Primary immunization coverage in lower socioeconomic strata in Telangana – Perceptions & pitfalls Perceptions & Pitfalls in Primary Immunization Coverage

To improve primary immunization coverage, it becomes necessary to understand the various issues which can impede its effective implementation. Objective: This study was undertaken to analyze the extent of primary immunization coverage and the factors influencing its implementation in children of 12-23 months of age belonging to low socioeconomic strata. Materials and Method: This cross sectional community based observational study was undertaken in urban health centers and rural primary health centers on population belonging low socioeconomic strata. A structured questionnaire and immunization cards were used to obtain the incidence of primary immunization coverage and the factors affecting its implementation in children in urban slums of Hyderabad and rural areas of Telangana state over a period of one year. The data thus obtained was statistically analyzed. Results: Of the population studied, 81.8% were completely immunized, 17.6% partially immunized and 0.6% were non-immunized with no gender inequity observed. The children of lower birth order and those from joint families had a significantly better immunization coverage. Children from schedule caste and of Hindu community tended to have more complete immunization coverage. Gender of the household head did not significantly affect immunization coverage. Literacy levels of the caretakers, media exposure and OP reminders served to significantly improve primary immunization coverage. Parental preoccupation with livelihood was the commonest cause of delayed immunization. While ill health was most frequently the cause of partial or non immunization, of concern was the fear of pain /other adverse events following vaccination as well as non availability of a health centre close by. Conclusion: The primary immunization coverage is deficient in one fifth of the socioeconomically deprived population. Focusing on improving parental awareness from media and other literacy programmes as well as reminders by healthcare workers during interactions will play a vital role in improving primary immunization coverage in our infants.