Key Partners





Bihar, Uttar Pradesh


Improving Urban RI Services

The Bill and Melinda Gates Foundation (BMGF) is supporting a 3-year Urban Routine Immunization (RI) project implemented by JSIPL in 23 National Urban Health Mission (NUHM)cities falling in 12 districts (3 in Bihar and 9 in Uttar Pradesh). The project, launched in December 2020, works closely with the government at all levels to assist intervention geographies in improving Urban Routine Immunization (RI) coverage. It has also set up model immunization centre at Gorakhpur, Uttar Pradesh.

Addressing Gaps and Challenges

  • Multiple factors contribute to the issue of lower coverage of Routine Immunization (RI) and related service utilization in urban areas. Addressing all determinants for uptake of Immunization remains complex and resource-intensive. Added to this are diverse health systems, the differential pace of Urbanization, and changing demographics.
  • Urban RI coverage is a challenge in achieving Sustainable Development Goal 3 due to several reasons such as health awareness, access issues, and especially fluctuating boundaries and expanding peri- urban zones. These reasons inevitably reduce vaccine uptake posing the risk of Vaccine Preventable Disease (VPD) outbreaks.
Key Objectives

To establish RI service delivery models for urban areas and create community demand for RI services with a particular focus on reaching marginalized populations of the urban community

To strengthen urban RI service delivery mechanism under NUHM infrastructure

To expand coverage for COVID-19 immunization and service delivery

JSIPL’s role in Prioritizing Urban Immunization

The urban RI Project, which is being implemented in the states of Bihar and Uttar Pradesh, follows a unique 5-D approach to address RI coverage and equity issues. The 5-D Approach covers the five critical “D’s” of immunization: diagnosis, design, delivery, demand, and diffusion. It includes designing feasible and scalable interventions to address the immunization needs of under-served communities facing multiple challenges, including social and financial security.
The project invests in integrating and converging with other ongoing national programs that expand and enhance immunization service delivery in an evolving urban sphere. The Project partners withother urban stakeholders to strengthen existing governance mechanisms, data-driven approach, and people-centric quality assured service delivery in a decentralized manner.



  • Support to intervention district for review and Routine Immunization related microplanning.
  • Assisting in capacity building at all levels of existing NUHM human resource.
  • Supportive Supervision and data-driven feedback for systemic correction.
  • Custom fit demand generation interventions.
  • Supporting local level innovations and documentation of best practices.


  • ‘Urban Routine Immunization (RI) project-Baseline Situational Analysis’ for Uttar Pradesh (UP) and Bihar states was completed. The report provides a health system analysis for the diagnosis and detection of issues affecting Urban Immunization in 23 intervention cities (UP- 20 and Bihar-3) and provides possible solutions for overcoming the challenges identified.
  • UP’s first Model Immunization Center (MIC) has been conceptualized based on learnings from Bihar. A tripartite MoU has been signed between All India Institute of Medical Sciences (AIIMS) Gorakhpur, JSI and the District Immunization Officer (DIO) for establishing MIC at AIIMS Gorakhpur.
  • State-level training on Urban RI was held in December 2021 for Uttar Pradesh’s National Urban Health Mission (NUHM) district-level Urban Health Consultants.
  • Demand Generation (DG) workshop was held at Lucknow, UP in March 2022 aiming tostrengthen the capacity of internal project teams of both States on demand generation for Urban RI.
  • The project focuses on ensuring the quality of micro plans prepared at the Urban PHC level,by facilitating the State and Zonal level ToTs of functionaries in Uttar Pradesh. 164 functionaries were trained as of Nov 2022.
  • Training of Urban RI data handlers was conducted in both States in all 12 intervention districts to enhance the quality of data management.

Looking Ahead

By 2023, the project is expected to deliver a feasible, scalable, and sustainable model for improving Urban RI service delivery.

Project learnings/best practices will be disseminated among national and global public health communities.