Timeliness of primary childhood vaccination in a rural area of Puducherry, South India: evidence from routine management information system

Authors

  • Gomathi Ramaswamy Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  • T. K. Pruthu Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  • Kalaiselvi Selvaraj Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  • V. M. Vinayagamurthy Department of Community Medicine, Sri Venkateswaraa Medical College Hospital and Research Centre, Puducherry, India
  • Palanivel Chinnakali Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Keywords:

Age-appropriate vaccination, Immunization coverage, Primary immunization, Vaccination delay

Abstract

Background: Immunization plays an important role in reducing mortality due to vaccine preventable diseases in children. In areas with high vaccine coverage, age-appropriate vaccination or timeliness of vaccination will be helpful in assessing quality of vaccination program. The objective was to assess the delay in primary childhood vaccination in a primary health center (PHC) of rural Puducherry.

Methods: A record based study was conducted in a primary health center situated in rural Puducherry using data from immunization and antenatal records. Children born between 1st January 2009 and 30th November 2013 were included in the study. Delay in vaccination of diphtheria-tetanus-pertussis 1 (DPT1), DPT2, DPT3 and measles were studied.

Results: A total of 457 children were included, 52.5% were males, and 47.5% were females. Immunization coverage was 100% for all vaccines. Delay in vaccination more than 2 weeks from the due date of vaccination for DPT1, DPT2, DPT3 and measles were 7.4%, 41.9%, 64.4% and 38.8% respectively. Median (interquartile range) days of delay for DPT1, DPT2, DPT3 and measles was found to be 6 (4-8), 13 (7-20), 19 (12-30) and 11 (4-24) respectively. Children with higher birth order were vaccinated with significant delay for DPT3 (p = 0.008). Delay in vaccination was less in children from the village where PHC is located (p < 0.001).

Conclusion: Vaccination coverage for DPT and measles is high. There are delays in vaccination for DPT and measles, though not so high, there is scope for improving timeliness of vaccination in this rural area.

References

UNICEF - UNICEF Publications - Committing to Child Survival: A Promise Renewed – Progress Report 2013. UNICEF. Available at http://www.unicef.org/publications/index_70354.html. Cited 16 May 2014

WHO|Global Vaccine Action Plan 2011-2020. WHO. Available at http://www.who.int/immunization/global_vaccine_action_plan/GVAP_doc_2011_2020/en/. Cited16 May 2014.

WHO|Immunization coverage. WHO. Available at http://www.who.int/mediacentre/factsheets/fs378/en/. Cited 16 May 2014.

Briand V, Bonmarin I, Lévy-Bruhl D. Study of the risk factors for severe childhood pertussis based on hospital surveillance data. Vaccine. 2007;25(41):7224-32.

Department of Health and Family Welfare. National Immunization Schedule (NIS) for Infants, Children and Pregnant Women. Immunization Handbook for Medical Officers. New Delhi: Ministry of Health and Family Welfare, Government of India; 2008: 19.

International Institution for Population Sciences. District Level Household and Facility Survey (DLHS-3, 2007-8). Tamil Nadu: Ministry of Health and Family Welfare; 2010: 15-6.

Mother and Child Tracking: Govt. of India. Available at http://www.nrhm-mcts.nic.in/MCH/. Cited 21 May 2014.

About ASHA - National Health Mission. Available at http://nrhm.gov.in/communitisation/asha/about-asha.html. Cited 21 May 2014.

Yadav K, Srivastava R, Kumar R, Chinnakal P, Rai SK, Krishnan A. Significant vaccination delay can occur even in a community with very high vaccination coverage: evidence from Ballabgarh, India. J Trop Pediatr. 2012;58(2):133-8.

BMC Public Health|Full text|Timeliness of childhood vaccine uptake among children attending a tertiary health service facility-based immunisation clinic in Ghana. Available at http://www.biomedcentral.com/1471-2458/14/90. Cited 22 May 2014.

Corsi DJ, Bassani DG, Kumar R, Awasthi S, Jotkar R, Kaur N, et al. Gender inequity and age-appropriate immunization coverage in India from 1992 to 2006. BMC Int Health Hum Rights. 2009;9 Suppl 1:S3.

Calhoun LM, van Eijk AM, Lindblade KA, Odhiambo FO, Wilson ML, Winterbauer E, et al. Determinants and coverage of vaccination in children in western Kenya from a 2003 cross-sectional survey. Am J Trop Med Hyg. 2014;90(2):234-41.

Delayed vaccination and related predictors among infants. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494233/. Cited 22 May 2014.

Ughade SN, Zodpey SP, Deshpande SG, Jain D. Factors responsible for delayed immunisation among children under 5 years of age. J Indian Med Assoc. 2000;98(1):4-5, 14.

Dombkowski KJ, Lantz PM, Freed GL. Risk factors for delay in age-appropriate vaccination. Public Health Rep. 2004;119(2):144-55.

Downloads

Published

2017-02-07

Issue

Section

Original Research Articles