Use of measles supplemental immunization activities (SIAs) as a delivery platform for other maternal and child health interventions: Opportunities and challenges

Measles supplementary immunization activities (SIAs) offer children in countries with weaker immunization delivery systems like India a second opportunity for measles vaccination. They could also provide a platform to deliver additional interventions, but the feasibility and acceptability of including add-ons is uncertain. We surveyed Indian programme officers involved in the current (2010–2012) measles SIAs concerning opportunities and challenges of using SIAs as a delivery platform for other maternal and child health interventions. Respondents felt that an expanded SIA strategy including add-ons could be of great value in improving access and efficiency. They viewed management challenges, logistics, and safety as the most important potential barriers. They proposed that additional interventions be selected using several criteria, of which importance of the health problem, safety, and contribution to health equity figured most prominently. For children, they recommended inclusion of basic interventions to address nutritional deficiencies, diarrhoea and parasites over vaccines. For mothers, micronutrient interventions were highest ranked.

► Programme officers from all 14 Indian states delivering measles SIAs responded to a survey.
► Respondents strongly support use of SIAs to deliver other maternal and child health interventions.
► Management challenges, logistics and safety may vitiate an expanded SIA strategy.
► Respondents recommended inclusion of non-vaccine over vaccine interventions.
► Nutritional screening should be added to future follow-up SIAs in India.