Demand and Supply Side Factors Affecting Utilization of Immunization Services in an Urban Village Of Delhi

Rathi, Akanksha; Meena, GS

doi:10.4172/2379-1764.1000206

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…The rate of quality immunization coverage found to be 86.6% among children delivered at health facilities compared to 63.6% among children delivered at non-health facilities. This observation is concordant with the observations from other recent studies which showed a strong association between institutional delivery and immunization status [14, 29, 30, 31, 32].…”

Section: Discussionsupporting

confidence: 93%

Coverage, quality, and correlates of childhood immunization in slums under national immunization program of India: A cross-sectional study

Singh

Sahu

Agrawal

et al. 2019

Heliyon

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Adequate and quality immunization coverage plays a key role in controlling the outbreaks of vaccine preventable diseases. Places where immunization coverage is low, vaccine preventable diseases contribute to worse health outcomes. This is especially true in Indian slum dwellings where 33.0% of the urban population live. The aim of the study was to explore the coverage, quality, and correlates of primary immunization under national immunization program among children aged 12–23 months, living in slums of Mumbai. A community based cross-sectional survey was conducted. Parents or caretakers of 550 eligible children aged 12–23 months were interviewed using a structured interview schedule. Regression analysis was used to detect correlates of full immunization coverage (children who received one dose each of BCG, measles, and three doses each of DPT, OPV, and HBV by his/her first birthday) and of quality immunization coverage (children who received primary vaccines at appropriate age and intervals as mentioned above and had filled immunization card). Out of total 550 children, 402 (73.1%), 131 (23.8%), and 17 (3.1%) were fully, partially, and unimmunized, respectively. Almost 86.0% children received quality immunization coverage. In the regression analysis, reminder for immunization services was found to be the single most significant correlate of full and quality immunization coverage.In this study, full immunization coverage was found to be below the expected level. This study also revealed that the awareness regarding the importance of adequate immunization was still lacking in the slum population. Emphasizing on reminders for immunization services, encouraging institutional deliveries, and scaling up use of postnatal care services may act as keys to improving the immunization coverage in Indian slums.

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Section: Discussionsupporting

confidence: 93%

Coverage, quality, and correlates of childhood immunization in slums under national immunization program of India: A cross-sectional study

Singh

Sahu

Agrawal

et al. 2019

Heliyon

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“…As the nation’s health system battles the COVID-19 pandemic, a diversion of resources [ 1 , 2 ] along with temporary suspension of vaccination outreach sessions [ 3 , 4 ] makes the ominous threat of vaccine-preventable diseases (VPDs) more palpable. In addition to this, India already falls short in achieving universal immunization by a significant margin [ 5 ], as indicated by the results of the National Family Health Survery-4 (NFHS-4) [ 6 ], that reveal 38% of children may not be fully immunized. Urban immunization coverage is often cited as a key bottleneck to achieving this universal coverage [ 7 ], as pockets of squatter settlements and expanding peri-urban zones are often densely populated and have few public services, including health care, thereby increasing the risk of VPD outbreaks [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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. Supplementary Information The online version contains supplementary material available at 10.1007/s12098-021-03843-0.

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“…Some of the strengths of this study include having a reasonably large sample, high response rate, and probability sampling. In addition, unlike many studies in India [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26], the current study analyzed data using a health theory-driven model with robust analytical techniques (SEM). The study also ha limitations.…”

Section: Plos Onementioning

confidence: 99%

“…Previous studies in India have examined demand/individual-related factors affecting routine vaccination [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Most of these studies, however, assumed direct relationships between sociodemographic, environmental, psychological factors and childhood vaccination in logistic regression models [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. On the other hand, some predictors of childhood vaccination may have a direct effect, and some may have an indirect effect.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, as sociodemographics vary between urban and rural residents in India, [8,9], we hypothesize that the effect of sociodemographic factors may vary by place of residence (urban and rural). Despite the availability of health frameworks that can help us examine factors affecting childhood vaccinations in a comprehensive manner, most studies on childhood vaccination in India did not use a theoretical framework [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Moreover, some predictors of childhood vaccination can be directly observed, as are some latent variables or constructs [27,28].…”

Section: Introductionmentioning

confidence: 99%

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Structural equation modeling to detect correlates of childhood vaccination: A moderated mediation analysis

Degarege¹,

Krupp²,

Srinivas³

et al. 2020

PLoS ONE

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Objectives This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination. Methods A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7 th through 10 th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one dose of Bacillus Calmette–Guérin; three doses of Diphtheria, Pertussis, Tetanus; three doses of oral Polio vaccine; and one dose of Measles vaccine. In addition, parents were asked about their attitudes towards childhood vaccination. Results Out of the 1599 parents, 52.2% reported that their children had received all the routine vaccines (fully vaccinated); 42.7% reported their children had missed at least one routine vaccine, and 5.2% reported that their children had missed all routine vaccinations. Perceptions about the benefits/facilitators to childhood vaccination significantly predicted the full vaccination rate (standardized regression coefficient (β) = 0.29) directly and mediated the effect of parental education (β = 0.11) and employment (β = -0.06) on the rate of full vaccination. Parental education was significantly associated indirectly with higher rates of full vaccination (β = 0.11). Parental employment was significantly associated indirectly with decreasing rates of full vaccination (β = -0.05). Area of residence moderated the role of religion (β = 0.24) and the ‘number of children’ in a family (β = 0.33) on parental perceptions about barriers to childhood vaccination. The model to data fit was acceptable (Root Mean Square Error of Approximation = 0.02, 95% CI 0.018 to 0.023; Comparative Fit Index = 0.92; Tucker–Lewis Index = 0.91). Conclusions Full vaccination rate was relatively low among children in Mysore, especially among parents who were unsure about the benefits of routine vaccination and those with low educational levels. Interventions increasing awareness of the benefits of childhood vaccination that target rural parents with lower levels of education may help increase the rate of full childhood vaccination in India.

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Demand and Supply Side Factors Affecting Utilization of Immunization Services in an Urban Village Of Delhi

Cited by 3 publications

References 8 publications

Coverage, quality, and correlates of childhood immunization in slums under national immunization program of India: A cross-sectional study

Coverage, quality, and correlates of childhood immunization in slums under national immunization program of India: A cross-sectional study

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

Structural equation modeling to detect correlates of childhood vaccination: A moderated mediation analysis

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