Abstract: Health Care service delivery system is the main source or base for the implementation of programme or project. The present paper aims to provide a standard model of follow up in BIMARU states if not all over India. Materials and Methods- The present paper is the outcome of the evaluation of the programme of Muskan Ek Abhiyaan (Immunisation Programme) which was launched on October 11, 2007 with the objective of achieving hundred percent immunizations of infants and pregnant women in the state of Bihar (India). The study used two stage thirty cluster analysis. Overall 1936 support workers were interviewed on various aspects for the availability of material and training. Conclusion- Scenario of Immunisation has changed drastically over four years in Bihar and it is interesting to conclude that factors behind such thumping success are due to the change in the health system, its governance and marked strategic shift the previous programme intervention in otherwise one of the worst performing states of India.