Background

Over 20% of children died in 2008 from vaccine preventable diseases owing to delays in vaccination. Since most of the infant vaccines are available free of cost in public health facilities, the delays are attributable to non-price factors such as lack of awareness and information on the immunization schedule and how to avail the vaccines among infant caregivers. Additionally, lack of incentives for frontline health workers (FHWs) and outdated workflow management is also a contributory factor. At village level, the vaccinations are delivered by regular FHWs or Auxiliary Nurse Midwife (ANM) assisted by Accredited Social Health Activists (ASHAs). ISB conducted a pilot in Muzaffarpur, Bihar to assess the impact of a package of interventions for improving timely immunization of infants. This RCT study follows that pilot.