Scaling up a Program to Boost Immunization Demand in Haryana: A Pilot Study

Researchers conducted surveys with registered caregivers of children in Haryana, India to understand the quality and reliability of data recorded by frontline health workers using the government’s m-health application, Auxiliary Nurse Midwife Online (ANMOL) and the extent of Covid-19-induced disruptions to routine immunization services. This descriptive study is a part of J-PAL South Asia’s collaboration with the National Health Mission, Haryana to pilot the implementation of rigorously tested interventions to boost demand for full immunization using ANMOL.

Project Summary

Location: Haryana (districts of Palwal, Gurugram and Mewat)
Sample: 500 caregivers registered on the ANMOL app; 700  frontline health workers called ANMs and ASHAs
Timeline: October 2020 - March 2021
J-PAL Initiatives providing funding: Innovation in Government Initiative
Target group: Health care providers (caregivers of children under one registered on ANMOL; Frontline health workers
Outcome of interest(s):  Access to health services; Immunization; Health outcomes
Covid-19 dimensions: Healthcare service delivery gaps and responses; Health system data generation and use under Covid-19 restrictions and after they were lifted
Mode of data collection: Computer-assisted Telephone Interviewing (CATI)/Phone Surveys; Analysis of administrative data
Nature of activities: Data collection (Surveys); Use of administrative data
Research paper(s): N/A

Project Details

Immunization is a highly cost-effective way of improving child survival. Despite large investments in increasing access, the rates of full immunization continue to be low in India. The National Health Mission, Government of Haryana, in partnership with J-PAL South Asia, is conducting a pilot to implement interventions that were rigorously tested under an evaluation to boost the demand for full immunization in two districts in the state. 

The pilot makes use of the  government’s existing m-health application called ANMOL, which is used by frontline workers to collect real-time administrative data on service delivery. This descriptive study aims to verify data collected by ANMOL for a small sample through surveys with caregivers and understand the challenges in using the m-health application by frontline workers. Given the Covid-19 pandemic and disruptions to regular health services, the study also aims to understand the extent of disruptions to regular services and the challenges faced in service delivery and perceptions and response efforts, six months after lockdown restrictions were lifted:

  • Survey of registered caregivers of children under the age of one (December 2020):  This survey was conducted with a small sample to verify the status of vaccinations received by children in this age group and qualitatively understand the extent of disruptions to immunization services. 
  • Survey of frontline health workers (February  2021): A second survey is being conducted with frontline workers—auxiliary nurse midwives (ANMs) and Accredited Social Health Activists (ASHAs)—to understand challenges faced in the delivery of routine immunization services as well as their experiences using the ANMOL application. 

Research Results

Results forthcoming.