, rubella, severe form of childhood tuberculosis, rotavirus diarrhoea, hepatitis B, meningitis and pneumonia (caused by hemophilus influenza type B)
(3) pneumococcal pneumonia and Japanese Encephalitis
(4) Rotavirus Vaccine, Pneumococcal Conjugate Vaccine, Measles Rubella vaccine, Injectable Polio Vaccine, Tetanus Diphtheria vaccine
(5) electronic Vaccine Intelligence Network (eVIN), National Cold Chain Management Information System (NCCMIS), ANM Online (ANMOL), Surveillance and Action for Events Following Vaccination (SAFE-VAC)
(6) Rapid Immunzations Skills Enhancement (RISE)
(7) Gurnani et al (2018). Improving vaccination coverage in India: lessons from Intensified Mission Indradhanush, a cross-sectoral systems strengthening strategy. BMJ 2018; 363; k4782
(9) National Family Health Survey-4, MoHFW, GoI
Lead, guide and mentor a high-powered multi-functional cluster implementation team capable of delivering impactful solutions in swift timelines
Develop strong understanding of the Routine Immunization coverage gap and related challenges within the cluster and enable creation of RI coverage improvement action plans
Enable identification of key interventions to be undertaken by the cluster team to solve geography specific challenges
Undertake operational planning for the activities to be undertaken by the cluster team and monitor progress effectively
Build trust-based relationships & identify synergies with district & block level health leadership, partner organizations, civil society organizations and other stakeholders for improving routine immunization performance in identified geographies
Provide advisory and capacity building support to immunization program managers at the district/block levels on effective immunization programme management
Identify and document local innovative solutions to enhance immunization service delivery
Support the development of comprehensive & systematic insights on the immunization context in UP
Travel across the assigned cluster on a regular basis and to other parts of the state as and when required
Undertake any other duties and responsibilities as assigned by the supervisor
Post graduate in the field of Social science, Public Health, Community Medicine, Management Sciences, or other allied fields
10+ years of experience in Routine Immunization/ Public Health programmes in governmental/non-governmental organizations
Strong understanding of different components of RI like microplanning, vaccine logistics management, cold chain, headcount survey and RI reporting
Prior experience in organizing and facilitating Immunization capacity building at the district and sub district level
Prior experience in diagnostics, assessments or monitoring for immunizatio