Adding interventions to mass measles vaccinations in India

Tuesday, 4th of October 2016 Print

Adding interventions to mass measles vaccinations in India

Mira Johri Stéphane Verguet Shaun K Morris Jitendar K Sharma Usha Ram Cindy Gauvreau Edward Jones Prabhat Jha & Mark Jit

Objective

To quantify the impact on mortality of offering a hypothetical set of technically feasible high-impact interventions for maternal and child survival during Indias 2010–2013 measles supplementary immunization activity.

Methods

We developed Lives Saved Tool models for 12 Indian states participating in the supplementary immunization based on state- and sex-specific data on mortality from Indias Million Deaths Study and on health services coverage from Indian household surveys. Potential add-on interventions were identified through a literature review and expert consultations. We quantified the number of lives saved for a campaign offering measles vaccine alone versus a campaign offering measles vaccine with six add-on interventions (nutritional screening and complementary feeding for children vitamin A and zinc supplementation for children multiple micronutrient and calcium supplementation in pregnancy and free distribution of insecticide-treated bednets).

Findings

The measles vaccination campaign saved an estimated 19 016 lives of children younger than 5 years. A hypothetical campaign including measles vaccine with add-on interventions was projected to save around 73 900 lives (range: 70 200–79 300) preventing 73 700 child deaths (range: 70 000–79 000) and 300 maternal deaths (range: 200–400). The most effective interventions in the whole package were insecticide-treated bednets measles vaccine and preventive zinc supplementation. Girls accounted for 66% of expected lives saved (12 712/19 346) for the measles vaccine campaign and 62% of lives saved (45 721/74 367) for the hypothetical campaign including add-on interventions.

Conclusion

In India a measles vaccination campaign including feasible high-impact interventions could substantially increase the number of lives saved and mitigate gender-related inequities in child mortality.

 

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