Access and Barriers to Immunization in West Bengal, India: Quality Matters

Abstract

performance (7). The maintenance of time schedule has been considered crucial proxy indicator of the quality of coverage of immunization (7-9). The other possible ways to look into the quality of immunization is to consider the availability of manpower, equipment, and drugs (10-12). The results of studies in Africa and Asia report that the quality of vaccination services still leaves much to be improved in developing countries (12). They found that the principal problems in maintaining the quality in vaccination process are as follows:• Inadequate supplies, particularly of vaccines, vaccination cards, registration materials, and other drugs• Lack of providing appropriate information on vaccines, vaccine-preventable diseases, and vaccination schedules in the vaccination sessions• Poor training facilities for health workers adversely affecting the frequency and regularity of vaccination sessions• Inaccuracies in the registration of vaccinations. Access and Barriers to Immunization in ABSTRACTWhile many studies attempted to evaluate performance of immunization programmes in developing countries by full coverage, there is a growing awareness about the limitations of such evaluation, irrespective of the overall quality of performance. Availability of human resources, equipment, supporting drugs, and training of personnel are considered to be crucial indicators of the quality of immunization programme. Also, maintenance of time schedule has been considered crucial in the context of the quality of immunization. In addition to overall coverage of vaccination, the coverage of immunization given at right time (month-specific) is to be considered with utmost importance. In this paper, District Level Household and Facility Survey-3 (DLHS-3) 2007-2008 data have been used in exploring the quality of immunization in terms of month-specific vaccine coverage and barriers to access in West Bengal, India. In West Bengal, the month-specific coverage stands badly below 20% but the simple non-month-specific coverage is as high as 75%. Among the demand-side factors, birthplace of the child and religion of the household heads came out as significant predictors while, from the supply-side, availability of male health workers and equipment at the subcentres, were the important determinants for month-specific vaccine coverage. Hence, there should be a vigorous attempt to make more focused planning, keeping in mind the nature of the barriers, for improvement of the month-specific coverage in West Bengal.

Factors influencing the hesitancy and refusal of vaccines in India: A study-using tool developed by WHO SAGE Working Group

“…The population's hesitancy was discovered to be because of a lack of accurate knowledge about the vaccine. This agrees with the findings of Dutta et al, who found that a child with a working mother is almost half as likely to be vaccinated as a child whose mother is unemployed [25] . Our findings contradicted those of Deborah et al, who found that vaccine optimism increased as educational levels increased and safety concerns decreased [26] .…”

Vaccine hesitancy for childhood vaccinations in urban slums of Bengaluru rural district, Karnataka

“…In the present study, lower SES showed a higher likelihood of vaccine hesitancy in similarity to observations by previous authors. 12,14 Among the characteristics of children, the gender of the child and birth order was found to be significantly associated with vaccine hesitancy in the present study. This is similar to findings from some of earlier studies.…”