Background: Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5-and 10-doses vials were used, which was considered as an opportunity for documenting the wastage. The wastage rates for other routine vaccines were also documented. Methods: A survey conducted in two districts (Kangra, Himachal Pradesh and Pune, Maharashtra) covered 49 vaccine stores, 34 sub-centres and 34 outreach sessions collected vaccine receipt, distribution and usage data for two complete years 2016 and 2017. Results: The overall wastage rates for almost all vaccines were higher in Kangra district (BCG 37.1%, DPT 32.1%, Measles 32.2%, OPV 50.8%, TT 34.1% and pentavalent 18.4%) than Pune district (BCG 35.1%, DPT 25.4%, Measles 21.7%, OPV 14.3%, TT 23.1% and pentavalent 13.2%). Wastage for pneumococcal conjugate and measles-rubella vaccines in Kangra district were 27 and 40.5%, respectively. With transition from 5-to 10-doses vials for rotavirus vaccine, wastage at stores levels increased in both Kangra (29 to 33.2%) and Pune (17.8 to 25.7%) districts. With transition from intramuscular to intradermal fractional inactivated polio vaccine, the wastage increased from 36.1 to 54.8% in Kangra and 18.4 to 26.9% in Pune district. Conclusions: The observed vaccine wastage rates for several vaccines were relatively higher than program assumption for forecasting. The observed variations in the vaccine wastage indicates need for state or region based documentation and monitoring in India for appropriate programmatic action.
Background: Government of India launched the Janani Shishu Suraksha Karyakram (JSSK) on 1st June 2011, a new national initiative, to make better health facilities for women and child. The scheme is estimated to benefit more than 12 million pregnant women who access govt. health facilities for their delivery. The objective was to study the factors affecting the knowledge of Janani Shishu Suraksha Karyakram (JSSK) among health workers in rural block Shirur.Methods: A cross-sectional study was conducted among health workers in field practice area of rural block Shirur which is the rural field practice area of B J Government Medical College, Pune. It consists of 9 primary health centers and total 43 subcenters. A pilot study was conducted before initiating the study and the proforma was tested. The data was collected during the weekly meeting at primary health center. All the health workers were given prior information regarding the day of interview. The information regarding the knowledge of JSKK was recorded on the pre-structured and pre-tested proforma was recorded. The detail information regarding of the health workers, duration of service, educational status and training of JSSK etc. was recorded. Results: About 34.64% health workers were having excellent knowledge whereas 46.53% of health workers were having adequate knowledge of JSSK. The age distribution of health workers according to knowledge showed no statistically significant association with knowledge. Among the female health workers majority were having excellent and adequate knowledge and difference observed in knowledge was statistically significant. Among the ANM only one was having poor knowledge of JSSK. Out of 16 LHV, 10 were having excellent knowledge. Majority of the health workers with less than 10 years of service were having excellent and adequate knowledge. Excellent and adequate knowledge was statistically significantly associated with the training status of the health workers. Conclusions: Female health workers (ANM and LHV) were having better knowledge as compared to other health workers. The training status of health worker has impact on their knowledge of JSSK.
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