scholarly journals Factors affecting immunization coverage in urban slums of Odisha, India: implications on urban health policy

2013 ◽  
Vol 1 (2) ◽  
pp. 18 ◽  
Author(s):  
Santosh K. Prusty ◽  
Bhuputra Panda ◽  
Abhimanyu S. Chauhan ◽  
Jayanta K. Das
Keyword(s):  
Child Survival ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Population Based ◽  
Urban Slums ◽  
Drop Out ◽  
Factors Affecting ◽  
Effective Interventions ◽  
Immunization Services ◽  
Local Decision

Infectious diseases are major causes of morbidity and mortality among children. One of the most cost-effective interventions for improved child survival is immunization, which has significant urban-rural divides. Slum dwellers constitute about one-third of Indian population, and most children still remain incompletely immunized. The main purpose of this study was to understand the factors behind partial or non-immunization of children aged 12-23 months in slum areas of Cuttack district, India. Session-based audit and a population-based survey were conducted in the urban slums of Cuttack city, April-June 2012. Total 79 children were assessed and their mothers were interviewed about the nature and quality of immunization services provided. Children fully immunized were 64.6%. Antigen-wise immunization coverage was highest for Bacillus Calmette-Guérin (BCG) (96.2%) and lowest for Measles (65.8%), which indicates high instances of late drop-out. Frequent illnesses of the child, lack of information about the scheduled date of immunization, frequent displacement of the family and lack of knowledge regarding the benefits of immunization were cited as the main factors behind coverage of immunization services. The study showed that there is an urgent need to revise the immunization strategy, especially for urban slums. District and sub-district officials should reduce instances of early and late dropouts and, in turn, improve complete immunization coverage. Community participation, intersectoral co-ordination and local decision making along with supportive supervision could be critical in addressing issues of drop-outs, supply logistics and community mobilization.

scholarly journals Supervision and monitoring to assess quality of outreach immunization sessions in a rural area using a checklist

2020 ◽  
Vol 7 (5) ◽  
pp. 1950
Author(s):  
Ambika R. Bhaskar ◽  
Mridula Solanki
Keyword(s):  
Tertiary Care ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Immunization Services ◽  
Timely Fashion ◽  
Assess Quality

Background: Immunization is one of the most cost-effective interventions to prevent the suffering that comes from avoidable sickness, disability and death. Outreach immunization services ensure that immunization is available to children who are unable to access a general practice in a timely fashion for their immunization events. Effective supervision and monitoring will help in improving quality and coverage of immunization.Methods: This was an observational cross-sectional study conducted in the rural field practice area of a tertiary care hospital. 50 outreach sessions held in various outdoor places including Anganwadi were supervised and monitored using checklist. 110 mothers and 20 stakeholders were interviewed. Immunization records were assessed.Results: Outreach immunization sessions were found to be of good quality. 89% children were fully immunized. ANMs and ASHAs were of the opinion that outreach session has significantly raised immunization coverage. 75.4% mothers had knowledge about services provided by outreach sessions.Conclusions: There was increase in immunization coverage due to outreach sessions. There is need for adequate supervision on safety injection practices and regular timely incentive to ASHA.

Localization of parathyroid tumours in the minimally invasive era: which technique should be chosen? Population-based analysis of 253 patients undergoing parathyroidectomy and factors affecting parathyroid gland detection.

2001 ◽  
pp. 63-69 ◽  
Author(s):  
F Lumachi ◽  
M Ermani ◽  
S Basso ◽  
P Zucchetta ◽  
N Borsato ◽  
...  
Keyword(s):  
Ct Scan ◽  
Cost Effective ◽  
Population Based ◽  
Preoperative Localization ◽  
Factors Affecting ◽  
Parathyroid Adenomas ◽  
Magnetic Resonance Imaging Mri ◽  
Parathyroid Tumours ◽  
Double Adenomas ◽  
Subtraction Scintigraphy

A series of 253 consecutive patients with proved primary hyperparathyroidism due to parathyroid tumours was reviewed. There were 68 (26.9%) men and 185 (73.1%) women, with a median age of 57 years (range 13-82 years). All patients, prior to successful parathyroidectomy, underwent one or more preoperative localization procedures such as: neck ultrasonography (US) in 191 (75.5%), (201)Tl/(99m)Tc-pertechnetate subtraction scintigraphy (TPS) in 144 (56.9%), CT scan in 92 (36.4%), (99m)Tc-sestamibi/(99m)Tc-pertechnetate subtraction scintigraphy (MPS) in 90 (35.6%), selective venous sampling (SVS) with parathyroid hormone (PTH) assay in 30 (11.9%), and magnetic resonance imaging (MRI) in 6 (2.4%) patients. The results were compared with operative and histological findings that showed 235 (92.9%) solitary parathyroid adenomas, 13 (5.1%) carcinomas and 5 (2.0%) double adenomas. Sensitivity and positive predictive value were 82.9% and 93.8% for US, 83.6% and 91.8% for TPS, 81.3% and 98.7% for CT scan, 85.1% and 96.1% for MPS, 65.4% and 80.9% for SVS, and 80.0% and 80.0% for MRI respectively. No different results (P=NS) were found using US, TPS, MPS or CT scan, whereas SVS and MRI sensitivity was lower (P<0.05). The combination of MPS and US was 94.0% sensitive (P<0.05) but when TPS, CT scan or MRI were also used overall sensitivity did not improve significantly (P=NS). In conclusion, MPS should be used as the starting preoperative localization procedure, while US and MPS together represent the most reliable noninvasive localization tool. If MPS and US are negative or not in agreement, further studies are not cost-effective and the patient should undergo bilateral neck exploration.

Cost-Effectiveness of Population-Based Tobacco Control Interventions on the Health Burden of Cardiovascular Diseases in Vietnam

2021 ◽  
pp. 101053952199987
Author(s):  
Duyen Thuy Nguyen ◽  
Khue Ngoc Luong ◽  
Hai Thi Phan ◽  
Anh Tuan Tran ◽  
Son The Dao ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Tobacco Control ◽  
Cost Effective ◽  
Population Based ◽  
Activity Based Costing ◽  
Community Based Interventions ◽  
Potential Health ◽  
Cigarette Taxes ◽  
Effective Interventions ◽  
Intervention Impact

This study seeks to assess the cost-effectiveness of population-based tobacco control interventions, which include health promotion and education, smoke-free models, cessation programs, warning on package, marketing bans, and raising tax. Standardized activity-based costing ingredient approach was applied with the provider perspective to calculate interventions cost from 2013 to 2017. The potential health impacts of the aforementioned interventions were calculated through a Microsoft Excel-based modeling adapted from Higashi et al and Ngalesoni et al. All 6 population-based tobacco control interventions were highly cost-effective with ranges from 1405 VND (Vietnamese Dong) to 135 560 VND per DALY (disability-adjusted life year) averted. It was identified that raising cigarette taxes and applying health warnings on tobacco packages are the most favorable, cost-effective interventions. The results from this study provide a robust message that calls for increased attention and efforts in developing an appropriate policy agenda, which jointly integrates both political and community-based interventions, to maximize intervention impact on tobacco use.

scholarly journals The post-2015 agenda: staying the course in maternal and child survival

2015 ◽  
Vol 100 (Suppl 1) ◽  
pp. S76-S81 ◽  
Author(s):  
Jennifer Harris Requejo ◽  
Zulfiqar A Bhutta
Keyword(s):  
Child Survival ◽  
Cost Effective ◽  
Access To Education ◽  
Unfinished Business ◽  
Child Health Outcomes ◽  
Child Deaths ◽  
Effective Interventions ◽  
Development Agenda ◽  
Humanitarian Crises ◽  
Women And Children

In this article, we draw on available evidence from Countdown to 2015 and other sources to make the case for keeping women and children at the heart of the next development agenda that will replace the Millennium Development Goal (MDG) framework after 2015. We provide a status update on global progress in achieving MDGs 4 and 5, reduce child mortality and improve maternal health, respectively – showing that although considerable mortality reductions have been achieved, many more women's and children's lives can be saved every day through available, cost effective interventions. We describe key underlying determinants of poor maternal and child health outcomes and the need for well-coordinated, comprehensive approaches for addressing them such as introducing a combination of nutrition specific and sensitive interventions to reduce pervasive malnutrition, targeting interventions to the underserved to reduce inequities in access to care, and increasing women’s social status through improved access to education and income-earning opportunities. In the wake of population momentum and emergencies such as the recent ebola outbreak and other humanitarian crises, health systems must be strengthened to be able to respond to these pressures. In conclusion, we underscore that the unfinished business of women's and children's health must be prioritized in the days ahead, and that ending preventable maternal and child deaths is not only a moral obligation but is achievable and essential to sustainable development moving forward.

The Use of Mass Campaigns in the Expanded Program on Immunization: A Review of Reported Advantages and Disadvantages

1997 ◽  
Vol 27 (4) ◽  
pp. 767-790 ◽  
Author(s):  
Vance Dietz ◽  
Felicity Cutts
Keyword(s):  
Outcome Measure ◽  
Vaccine Coverage ◽  
Immunization Coverage ◽  
Subsequent Development ◽  
Cost Effective ◽  
Advantages And Disadvantages ◽  
Mass Immunization ◽  
Health Care Infrastructure ◽  
Immunization Services ◽  
Expanded Program On Immunization

The use of mass immunization campaigns (MICs) has been and remains controversial. To evaluate these campaigns, the authors review the literature relating to their effectiveness, sustainability, and cost-effectiveness in controlling diseases and raising immunization coverage levels, and their impact on the subsequent development of routine immunization services. Well-conducted campaigns have increased vaccine coverage levels and decreased disease morbidity and mortality. Their use in the Americas has been associated with the apparent elimination of poliomyelitis. However, unless health care infrastructure is improved, or campaigns are repeated, gains in coverage levels may not be sustained. Studies suggest that MICs are often not as cost-effective for raising coverage as the delivery of vaccines through routine services, but the use of coverage as the only outcome measure is questionable. Mass immunization campaigns can increase awareness of vaccination and may be appropriate in situations where new programs are to be initiated, in refugee situations where people congregate into areas with little infrastructure, and in disease eradication efforts when specific time goals are set. Little information is available on whether MICs strengthen or interfere with the development of routine services. To be successful, MICs require a well-coordinated and planned effort on the part of national authorities with the identification of specific goals, intensive social promotion, and strong management. In addition, research is needed to clarify how MICs should be evaluated.

scholarly journals Determinants of Poor Utilization and Accessibility of Immunization Services: A Qualitative Study in Selected Counties in South Sudan

2021 ◽  
Vol 13 (9) ◽  
pp. 52
Author(s):  
David Majuch Kunjok ◽  
Paulo Okech. Ajak ◽  
Atem Agot Deng ◽  
Atem Nathan Anyuon ◽  
Philip Malong Thiel ◽  
...  
Keyword(s):  
Health Facility ◽  
Phenomenological Study ◽  
South Sudan ◽  
Immunization Coverage ◽  
Drop Out ◽  
Vaccine Uptake ◽  
Cold Chain ◽  
Mortality And Morbidity ◽  
Vaccine Preventable Diseases ◽  
Immunization Services

BACKGROUND: Reducing vaccine-preventable diseases mortality and morbidity in non-industrialized countries requires the enforcement of robust immunization strategies aimed at increasing coverage and reducing dropouts and missed immunization opportunities. Attaining high (&gt;80%) immunization coverage with a low drop-out rate in South Sudan has been challenging because of the program&rsquo;s high defaulting rates. This study aimed to determine the reasons for poor accessibility and utilization of immunization services in counties earmarked for Fragility, Emergency and Refugees (FER) in South Sudan. METHODS: A descriptive phenomenological study design was conducted across four counties of Northern Bahr El Ghazal, South Sudan, between May 2019 and December 2020 in which 42 focused group discussions and key-informant interviews involving the community and primary healthcare centers and units were conducted. Relevant EPI (Expanded program on immunization) tools were reviewed and data were analyzed using thematic analysis. RESULTS: The main reasons identified were negative attitudes towards healthcare workers and immunization services, competing priorities of the caregivers, delayed opening of the immunization sessions, insufficient cold chain facilities, inadequate knowledge and information about immunization services, and non-availability of vaccines at the health facility. CONCLUSIONS: A plan to supply adequate vaccines and related supplies to the counties by identifying stock levels in time must be a priority. Health facility micro-plan development and implementation should be supported by increased funding for the implementation of outreach and mobile sessions to reach missed children, intensified door-to-door health awareness, and regular community meetings to increase vaccine uptake.

scholarly journals Measles vaccination coverage among children aged (12-23) months in Marawi locality - Northern state, Sudan - 2016

2018 ◽  
Vol 5 (6) ◽  
pp. 2195
Author(s):  
Wafaa Mubark Mohamed Osman
Keyword(s):  
Vaccination Coverage ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Negative Attitude ◽  
Immunization Coverage ◽  
Target Population ◽  
Total Sample ◽  
Working Environment ◽  
Factors Affecting ◽  
Immunization Services

Background: Worldwide measles remains the fifth cause of mortality among children under 5 years. Immunization coverage is the proportion of individuals in the target population who are vaccinated. It is a key measure of immunization system performance. Coverage for measles in Eastern Mediterranean region in 2015 for MCV1 was 85%, and MCV2 was 61%.Methods: A total sample size of 462 mothers was determined according to WHO guidelines regarding coverage survey in (February - July 2016). Data were collected using a prepared and pretested questionnaire, reviewing cards of children, and interview with EPI personnel. Data were analyzed using SPSS version 20, p≤0.05 was considered significant.Results: The majority of the children (96.1%) were vaccinated against MCV1, and (77.4%) were vaccinated against MCV2. Small group of mothers (5.7%) had a negative attitude towards immunization. Most mothers (94.3%) were satisfied with measles immunization services. More than half of mothers (55.7%) wait for <15 minutes to immunize their children. Most of the mothers (62.3%) went to the immunization centers by public transports. The main factors affecting vaccination coverage were: weakness of incentives, lack of means of transport for staff, poor working environment like: shortage of water, furniture and technological materials.Conclusions: The coverage with MCV1 was reaching the WHO elimination standards while the coverage of MCV2 was not; due to many factors that affected the vaccination coverage. The study recommends health education covering all aspects of immunization, improvement of the working environment, and availing outreach centers.

scholarly journals Implementation of Immunization Services for the Under-Five Children during Covid-19 Pandemic at Twano Community Health Center, Jayapura

2020 ◽  
Author(s):  
Goklian Paraduan Haposan ◽  
◽  
Pujiyanto Pujiyanto ◽  
Keyword(s):  
Community Health ◽  
Health Center ◽  
Health Workers ◽  
Community Health Center ◽  
Immunization Coverage ◽  
Immunization Service ◽  
Factors Affecting ◽  
Under Five ◽  
Under Five Children ◽  
Immunization Services

Background: Immunization service is essential in reducing infant mortality rate. However, due to physical distancing and social distancing, the Covid-19 pandemic may have reduced the utilization of immunization service. This study aimed to determine the implementation of immunization services for the under-five children during Covid-19 pandemic at Twano community health center, Jayapura. Subjects and Method: This was a qualitative study conducted at the Twano Entrop Community Health Center, Jayapura City, Papua, from August to September 2020. A sample of informants including immunization personnel and head of community health center. The data were collected by in-depth interview, questionnaire, and document review. Result: The immunization coverage was 43% at Twano community health center, which was far below the national target of 80%. The factors affecting immunization coverage included: (1) worries of infection; (2) parental ignorance; (3) no invitation from the health workers. Conclusion: The factors affecting immunization coverage included are worries of infection, parental ignorance, and no invitation from the health workers. Keyword: immunization, the under-five children, Covid-19 pandemic. Correspondence: Goklian Paraduan Haposan. Faculty of Public Health, University of Indonesia. Pondok Cina, Beji district, Depok city, West Java 12345. Email: [email protected]. Mobile: 081344237365. DOI: https://doi.org/10.26911/the7thicph.02.16

scholarly journals Evaluation of primary immunization coverage among children in a rural block of district Rohtak, Haryana, India

2017 ◽  
Vol 4 (5) ◽  
pp. 1612 ◽  
Author(s):  
Sahil Goyal ◽  
Vijay Kumar ◽  
Ritika Garg
Keyword(s):  
Immunization Coverage ◽  
Cost Effective ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Drop Out ◽  
Primary Immunization ◽  
Cross Sectional ◽  
Life Threatening ◽  
Age Appropriate ◽  
The Right

Background: Vaccination is the most important preventive and cost-effective intervention to decrease morbidity and mortality rates in children. Every year, vaccination averts an estimated 2-3 million deaths from diphtheria, tetanus, pertussis and measles. These are all life threatening diseases that disproportionately affect children. An estimated 1.5 million children die annually from diseases that can be prevented by immunization. In the past 50 years, vaccination has saved more lives worldwide than any other medical products or procedures. The objectives of the study were to evaluate primary immunization coverage along with 1st dose of Vitamin-A supplementation coverage, age-appropriate immunization and also to know the reasons for partial or non-immunization among children.Methods: Community-based cross sectional study was conducted among 540 children in the rural area of Rohtak, Haryana during June 2015-May 2016. Information was collected from the mothers regarding immunization status of their children aged 12-23 months old and socio-demographic variables using a semi-structured interview schedule.Results: 395 (73.15%) of 12-23 months old children were fully immunized and the rest 145 (26.85%) were partially immunized. The major reason for drop-out rate was found to be unawareness regarding need for immunization. Immunization coverage was found to be significantly associated with the presence of immunization card and literacy level of mothers.Conclusions: Though the immunization coverage showed improvement through intensive immunization campaigns in recent years, still a lot needs to be done to increase awareness regarding importance of full immunization at the right time as mentioned in the National Immunization schedule (NIS).

scholarly journals Immunization status of 24-35 months old children in urban slums of Ahmedabad, Gujarat, India: a cross sectional study

2017 ◽  
Vol 4 (2) ◽  
pp. 548
Author(s):  
Chintu C. Chaudhari ◽  
Geet Gunjana ◽  
Khushboo Kiritbhai Modi ◽  
Manali Prashantkumar Patel ◽  
Nisarg Rajivbhai Thakker ◽  
...  
Keyword(s):  
Immunization Coverage ◽  
Cost Effective ◽  
Urban Slum ◽  
Dropout Rate ◽  
Cross Sectional Study ◽  
Urban Slums ◽  
Age Group ◽  
Childhood Diseases ◽  
Community Based ◽  
Cross Sectional

Background: Immunization is one of the most cost effective methods of preventing childhood diseases and needs to be sustained with higher coverage for desired benefits. Objective of the study was to assess immunization coverage in children of 24-35 months of age group in urban slums of Ahmedabad city, India.Methods: Using the purposive sampling method, a cross sectional community based study was conducted in urban slum area (Vadaj area) of Ahmedabad city during July-November 2014. All 214 children of 24-35 months age group of the area were included after taking verbal informed consent of their parents or guardians. Vaccination status of the children was verified using the Immunization card. In conditions where the Immunization card was not available, the mother/parents were asked about the site of vaccinations to confirm the vaccines being given. Analysis of study was done by using appropriate statistical software. Results: Total 936 households were surveyed. There were 214 children in the 24-35 months age group. Mamta card or immunization record was available with 145 (73.6%) mothers of 24-35 months age group of children. Vaccination coverage in the age group of 24-35 months old children was maximum for BCG and OPV first dose (96.7%) followed by Pentavalent first dose (95.8%) and OPV second dose (95.3%). Overall, 75.7% of the children in the 24-35 months age group were completely immunized while only 6 children were unimmunized. Dropout rate percentage for Pentavalent 1st dose to pentavalent 3rd dose was 3.44% while for BCG to second dose of measles was 19.75%.Conclusions: Complete immunization coverage was 75.7% which was better than the national surveys still the causes for no/ partial vaccinations need to be addressed. 

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