Factors affecting immunization coverage levels in a district of India

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• Immunization coverage is a key indicator for evaluating the success of national public health programs like the Expanded Programme on Immunization.
• Assessing vaccination rates is crucial for identifying disparities and informing targeted interventions.

Purpose of the Study:

• To evaluate immunization coverage among children aged 12-23 months in the North Arcot District of southern India in 1988.
• To identify factors influencing vaccination coverage differences between urban and rural settings.

Main Methods:

• A 30-cluster sample survey was conducted in 12 towns.
• A systematic sample of 159 panchayats was selected from 35 rural blocks, surveying all children within them (n=7300).
• Vaccine-specific coverage rates were analyzed for BCG, DPT, OPV, and measles.

Main Results:

• Urban areas showed higher coverage: BCG (65-91%), DPT/OPV 3rd dose (60-80%), measles (29-53%).
• Rural areas had significantly lower coverage: BCG (25.1-34.1%), DPT/OPV 3rd dose (39.6-50.4%), measles (10.8-19.3%).
• Private providers in towns contributed to higher coverage due to accessibility, contrasting with government-provided free services in rural areas. Rural areas exhibited significant intra-block variations.

Conclusions:

• Urban-rural disparities in immunization coverage are substantial in India.
• Accessibility and availability of vaccination services, including those offered by private entities, play a critical role in achieving higher coverage.
• Targeted strategies are needed to address significant variations in coverage within rural administrative units.