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Letters to the Editor

Indian Pediatrics 2005; 42:401-402

Immunization Status of Children in Goa


We conducted a study to review the immunization status of children in Goa, to identify risk factors for under immunization and to suggest measures to improve immunization coverage, A pilot study was carried out in Pediatric ward of Department of Pediatrics, Goa Medical College for a period of one year followed by a study using the WHO 30 cluster method) n different parts of Goa over a period of 6 months from December 2000 to May 2001.

The study sample consisted of 362 children with 12 children from each cluster in 12-23 months age group. A child was said to be fully immunized if he/she had received one dose of BCG, 3 doses of OPV and DPT and one dose of measles at the end of 12 months age. Anything less was considered as partial immunization and if the child had not received any immunization, he was considered as unimmunized.

The immunization coverage for Goa can be summarized as 85.35% children fully immunized, 11.87% children partially immu-nized and 2.76% children unimmunized. The coverage for individual vaccines was BCG (94.7%), OPV1 (96.7%), OPV2 (95.8%), OPV3 (9o.6%), DPTl (96.1%), DPT2 (95%), DPT3 (90.6%), Measles (88%), Hepatitis B (19%), MMR (5%). The immunization coverage levels by individual characteristics are presented in Table I.

Characteristics Fully
Immunized
Partially
Immunized
Unimmunized
Total 85.3 11.9 2.3
Gender
Male 84.6 13.8 1.6
Female 86.2 9.8 4
Birth Order
1 86.6 12.2 1.1
2 88.8 9 2
3 69.2 23 7.6
4 75 0 25
Religion
Hindu 83.7 13.9 2.4
Christian 97.8 2.2 0
Muslim 56 28 16
Residence
Rural 80 16.7 3.3
Urban 90.6 7.1 2.3
Mother's education
Uneducated 70.8 22.1 7
Primary 91.2 6.8 1.9
Secondary 90.7 9.2 0
Graduate 100 0 0
Father's education
Uneducated 56 20.6 23.5
Primary 75.3 21.9 8.7
Secondary 89.8 10.2 0
Graduate 98.5 1.4 0
Socio-economic status
Class I 100 0 0
Class II 95.8 4.2 0
Class III 92.1 7.9 0
Class IV 81.7 15.6 2.6
Class V 48.6 32.4 19
Household size
<3 98.4 0.6 0
3-6 85.4 12.3 2.3
>6 68 23  

The main reasons for non immunization were found to be lack of information and obstacles to immunization.

The results of our study are comparable to some of the other recent studies in Goa who found a similar coverage(2,3), but were in sharp contrast to the reported figures of 100% coverage by the Health Services(4). This shows that the reported figures are a gross overestimation of the actual immunization coverage. This also stresses the need for coverage surveys from time to time to assess immunization coverage instead of relying on the reported coverage.

In our study we found that children with high birth order, Muslim religion, those residing in rural areas, children with low parent education and socioeconomic status and those from high household size had significantly low immunization coverage levels compared to children from other groups (P <0.05). Also a trend analysis showed improvement in immunization status with improvement in parent education, socio-economic status and decreasing family size.

Ashwin Dalal,
M.P. Silveira,

Department of Pediatrics,
Goa Medical College,
Bambolim, Goa.
Correspondence to:

Dr. Ashwin Dalal,

Senior Resident,
Department of Medical Genetics,
Sanjay Gandhi Postgraduate Institute of
Medical Sciences,
Raibarelly Road, Lucknow.
E-mail: [email protected] 
 

References


1. Henderson R.H, Sundaresan T. Cluster sampling to assess immunization coverage-a review of experience with simplified sampling method. WHO Bulletin 1982; 60: 253-260.

2. Population Research Centre, JSF Institute of Economic Research Dharwad and International Institute of Population Science, Mumbai National Family Health Survey-Goa Summary Report 1999-2000: 17-18.

3. Umamani KS, Raju KNM. Mutharayappa R, UNICEF Rapid Household Survey-Reproductive and Child Health Project 1998: 17-20.

4. Family Welfare Program in Goa-Achievements, Challenges, and Strategies Directorate of Health services, April 2000: 5.

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