Abstract

Background:In India Immunization services are provided by Government by Central/state/district/block and village levels institutions and also by private institutions at various levels by pediatricians and other general medical practitioner as per IAP or EPI schedule. This both parallel systems work for same goal of immunization of children and preventing vaccine preventable diseases.Now days as there is increase in number of private institutions which provides immunization services it is time to take them into consideration for strengthening Routine immunization services and coverage of children. So this study focus on impact of these two parallel immunization services in Jodhpur, Rajasthan - India and identify gaps in terms of unimmunization/partial immunization in children aged 12-23 months in relation to types of institutions. Purpose:To asses impact of parallel immunization services -India and rule out reason for low full immunization coverage by assessing factors contributing for Un immunization/Partial immunization in various institutions with exploring need for strengthening of immunization services .Materials and Methods:The study was conducted in Jodhpur district of Rajasthan.Lot Quality Assurance Sampling (LQAS) was used for survey to assess the quality of vaccination coverage, For urban 20 Lot and for rural 20 lots defined, in each lot/village/zones, 10 households with child age 12-23 months were selected from each zones using systematic random sampling procedure and from selected households all eligible mothers/care givers were interviewed,children were categorized as per working definition’s as follows 1. Fully immunized - who received BCG and 3 doses of DPT & and 3 of OPV and 1 dose of measles, 2.Partially immunized – who has missed any one or more but not all dosages of UIP, 3. Not immunized /un-immunized – who has not received any vaccines in UIPResults:Amongst 400 children of 12 – 23 months of age. Children out of whom 75.25% contacted Government institutes for immunization services and 18% children were contacted private institute and 6.75% were no contacted for immunization services.contacting type of facility for immunization (urban + rural), children contacting only government institute were 301 children out of them (221) 73.42% are fully immunized and (80) 26.58% are partially immunized. Whereas in private institute (urban + rural) 72 children contacted out of them (43) 59.72% are fully immunized and (29) 40.28% are partially immunized. Children who contacted private institution have not completed their full immunization schedule are 13.7% more as compare to Government institution.It is evident that unavailability of vaccine (13%) and trained staff (8%) is major reason with cost of unimmunized in urban private and in government fear of AEFI (10%) with lack of information of immunization was major reason. Conclusion: This study therefor confirms that parallel services of immunization are causing impact in terms of increase in respective percentage of partial immunization or un- immunization of children and un-equality of antigens with economic burden on community

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