Documentation of vaccine handling and service delivery at outreach immunization sessions across 27 districts of India

Outreach sessions constitute a major share of routine immunization service under national program in India. To document the organisation, logistics, vaccine handling and services delivered during outreach sessions in India. This cross-sectional study was undertaken at 136 outreach sessions across 27 districts in three states (Bihar-62, Gujarat-43 and Kerala-31). Data was collected on session organization, vaccine supply, handling, beneficiary interaction, documentation, and waste handling. All essential items and vaccines were available at 52.2% and 59.7% of sessions. The overall beneficiary turnout was 72.6%. Matching diluents were available for 94.4% of lyophilised vaccine vials. All four messages were given to 58.8% beneficiaries and 40% were advised to wait for 30 minutes. Few sites received vaccine vials with unusable vaccine vial monitors and frozen free-sensitive vaccine vials. Program attention is needed to improve organisation, logistics and vaccine handling at the outreach sessions to ensure optimal service delivery and beneficiary experience. The supportive supervision and monitoring must be strengthened focusing on updated beneficiary list, vaccine handling, counselling and waste handling.