Four-Dimensional (4-D) Immunization Clinic

We developed this concept in 2012 to focus on complementary feeding (Food for babies between 6 -24 months) with Growth Monitoring.

Complementary Feeding situation has always been dismal. NFHS-4 Survey showed that only 9.6 % & 5.3 % of children in India & Maharashtra respectively receive adequate diet. Need was perceived to devise a simple method to teach mothers, health Care Providers & ICDS Staff about initiating complementary feeding at the end of 6 months of age & a method to subsequently audit feeding practices. We invented the ‘Diet Audit Sheet’ to meet both the objectives. This was coupled with Growth monitoring to link Growth Charts to Feeding Practices to provide effective counselling.

Health Care Providers have the best opportunity for dietary counselling during immunization visits when the child has not come for a health problem. Thus, was developed the concept of ‘4-Dimensional Immunization Clinic’ for comprehensive health care during immunization. It is important that first 3 D’s are discussed with the mother before the last ‘D’ i.e. Dose (administering the Vaccine)

This can also be used as 3-D (1,2,3), 2-D (1 & 2) or 1-D (Only first D) approach also when vaccination is not on agenda. Thus, it can be used by Anganwadi Workers & Asha Workers in Anganwadis or during home visits. It can also be used for assessment & monitoring of malnutrition.

Four Dimensions of the 4D CLINIC

Diet Audit & Growth Monitoring

Diet, Growth & Correlation


Monitor Milestones


for Lactating Mothers, LBW Babies, etc.

Dose (Vaccination)

Immunization for the Child