EPI Coverage among Under 5 Children Attending Pediatric Department of Dhaka Medical College Hospital

Abstract

:This cross-sectional study was carried out among 1000 children between 10 months to 5 years of age during November 2004 to February 2005 attended in the department of pediatrics, Dhaka Medical College Hospital (DMCH) with different childhood illness. Aim of study was to know the Immunization (EPI) coverage, dropout rate and factors influencing dropout. According to parent's statement, 82.5% of the children were fully, 16.1% were partially and 1.4% were non-immunized. Specific immunization coverage revealed that, 97.3% were immunized with BCG, 96.7% with DPT1/OPV1, 92.9% with DPT2/OPV2, 91% with DPT3/OPV3 & 84% with measles vaccine. Among the BCG vaccinated children 91.77% had BCG scar. Drop out of DPT1-DPT3 was 5.78% & DPT1-measles was 12.88%. The main reason found for non-immunization were lack of faith in programme (57.1%), lack of awareness (21.4%), and fear of side effects (21.4%), whereas lack of awareness (41.6%) and illness of child (32.9%) played role behind drop out. Drop out cases were found to be associated with female sex, parent's illiteracy, higher number of children in the family and father's occupation (p<0.001), whereas mothers occupation had no independent effect on coverage (p>0.05). The study findings suggested that despite the effort taken by Government and NGOs to expand coverage, dropout rates are unacceptably high. To combat this challenge counseling and motivation on EPI, improvement of information system, health education and training of health workers are required.

Immunisation knowledge and practices among mothers attending a paediatric clinic in Karachi, Pakistan

“…Other studies have reported the same. 13,14 It shows that despite access to health centres, children miss out on subsequent vaccines. The higher dropout rate for measles may be due to the longer time interval between DPT3 and the measles vaccine.…”

“…The higher dropout rate for measles may be due to the longer time interval between DPT3 and the measles vaccine. 13 Researchers suggest that the mothers need reminders at each visit to bring the child for the next vaccine. 12 A study in Kenya found that mothers who received advice about next vaccination date were 3 times more likely to get their children fully immunised.…”

“…Researchers in Nigeria, and Bangladesh have also reported this problem of healthcare staff being absent. 13,16 Such logistic problems need to be addressed by the health department to maintain sustainability of the EPI program. Work needs to be done both on the demand side and the delivery side.…”

“…Shoma et al also reported that none of the mothers had the child's immunisation card at the time of the interview. 13 Mothers must be instructed to bring the child's immunisation card with them whenever they take their children to health facilities for any purpose. This can be an opportunity to check the child's immunization status and update it, if required.…”

“…7,11 Studies from India and Bangladesh also reported that the majority of mothers learned about vaccination from the healthcare staff. 10,13 The role of health care staff in educating the mothers and caregivers on childhood immunisation needs to be strengthened further.…”