India has made significant strides in reducing the number of "zero-dose" children, defined as those who have not received a single vaccine, with the percentage dropping from 0.11% in 2023 to 0.06% in 2024. This accomplishment, acknowledged by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) in its 2024 report, positions India as a global leader in child health and immunization. The Union Health Ministry attributes this progress to sustained efforts and the intensified implementation of nationwide vaccination drives and campaigns.
This achievement is a testament to India's commitment to its Universal Immunization Programme (UIP), which provides free vaccines to approximately 2.9 crore pregnant women and 2.6 crore infants annually. The UIP, one of India's most comprehensive public health initiatives, offers free immunization against 12 vaccine-preventable diseases. These include Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, severe forms of Childhood Tuberculosis, Hepatitis B, and Meningitis & Pneumonia caused by Haemophilus Influenzae type B. Sub-nationally, the program also covers Rotavirus diarrhea, Pneumococcal Pneumonia, and Japanese Encephalitis.
The success of India's immunization program is also reflected in the country's improved maternal and child health indicators. India's Maternal Mortality Ratio (MMR) has declined to 80 per lakh live births in 2023, an 86% reduction since 1990, which far outpaces the global decline of 48%. Additionally, India has achieved a 78% decline in the Under-Five Mortality Rate and a 70% decline in the Neonatal Mortality Rate between 1990 and 2023, compared to global reductions of 61% and 54%, respectively.
Several initiatives have contributed to the reduction in zero-dose children. Mission Indradhanush (MI), launched in December 2014, aims to achieve 90% full immunization coverage by focusing on areas with low immunization rates and hard-to-reach populations. Intensified since 2017, Mission Indradhanush has vaccinated over 5.46 crore children and 1.32 crore pregnant women. The Zero Dose Implementation Plan 2024, currently underway in 143 districts across 11 states, targets vaccine coverage gaps among migratory populations, urban slums, and regions with persistent vaccine hesitancy.
India has also maintained its polio-free status since 2014 through sustained Pulse Polio campaigns. More than 1.3 crore immunization sessions are conducted annually by healthcare workers, including ASHAs (Accredited Social Health Activists) and ANMs (Auxiliary Nurse Midwives), ensuring widespread vaccine outreach. These frontline workers conduct regular outreach and awareness campaigns in coordination with states and union territories, focusing on reaching zero-dose children in underserved areas and communities affected by vaccine hesitancy.
Digital innovations like the U-WIN platform are also being leveraged to track immunization data and prevent dropouts. The U-WIN portal, available in 11 regional languages, provides a fully digitized record of vaccination for pregnant women and children and enables easy access and management of immunization records. As of September 16, 2024, the platform has registered 6.46 crore beneficiaries, conducted over 1.04 crore vaccination sessions, and recorded 23.06 crore administered vaccine doses.
India's progress in reducing the number of zero-dose children has garnered global recognition. The country was awarded the Measles and Rubella Champion Award by The Measles and Rubella Partnership in March 2024. India's UIP now covers 12 vaccine-preventable diseases, up from just six in 2013, and its DTP-1 coverage stands at 93%, on par with several high-income nations. The decline in zero-dose children is attributed to the government's proactive and inclusive approach, along with the dedication of healthcare workers. The government has also clarified that comparisons with other countries with high burdens of zero-dose children must consider India's large population size and high vaccination coverage rate.
