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Immunization Status, Immunization Coverage, and Factors Associated with Immunization Service Utilization Among
Mousumi Datta1, Shamima Yasmin2, Rahul Biswas2
1Department of Community Medicine, R. G. Kar Medical College, Kolkata, India.
Insights
Immunization coverage for children affected by HIV in India is low, primarily due to parental unawareness and stigma. Improving vaccination rates requires better record-keeping and respectful healthcare provider training.
Area of Science:
- Pediatrics
- Public Health
- Immunology
Background:
- Children born to HIV-infected mothers often face challenges with immunization coverage.
- Current immunization status for this vulnerable group in India remains largely unknown.
- This study addresses the critical need to understand vaccination gaps in HIV-affected children in India.
Purpose of the Study:
- To assess the immunization status of children born to HIV-infected mothers in West Bengal, India.
- To identify service utilization issues impacting vaccination completion.
- To determine factors associated with immunization status in this population.
Main Methods:
- A descriptive, cross-sectional, multisite study was conducted in four districts of West Bengal, India.
- Data was collected from 131 children aged 12-59 months using interviewer-administered questionnaires.
- Immunization status was analyzed using Chi-square and regression analyses.
Main Results:
- Only 58.8% of children received all recommended vaccines, including the birth dose of Hepatitis-B (Hep-B).
- Lower immunization rates were observed in specific districts, with Murshidabad and South 24 Parganas showing the lowest coverage.
- Key barriers included lack of awareness about due dates and stigma experienced from healthcare providers.
Conclusions:
- Lower immunization coverage is linked to parental unawareness and stigma encountered during healthcare access.
- Implementing strategies like documenting vaccine due dates can improve coverage.
- Training healthcare providers to offer non-discriminatory, respectful care is crucial for enhancing vaccination rates.
Background And Objective:
HIV-infected and HIV-exposed children are known to have a lower immunization coverage. However, the current immunization coverage for this group of children in India is unknown. The present study assessed the immunization status, service-utilization issues, and factors associated with immunization status among them.
Methods:
A descriptive, cross-sectional, and multisite study was conducted in four districts (Nadia, Murshidabad, South and North 24 Parganas) of West Bengal, a state in the Eastern part of India. Children aged between 12 and 59 months were included in the study. A sample size of 131 was calculated using Cochrane's formula. Onsite data was collected using an interviewer-administered predesigned, pre-tested, face-validated, semi-structured schedule. Immunization status was the outcome variable. The unadjusted association of the outcome variable with other variables was tested by the Chi-square test and the adjusted association was tested by regression analysis.
Results:
The mean age of the children was 35.5 months (±15.7) and 50.4% were male. There were 18 (13.7%) HIV-infected children. Eighty-four percent of children were adequately immunized, but when considered along with the birth dose of the Hepatitis-B (Hep-B) vaccine, this reduced to 58.8%. Murshidabad district had the lowest proportion of fully immunized children (50%), while South 24 Parganas district had the lowest proportion of completely immunized children (60%). More than 95% of vaccinations were done in government facilities. Service utilization issues identified were lack of awareness of vaccine due dates and facing stigma from providers. Immunization status was associated with experience of stigma, mode and place of delivery by Chi-square test, it was only associated with stigma by regression analysis.
Conclusion And Global Health Implications:
Relatively lower immunization coverage among children born of HIV-infected women can be attributed to parents' unawareness about vaccination due dates and facing stigma while accessing service. Measures like documenting vaccine due dates and training healthcare providers on non-discriminatory, respectful care may improve vaccination coverage.
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