Evaluation of immunization coverage in the rural area of pune, maharashtra, using the 30 cluster sampling technique

Trends in Urban Immunization Coverage in India: A Meta-Analysis and Meta-Regression

OBJECTIVES

To assess the gaps and trends in child immunization coverage among urban and rural areas in India, and compare the success of immunisation program in each.

METHODS

PubMed, Scopus, and Crossref, and Google Scholar electronic databases were searched on October 9, 2019, and March 21, 2020, for studies that measured and reported immunization coverage indicators in India. Random-effects meta-analyses and meta-regressions were conducted.

RESULTS

The authors' search identified 545 studies, and 2 were obtained by expert suggestion. Among these 68 studies and 6 surveys were included. They found that full immunization coverage has grown yearly at 2.65% and 0.82% in rural and urban areas, respectively whereas partial immunization coverage declined by -2.44% and -0.69%, respectively. Percentage of nonimmunized children did not show a statistically significant trend in either.

CONCLUSION

While rural immunization coverage has seen a large increase over the past two decades, the progress in urban areas is weak and negligible. This was largely attributable to a focus on minimizing dropouts in rural areas. However, a lack of significant reduction in unimmunized children may indicate left-out children or pockets in both rural and urban areas. The poor performance of immunization programs in urban areas, coupled with a larger impact of COVID-19, warrants that India urgently adopts urban-sensitive and urban-focused policies and programs.

Immunization coverage among under-five children living along a school student through child-to-child and child-to-parent information, education and communication strategy

Background

In spite of being a principal producer and exporter of vaccines and billions spent over decades, India is home to one-third of the world's under-five children (U5C) with no immunization.

Objectives

The objective of this study was to find the outcome of child-to-child and child-to-parent Information, Education and Communication (IEC) strategy on the current percentage of immunization coverage (IC).

Methods

A mixed design research with multilevel concurrent sampling was conducted in Pune. Based on school students' households, 44 clusters having U5C were divided randomly into 11 experimental/control groups each. IEC strategy to students was independent variable and IC among U5C was dependent variable. Data were collected from 1092 students and 2352 U5C parents over 6 years. Vaccination card and Bacillus Calmette-Guérin mark were considered as evidence to conclude on full, partial and no IC. Change in knowledge quotient (KQ) among students/parents and U5C IC before and after IEC strategy assessed.

Results

Rural/urban age-appropriate full IC of U5C was 51% and 67% before and 88% and 85% in post-IEC, respectively. The mean KQ change score of 8-12/20 in students is likely to increase full IC by 37% and 18%, decrease partial coverage at 14% and 12%, and improve none coverage at 23% and 16%, from its existing level positively in experimental groups. Numerous factors discouraged parents to pursue their U5C immunization.

Conclusions

Advocacy through school students can be an economically viable alternative marketing strategy for inadequate U5C IC than billions spent on treating vaccine-preventable diseases and impractical options.

Socio-demographic determinants of childhood immunization coverage in rural population of Bhojpur district of Bihar, India

Introduction

Avoidable sickness, disabilities and death among under 5 children are prevented by routine immunization against some specific diseases. The percentage fully immunized children was 69.9% in Bihar, India, and was almost same in rural area. Immunization coverage is also associated with various socio-demographic factors. The aim of this study is to assess the immunization coverage among children in rural areas of Bhojpur district and identify socio-demographic factors associated with it.

Methods

A cross-sectional study was conducted in rural areas of Bhojpur district during January to May 2015. 2 stage cluster sampling was done. 36 villages were selected randomly as primary selection units and within each village, 10 children of age 12-36 months were selected from the sampling frame of all eligible children in selected village. A pre-designed, pre-tested checklist was used by the trained investigators during their visits.

Results

A total of 360 children of age 12-36 months were included in the study, of which 65% of children were fully immunized, 33.9% were partially immunized, and 1.1% were not immunized at all. Mother's education (AOR 2.28 (1.28-4.05), P value = 0.005), place of birth (AOR 29.04 (10.75-78.43), P value = 0.0001) and availability of immunization card (AOR 120.04 (15.82-916.47), P value = 0.001) were significantly associated with immunization status.

Conclusion

Immunisation coverage in this area was lower. Socio-demographic factors like mother's literacy, place of birth and availability of immunization cards were significantly associated with full immunization of children. It is needed to focus on health related education among parents regarding immunizing services.

Equity and determinants of routine child immunisation programme among tribal and non-tribal populations in rural Tangail subdistrict, Bangladesh: a cohort study

OBJECTIVES

The study estimated valid vaccination coverage of under 5 children in a rural area under Tangail subdistrict and examined their sociodemographic correlates including ethnicity.

SETTING

The study sites are three primary areas where tribal and non-tribal population resides together in a rural subdistrict of Bangladesh.

PARTICIPANTS

Routine vaccination information of a cohort of 2802 children, born between 1 January 2011 and 31 December 2012, were retrieved from the Expanded Program on Immunization (EPI) registers maintained by the health assistants. Collected data were entered in an Oracle-based computer program. Univariate, bivariate and multivariate analyses were performed in SPSS V.20 to explore coverage and differentials for full valid vaccination coverage in the study area.

RESULTS

Valid vaccination coverage was 90.6% among tribal population and 87.3% among non-tribal population(p=0.25). Compared with females, males had higher valid vaccination coverage (89.2% vs 85.9%) and lower invalid (5.4% vs 6.9%) and no-coverage (5.3% vs 7.3%) (p=0.03). Households with mobile phones had higher valid coverage (90.9% vs 86.5%) and lower invalid (4.5% vs 6.7%) and no coverage (4.5% vs 6.9%) compared with those without mobile phones (p=0.01). Coverage of valid vaccination was higher among children of Oronkhola union than in children of the other two unions.

CONCLUSION

The study documented that valid vaccination coverage was high in this rural area, and there was no significant ethnic variation which was one of the strengths of the national EPI. However, there is significant variation by gender of the child, household ownership of mobile phones and geographical location of households.