Immunization coverage in India for areas served by the Integrated Child Development Services programme. The...

Area of Science:

• Public Health
• Pediatrics
• Social Medicine

Background:

• The Integrated Child Development Services (ICDS) program, launched in 1975, aims to deliver health, nutrition, and education to mothers and children.
• Assessing the long-term impact of established ICDS projects on essential health services is crucial for public health policy.

Purpose of the Study:

• To evaluate the impact of the Integrated Child Development Services (ICDS) program on immunization coverage.
• To compare immunization rates among children (12-24 months) and mothers in ICDS versus non-ICDS areas.

Main Methods:

• A cross-sectional study was conducted in 1988 across 36 ICDS projects (19 rural, 8 tribal, 9 urban) operational for over 5 years.
• Immunization coverage data for BCG, DPT, poliomyelitis, and tetanus toxoid were collected and compared between ICDS and non-ICDS populations.
• Analysis included stratification by project type (rural, tribal, urban) and socio-economic groups.

Main Results:

• Complete immunization coverage was substantially higher in ICDS areas: 65% (BCG), 63% (DPT), 64% (polio) for children, and 68% for maternal tetanus toxoid.
• Non-ICDS areas showed significantly lower coverage: 22% (BCG), 28% (DPT), 27% (polio), and 40% for maternal tetanus toxoid.
• Immunization coverage varied by project location, being higher in urban and lower in tribal projects, yet equitable across different caste and community groups within ICDS.

Conclusions:

• The ICDS program demonstrates a significant positive impact on improving child and maternal immunization coverage in India.
• Targeted interventions within ICDS are effective in reaching priority populations, ensuring equitable health service delivery.
• Sustained operation of ICDS projects is associated with enhanced public health outcomes in maternal and child health.