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15.  The indifference of the village officers in the proper maintenance of the
village vaccination registers is another great obstacle to the progress of
vaccination. The record of work done by the District Health staff in this direction
during the last vaccination off-season shows how numerous are the omissions of
unprotected cases in the registers. Complaints preferred by the Health staff
on this account are often taken no notice of. The instructions laid down in regard
to the maintenance of these registers by Presidents of Union Boards in union areas,
are in some instances not given effect to. The District Health Officer,
Trichinopoly, reports that the Lalgudi Union Board has refused to undertake this
duty and has formally passed a resolution to that effect.

16.  The kits of vaccinators in certain districts were either not promptly
supplied or were very unsatisfactory. A circular detailing the list of articles to
be supplied to vaccinators was issued to all local bodies during the year and they
were requested to see that the supply was made promptly. It has been suggested
that it would conduce to greater efficiency if the supplies and renewals of
equipments are undertaken by the District Boards themselves, recovering the
cost thereof from the Taluk Boards in due course. This is worth consideration.

17.  In regard to the enforcement of the compulsory provisions of vaccination
there seems to be wide variations between one district and another. The great
majority of the Taluk Boards show disinclination to sanction prosecutions.
This hampered the work of vaccination a good deal and afforded every
convenience to the villagers to slight the rules and render the compulsory system
practically a misnomer. Until more of the Taluk Boards realize the necessity
for enforcing the compulsory rules, not much benefit will result from " Compulsory
Vaccination." In one district—North Arcot—although Government in their
Order No. 1257-P.H., dated 9th August 1922, approved of the introduction of
compulsory vaccination, the required notification was not published in the District
Gazette by the District Board, with the result that the District Health Staff could
take no action against defaulters.

18.   Correct registration of births goes hand in hand with vaccination and
unless birth registers are maintained properly, the lists of unprotected children
cannot be maintained accurately. The question of introduction of compulsory
registration of births and deaths has therefore to be considered side by side with
compulsory vaccination.

19.  A steady and continuous propaganda is another important factor needed
for the progress of vaccination. In many districts, opposition of the villagers to
vaccination is due to gross ignorance and propaganda affords the only effective
means to dispel it. Lectures illustrated by magic lantern slides and charts
delivered by the District Health Staff have accomplished much in this direction,
but it is regrettable to note that in several cases Taluk Boards have failed to
provide the lanterns and slides. In this connexion, it may be stated that the
efforts of the local health committees formed in a few districts in accordance with
G.O. No. 765-A-P.H., dated 1st June 1922, have already been crowned with
success and it is hoped that this will serve as an eye-opener to the other Taluk
Boards.

20.  The bifurcation of the Agency ranges in the districts of Gōdāvari and
Vizagapatam, referred to in the last year's report, is still under the consideration of
Government.

21.   The total vaccination work done during the past two years by all
Agencies throughout the Presidency is shown in the following table:—

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