VACCINATION COVERAGE SURVEY BANGALORE (URBAN) DISTRICT
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BANGALORE (URBAN) DISTRICT - extracted text
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VACCINATION COVERAGE SURVEY
BANGALORE (URBAN) DISTRICT
MARCH 1991
DEPT. OF PREVENTIVE & SOCIAL MEDICINE
BANGALORE MEDICAL COLLEGE
BANGALORE
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F.I.A P.S.M.,
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The Coverage Evaluation Survey in Bangalore (Urban) District
was carried out during March 1991 as one of the Surveillance
activities for Vaccine Preventable Diseases.
The study is co
ordinated by Indian Council of Medical Research.
I am once again proud of my colleagues and post-graduate
students who worked enthusiastically for conducting this survey.
An exemplary team spirit was exhibited.
We are
are grateful to Dr.Kumarswamy and all the health workers
who extended co-operation in conducting the study.
I am sure the finding, of this study will help improve the
implementation of the Universal Immunisation Programme and related
activities for better Maternal and Child Health activities.
L
X.
(DR (MRS) M.K. VASUNDHRA ).
PHONE : OFFICE ! 601529
601544
GOVERNMENT OF KARNATAKA
PRINCIPAL
REF. NO.
BMC/CM/
/91-92
J
ft?
BANGALORE MEDICAL COLLEGE
BANGALORE-560 002
DATED.. ..0.8770.4.-19.9.1*
I am pleased to go through the report on Coverage Evaluation
Survey in Bangalore (Urban) District conducted by the Department
of Preventive and Social Medicine. This Survey is a part of ICMR
- Government of India initiated Disease Surveillance Programme of
Vaccine Preventable Diseases.
The Survey has been conducted under severe constraints of staff
and time, since the examinations were scheduled for this period.
The fact that it has still been conducted efficiently and accurately
can be attributed to the leadership of Dr (Mrs) M.K.Vasundhra,
Professor and Head of the Department of P & S Medicine.
team members for the excellent work
I congratulate all the
1
turned out and I am surej the report will contribute to improving
the UIP of this state.
I
7
teJtTCIPAL
BANG .ORE MEDICAL COLLEGE
BANGALORE
£QNIE.fclI£
Page No.
1.
Team of investigators who conducted the survey
1
2.
Methodology
2
3.
General information
Child coverage survey
3
4.
Coverage figures
3
5.
Source of immunisation
4
6.
Reasons for immunisation failure
5
7.
Drop out rates
7
8.
Age at initiation & completion of Antigens
8
(12-23 month children)
MOTHER COVERAGE
9.
Coverage figures
9
10.
Source of immunisation
9
11 .
Antenatal care
10
12.
Place of delivery & personnel attending
11
13.
Month of initiation & completion of TT antigen
12
INFANT COVERAGE
14 .
Coverage •figures
15.
Source of immunisation
16.
17.
Immunisation status of infants at the time of
study
K.A.P of Reliable Respondents of 12-23 month
13
14
14
15
children
18.
K.A.P of Reliable Respondents of 0-12 month
infants
19.
Lameness survey
20.
Neonatal Tetanus survey
21 .
Comparison with reported performance & previous
surveys
22.
Summary
23.
Recommendat ions
24.
Area Map with list of clusters
17
20
22
24
25
27
28
1
TEAM OF INVESTIBATORS WHO CONDUCTED THE SURVEY
1 .
Dr.(Mrs) M.K.Vasundhra
Prof. & HOD of P&S Medicine, Chief Co-ordinator.
2.
Dr.(Mrs) H.S.Sheela
Asst.Professor, Dept.of P&S Medicine, Resource person.
3.
Dr. S.A.Vastrad
Lecturer, Dept, of P&S Medicine, Resource person.
POSTGRADUATES
4.
Dr. Yarnal , S-S
5.
Dr. Gangadharaswamy, G.O
6.
Dr. Satish H.V
7.
Dr. Somashekar.S.N
8.
Dr. Hooli
9.
Dr. Das .T.S
10.
Dr. Mai 1ikarjunaswamy
11 .
Dr (Mrs) Anasuya H.N
12.
Dr. Abdul Rahim
13.
Dr. Samagond R.O
14.
Dr. Manjunath K.R
15.
Dr. Vijay Kumar K.Y
.B.A
2
METH0D0L06Y i
The
Bangalore District CenBut Report of 1981
wae
procured
from
the Directorate of Health Services (Urban)
District
with
a list of modif ied area 1imits of the Urban
District•
clusters
were
seiected
from this utilising
cluster sampling Technique.
the
WHO
al ong
30
approved
The list of selected clusters
al ong
with the area map is appended (APPENDIX - I).
survey
The
was conducted as part of
ongoing
UIP
Disease
surveillance programme of I.C.M.R. New Delhi, and was financed by
I.C.M.R.
The survey was proceeded by a briefing session on 18-01-1991
The
cl usters
were divided into 2 groups based
on
geographical
convenience and a Team Leader assigned to each group.
The
survey
was
conducted over a period of
4
days
(12th
March to 15th March).
DEFINITIONS 8
Ful1y Immunised :
1 .
BCG
from
A child, who has received
1 dose
of
0-12 months, 3 doses each of DPT & OPV from 6 weeks to
12 months and 1 dose of Measles from 9-12 months.
2.
Partial 1y Immunised :
A child who has received one
or
more antigen but has not received all doses.
3.
Not Immunised :
single dose of any antigen.
A child who has not received
even
a
GENERAL
INFORMATION
1 .
Total No.of houses visited in 30 clusters
2.
Minimum No.of houses visited - Mothers 21, Children 25
3.
Maximum No.of houses visited - Mothers 105, Children 120
4.
Average
5.
Minimum time spent ( in minutes )
90
6.
Maximum time spent ( in minutes )
260
7.
Average time spent ( in minutes ) per cluster - 178.16 Min.
8.
No. of house-holds visited to get 210 children
1582
9.
Total population enumerated to get 210 children
8905
1946
No.of houses visited per cluster
Mothers 51.23,
Children 52.73
10. No. of house-holds visited to get 210 Mothers of infants-1537
11. Total
9167
population enumerated to get 210 Mothers of Infants
12. Average size
of family - 5.36
13. Total No. of infants
14. Crude birth rate
211
22.91 (1990)
10,209
15. Total No. of 0-5 year old children
16. Total live births in last on year
2334
COVERAGE FIGURES (12 z 23 MONTHS CHILDREN)
Total No. of 12
23 months children - 210 (Male 119, Female 91)
IMMUNISATION CARD AVAILABLE
81 (38.57'/)
NOT AVAILABLE
129 (61 .43%)
4
Antigen
No • CZ)
B.C.G
Scar present
D.P.T - 1
D.P.T - 2
D.P.T - 3
DROP OUT RATE (1-3)
O.P.V - 1
O.P.V - 2
O.P.V - 3
DROP OUT RATE (1-3)
MEASLES
193 (91.90%)
185 (88.10%)
200 (95.24%)
186 (88.57%)
172 (81.90%)
28 (14.00%)
200 (95.24%)
185 (88.10%)
172 (81.90%)
28 (14.00%)
140 (66.66%)
Fully Immunised
Partially Immunised
Not Immunised
134 (63.81%)
71 (33.81%)
5 ( 2.38%)
Fully immunised children form 63.81%, when immunisation as
per the schedule is the criteria. However, when 6 children who
were given measles antigen within 15 months are also considered,
the coverages is 66.66% .
SOURCE OF IMMUNISATION
ANTIGEN
HOSPITAL
H.C
OUTREACH
PRIVATE
B.C.G (193)
DPT
(200)
116(60.10%)
63(31.50%)
40(20.73%)
47(23.50%)
8(4.15%)
15(7.50%)
29(15.03%)
75(37.50%)
DPT 2 (186)
DPT 3 (172)
58(31.18%)
53(30.81%)
45(24.19%)
41(23.84%)
12(6.45%)
10(5.81%)
71(38.17%)
68(39.53%)
OPV 1 (200)
OPV 2 (185)
OPV 3 (172)
64(32.00%)
62(33.51%)
54(31.40%)
47(23.50%)
45(24.32%)
41(23.84%)
17(8.50%)
12(6.49%)
10(5.81%)
72(36.00%)
66(35.68%)
67(38.95%)
Measles(140)
48(34.29%)
25(17.86%)
12(8.57%)
55(39.29%)
5
Hospital and Health Centre were together the leading source
of B.C.G (80.83%) Hospital & Private sources accounted for 70.34%
of DPT 3, 70.35% of OPV 3 & 73.58"Z of Measles.
REASONS
JDR IMMUNISATION FAILURE
PI (33)
BCG/DPT/OPV
P.I (38)
MEASLES
N.I (6)
I.
LACK OF INFORMATION
1 .
Unaware of need
3 (9.09%)
8 (21.05%)
3 (50.00%)
2.
Unaware of need to
return for 2/3 dose
6 (18.18%)
1
O
Place/time of
immunisation unknown
0
0
4.
Fear of side reactions
2 (6.06%)
5.
Wrong ideas about
Contra-indicat ion
1
Others
0
0
4 (12.12%)
1
3.
6.
(2.70%)
O
O
(3.03%)
1
(2.70%)
0
O
11 . LACK OF MOTIVATION
1 .
Postponed till
another time
(2.70%)
1
(16.66%)
2.
No faith in
immunisat ion
0
0
1 (16.66%)
3.
Rumours
0
0
0
4.
Others
0
0
0
6
III. OBSTACLES
1 .
Place too far
1
2.
Time inconvenient
3.
(3.03%)
0
0
0
2 (5.41%)
0
Vaccinator not present
1(3.03%)
0
0
4.
Vaccine not available
0
0
0
5.
Mother too busy
0
11(29.73%)
1
6.
Fam i1y prob1ems
0
3 (8.11%)
0
7.
Child ill, not brought
for immunisation
9 (27.27%)
3 (8.11%)
0
Child ill, brought,
not immunised
4 (12.12%)
1
0
9.
Long waiting time
1
(3.03%)
0
0
10.
Child afraid of
i nject ion
1
(3.03%)
0
0
11 .
Lost Card
0
1
(2.70%)
0
12.
Wrong timing - Late
Earl y
0
0
6 (16.22%)
0
0
0
8.
Ch i1dren
who
(2.70%)
were partially immunised due
to
not
(16.66%)
having
received one of the 3 antigens (BCG/OPV/DPT) numbered 33 (46.88%)
and the most common reason was 'child being ill and not taken for
immunisation'.
Part ial 1y
numbered
busy'.
immunised children who had not
received
measles
38 (53.52%) and the most common reason was 'Mother
too
7
DROP OUT RATES
I
&
II
dose
II & III
I &
III
dose
P.P.T
O.P,V
14
15 (7.50‘Z)
(7.00’Z)
14 (7.53-Z)
13 (7.03%)
28 (14.00%)
28 (14.00%)
INITIATION OF ANTIGENS
0 - 1 1/2 M
1 1/2 - 3 M
4M
5 M
6 M
7M
B.C.G
(193)
154(79.79%)
15(7.77%)
4(2.07%)
7(3.63%)
1(0.52%)
D.P.T 1
(200)
0
154(77.00%)
29(14.50%)
6(3.00%)
0
154(77.00%)
29(14.50%)
0
0
O.P.V 1
(200)
Measles
(140)
0
8M
9M
2(1.04%)
2(1.04%)
1(0.52%) 4(2.07%)
2(1.04%) 1(0.52%:)
5(2.50%)
1(0.50%)
3(1.50%)
0
1(0.50%)
0
K0.50T)
6(3.00%)
5(2.50%)
1(1.50%)
3(1.50%)
0
0
0
0
0
0
0 0
0
0
D.P.T.l,
O.P.V.l
0
The number of children receiving immunisation with B.C.G.,
was respectively (79.79%, 77.00%, 77.00% and 72.86%)
&
10 M
11 M
12 M
102(72.86%) 17(12.14%) 15(10.71%)
Measles at the earliest recommended ase
COMPLETION OF IMMUNISATION (Fully immunised).
10 - 12 Months
12 + Months
Male - 119
72 (60.50%)
3 (2.52%)
Female-91
62 (68.13%)
3 (3.30%)
Total
134
6
72 °f the fully immunised were males (60.60% of all males) and 62 of the f
Completion after 12 months by 6 children was considered as partially immunised.fully immunised were females (68.13% of all females)
9
MOTHER COVERAGE
Total No. of pregnant Women
211
Card available
120 (56.87%)
Not available
91 (43.13%)
CARD
HISTORY
TOTAL
TT
1
105
84
189 (89.59%)
TT
2
100
83
183 (86.73%)
Booster
3
1
4 ( 1.90%)
Fully immunised
187 (88.63%)
Part i a11y i mmun i sed
10 ( 4.74%)
Not immunised
14 ( 6.63%)
Out
120
of
pregnant
mothers who had a
card
17 (14.16%)
remained unimmunised and 5 (4.16%) partially immunised.
SOURCE OF IMMUNISATION
II Z 1 (189)
TT
HOSPITAL
78 (41.27%)
74 (39.57%)
HEALTH CENTRE
15 ( 7.94%)
16 ( 8.56%)
OUT REACH
11 ( 5.82%)
8 ( 4.28%)
PRIVATE
85 (44.97%)
89 (47.59%)
Hospital
&
TT 2/B dose.
Private
sources together accounted
for
2/B(187)
87.16%
of
10
ANTENATAL CONTACTS
No. of contacts
Number (Percentage)*
3 or more than 3
153 (72.5rZ)
1
3
39 (18.48’Z)
0
19 ( 9.01%)
SERVICES PURING A.N.C
No.of Times
Urine examination
0
1
2
3
4
5
Pregnant
contacts
atleast
50
48
29
52
9
23
(23.70%)
(22.75%)
(13.74%)
(24.64%)
(04.27%)
(10.90%)
women
who
numbered
3
had
B.P. Check up
33
35
38
43
11
51
at
(15.64%)
(16.59%)
(18.01%)
(20.38%)
( 5.21%)
(24.17%)
1 east
3
153 (72.51%) while the
investigations each, was true of
105 (49.76%) and 47 (22.27%) for Urine
Hb%
or
48
76
40
27
6
14
more
minimum
onl y
(72.75%)
(36.02%)
(18.96%)
(12.80%)
( 2.84%)
( 6.64%)
antenatal
criteria
84
of
(39.81%),
Examinat ion, B.P
checkup
and Hb% estimation respectively.
IRON & EOLIC ACID TABLETS CONSUMED
Number (%)
100 or more
1 - 100
No tablets
107 (50.71%)
67 (31.75%)
37 (17.54%)
Totally 174 (82.46%) pregnant women consumed Iron and
Fol ic
Acid tablets and 107 (61.49%) of these took 100 or more tablets.
11
PLACE OF DELIVERY
PLACE
Number (7)
Hospital/Heal th Centre
125 (59.242)
Home
44 (20.852)
Private Nursing Home
42 (19.912)
Others
0
DELIVERY ATTENDED BY
Number (2)
Doctors
104 (49.292)
Health Staff
65 (30.812)
Trained dai
6 ( 2.842)
Untrained dai
14 ( 6.642)
Others
22 (10.432)
Delivery was conducted at equipped centres for 167
(79.152)
of the deliveries with doctors attending 104 (62.282) of these .
Dual ified
infants.
personnel conducted the delivery of 175
(82.942)
The 'Others' category refers to a relative staying
home or some one passing by or even no attendants.
0
COMMUNiTY MeAi/n ceu
326, V Main, I Block
amongalci
Bangalore-560034
India
at
INITIATION OF TT IMMUNISATION
MONTHS OF PREGNANCY
3
4
5
6
7
8
9
TT - 1
11(5.82%)
9(4.76%)
64(33.86%)
56(29.63%)
44(23.28%)
5(2.65%)
0
(189)
COMPLETION OF
Totllta?
IMMUNISATION
MONTHS OF PREGNANCY
3
4
5
6
7
8
9
TT - 2 (183)
0
0
12(6.56%)
35(19.13%)
57(31.15%)
58(31.69%)
14(7.65%)
Booster (4)
0
0
1(25.00%)
0
2(50.00%)
1(25.00%)
0
84 (39.81%) of mothers had been Initiated by 5th month, which is usually the period of initiation,
of these were immunised by 6th month indicating a greater than 1 month dosage interval.
Total ro
But only 47(H.
(55.95%)
13
COVERAGE FIBURES II 1/2 to 11 month Inf*nt»>
(Male
Total No. of infants
196
Card available
118 (60.20%)
Not available
78 (39.80%)
88
V.
Female
ANTIGEN
No.(%)
B.C.G
175 (89.29%)
Scar present
165 (84.18%)
DRV 1
166 (84.69%)
OPV 2
143 (72.96%)
OPV 3
113 (57.65%)
DPT 1
166 (84.69%)
DPT 2
143 (72.96%)
DPT 3
113 (56.65%)
Measles
30 (15.31%)
Fully Immunised
26 (13.27%)
Partially immunised upto date
99 (50.51%)
Less than due
66 (33.67%)
5 ( 2.55%)
Not immunised
The
number
108)
of
fully immunised plus
the
number
who
immunised upto date together form 125 (63.78%) of infants.
are
14
IMMUNISATION STATUS OF INFANTS AT THE TIME OF STUDY
Eli g ibi1ity
f or
AGE
Immunisation
6-10weeks 10-14weeks 14weeks
10-12 mnths
TOTAL
Partially immunised
upto date
6(4.80’/)
13(10.40"/) 80(64.00"/) 26(20.80"/)
125
Partially immunised
less than due 4(6.06’/)
6( 9.09’/) 39(59.09"/)
17(25.76"/)
66
1 (20.00’/)
5
Not immunised
0
O
4(80.00"/)
The number of children who were partially immunised due
not receiving B.C.G/DPT/OPV total led 49(25.00'/) .
to
SOURCE OF IMMUNISATION
ANTIGEN
HOSPITAL
HEALTH CENTRE
OUTREACH
PRIVATE
BCG (175)
96 (54.96"/)
43 (24.57"/)
12 ( 6.86"/)
24 (13.71"/)
DPT-1(166)
67 ( 4.36’/)
37 (22.29"/)
14
( 8.43"/)
48 (28.92"/)
DPT-2(143)
52 (36.36"/)
34 (23.77"/)
12 ( 8.39"/)
45 (31.47’/)
DPT-3(113)
38 (33.63’/)
27 (23.89"/)
6 ( 5.31"/)
42 (37.17’/)
OPV-1(166)
67 (40.36"/)
37 (22.29’/)
13
( 7.83’/)
49 (29.52’/)
0PV-2(143)
52 (36.36"/)
34 (23.77"/)
12 ( 8.39"/)
45 (31.47"/)
OF’V-3 (1 13)
38 (33.63’/)
27 (23.89"/)
7 ( 6.19’/)
41
Measles(30)
9 (30.00’/)
5 (16.66’/)
4
12 (40.00’/)
(13.33’/)
(36.28"/)
15
K.A.P OF RELIABLE RESPONDENTS (12-23 month children)
FI (134)
PI
(71)
NI (?)
20
36
9
0
1
5
(28.17)
(50.70)
(12.68)
o
I.
USE OF INJECTION/DROPS
1.
2.
3.
4.
5.
6.
Maintains health
Prevent sickness
Prevent disability
Prevent death
Others
Don't know
II .
DISEASES PREVENTED BY THESE INJECTIONS/DROPS
1.
2.
3.
4.
5.
6.
7.
8.
Pol io
Tubercul osis
Diptheria
Pertussis
Tetanus
Measles
Others
Don't know
III .
22
64
19
13
7
9
76
43
26
18
31
29
17
11
(16.42)
(47.76)
(14.18)
( 9.70)
( 5.22)
( 6.72)
(56.72)
(32.09)
(19.40)
(13.43)
(23.13)
(21.16)
(12.69)
( 8.21)
37
20
8
7
13
11
14
8
( 1.41)
( 7.04)
(52.11)
(28.17)
(11.27)
( 9.86)
(18.31)
(15.49)
(19.71)
(11.27)
1
1
0
1
2
2
1
O
0
1
0
1
2
(20.00)
(20.00)
(20.00)
(40.00)
(40.00)
(20.00)
(20.00)
(20.00)
(40.00)
SOURCE OF IMMUNIZATION SERVICES
74 (55.22)
16 (11.94)
49 (36.57)
37 (52.11)
12 (16.90)
24 (33.80)
1.
2.
3.
Government Hospital
Outreach
Private
IV.
DAY OF AVAILABILITY OF IMMUNIZATION SERVICES
1 .
2.
3.
Any day
Fixed day
Don't know
V.
CORRECT AGE FOR GIVING INJECTIONS/DROPS
1.
2.
3.
4.
OPV
DPT
BCG
Measles
44 (32.84)
87 (64.93)
3 ( 2.24)
92
90
103
79
(68.66)
(67.16)
(76.87)
(58.96)
21 (29.58)
47 (66.20)
3 ( 4.23)
39
38
49
37
(54.99)
(53.52)
(69.01)
(52.11)
3 (60.00)
0
2 (40.00)
2 (40.00)
3 (60.00)
0
2
2
3
1
(40.00)
(40.00)
(60.00)
(20.00)
16
vi.
CORRECT NO. OF DOSES OF INJECTIONS/DROPS
OPV
DPT
BCG
Measlbb
1.
2.
3.
4.
VII .
1.
2.
3.
4.
5.
(73.88)
(72.39)
(76.87)
(57.46)
36
34
47
35
(50.70)
(47.89)
(66.20)
(49.30)
2
2
2
1
(66.42)
(19.40)
( 5.97)
( 5.22)
( 6.72)
49
18
6
0
2
(69.01)
(26.32)
( 8.45)
( 2.82)
2 (40.00)
2 (40.00)
0
0
1 (20.00)
(24.63)
( 4.48)
(29.85)
(21.64)
(11.19)
(31.34)
10 (14.08)
0
27 (38.03)
19 (26.76)
1 ( 1.41)
14 (19.72)
0
1 (20.00)
0
2 (40.00)
0
0
0
2 (40.00)
(40.00)
(40.00)
(40.00)
(20.00)
DECISION MAKER IN THE FAMILY
Mother
Father
Mother-in-1 aw
Father-in-1 aw
Others
VIII .
1 .
2.
3.
4.
5.
6.
7.
99
97
103
77
89
26
8
7
9
SOURCE OF INFORMATION
Health worker
33
Anganawadi worker
6
Medical practitioner 40
Newspaper/Poster
29
Relatives/Neighbours 15
Others
(TV)
42
No information
0
Reliable Respondents of 12-23 month old children who felt that
Antigens
prevented
sickness
numbered
101
16 (7.62’Z)
did not know their utility.
Awareness
of Vaccine preventable diseases
pol io
(48.10’Z) ,
was
maximum
whi 1 e
for
(54.762) and least for Pertussis (11.902). 21 (10.002)
did not know any of the diseases prevented by Vaccine.
The commonest source of immunisation services was
Government
Hospital or Health centre for 114 (52.292) of respondents and
was available on a fixed day, 137 (65.242).
17
age and number of doce was
highest
(73.81% 8< 72.38% respectively).
It was
The knowledge of correct
with regard
to
BCG
lowest for Measles
(55.71% & 53.81% respectively).
The decision to immunise 140 (66.66%) of the infants was taken
by the mother herself and the
commonest source of information
was the Medical Practitioner (32.86%).
K.A.P
OF RELIABLE RESPONDENTS (0-12 MONTHS CHILDREN)
I .
USE
OF INJECTION/DROPS
1 .
2.
3.
4.
5.
6.
Maintains health
Prevent sickness
Prevents disability
Prevents death
Others
Don't know
11 .
DISEASES PREVENTED BY THESE INJECTIONS/DROPS
1 .
2.
3.
4.
5.
6.
7.
8.
Pol io
Tuberculosis
Diptheria
Pertussis
Tetanus
Measles
Others
Don't know
III .
SOURCE OF IMMUNISATION SERVICES
1 .
2.
3.
Government Hospital
Outreach
Private
FI (187)
32
84
14
16
21
20
74
41
23
11
46
47
22
30
(17.11)
(44.92)
( 7.49)
( 8.56)
(11.23)
(10.70)
(39.57)
(21.93)
(12.30)
( 5.88)
(24.60)
(25.13)
(11.76)
(16.04)
96 (51.34)
25 (13.37)
69 (36.90)
NI (14)
PI (10)
2
4
1
0
2
1
(20.00)
(40.00)
(10.00)
(20.00)
(10.00)
3
6
2
0
0
3
(21.43)
(42.86)
(14.29)
(21.43)
5 (50.00)
2 (20.00)
2 (20.00)
2 (20.00)
4 (40.00)
3 (30.00)
2 (20.00)
1 (10.00)
6 (42.86)
3 (21.43)
0
2 (14.29)
3 (21.43)
4 (28.57)
2 (14.29)
2 (14.29)
5 (50.00)
0
4 (40.00)
7 (50.00)
2 (14.29)
3 (21.43)
It
IV.
DAY OF AVAILABILITY OF IMMUNISATION SERVICES
1.
2^
3.
Any day
Fixed day
Don't know
V.
CORRECT AGE FOR GIVING INJECTION/DROPS
1 .
2.
3.
4.
OPV
DPT
BCG
Measles
VI .
CORRECT DOSE OF INJECTION/DROPS
1 .
2.
3.
4.
OPV
DPT
BCG
Measles
VII .
DECISION MAKER IN THE FAMILY
Mother
Father
Mother-in-law
Father-in-1 aw
Others
1 .
2.
3.
4.
5.
VIII .
63 (33.69)
118 (63.10)
6 ( 3.21)
117
108
140
102
107
101
132
96
3 (30.00)
7 (70.00)
0
3 (21.43)
10(71.43)
1 ( 7.14)
6
6
7
5
(60.00)
(60.00)
(70.00)
(50.00)
8
7
9
5
(57.14)
(50.00)
(64.29)
(35.71)
5
5
7
5
(50.00)
(50.00)
(70.00)
(50.00)
8
6
9
4
(57.14)
(42.86)
(64.29)
(28.57)
(57.14)
(28.57)
(28.57)
(62.57)
(57.75)
(74.87)
(54.55)
(57.22)
(54.01)
(75.59)
(51.34)
98
39
9
11
32
(52.41)
(20.86)
( 4.81)
( 5.88)
(17.11)
7 (70.00)
2 (20.00)
0
0
1 (1O.OO)
8
4
4
0
1
( 7.14)
39
21
52
28
14
29
6
(20.86)
(11.23)
(27.81)
(14.97)
( 7.49)
(15.51)
( 3.21)
3
2
3
2
2
1
1
(30.00)
(20.00)
(30.00)
(20.00)
(20.00)
(10.00)
(10.00)
3
2
1
2
3
1
3
(31.43)
(14.29)
( 7.14)
(14.29)
(21.43)
( 7.14)
(21.43)
186
169
17
0
1
(99.47)
(90.37)
( 9.09)
8
6
3
1
0
(80.00)
(60.00)
(30.00)
(10.00)
13(92.86)
6 (42.86)
6 (42.86)
1 ( 7.14)
1 ( 7.14)
SOURCE OF INFORMATION
1 .
2.
3.
4.
5.
6.
7.
Health worker
Anganawadi worker
Medical Practitioner
Newspaper/Poster
Relatives/Neighbour
Others (TV)
No information
IX.
INTENTION
1 .
2.
3.
4.
5.
Yes
Al ready started
Completed
No
Others
( 0.53)
19
Reliable
reBpondentB of 0-12 month® old infant® who
stated
that the antigens prevented sickness numbered 94 (44.552),
while
16 ( 7.622) did not know their utility.
Awareness
of vaccine preventable diseases was
polio (40.282) and least for pertussis ( 7.112).
maximum
for
33 (15.142) did
not know any of the diseases prevented.
The commonest mentioned source of immunisation services
Government
Hospital
or
Heal th
Centre
for
108
(51.182)
was
of
respondents and was available on a fixed day, 135 (63.982).
The knowledge of correct age and number of doses was highest
with regard to BCG (73.932 & 70.142 respectively).
It was lowest
for Measles
(53.082 & 49.762 respectively).
The
decision to
immunise
113 (53.552) of the
infants was
mother
herself
and
source
of
expressed
the
taken
by
the
information was Medical
Of
intention
the
211
Practitioner
pregnant women,
the
commonest
(26.662).
207
(98.102)
to immunise the child, while 2 (0.952) did not
to get their child immunised.
intend
20
LAMENESS SURVEY
No .of
0
10,209
year old children
5
No.of Lame children
9
Cause of Lameness
No. (’Z)
Poliomyelit is
4 (44.44’Z)
Trauma
o
Congenital
3 (33.33Z)
Others (IBM)
2 (22.22’Z)
Lameness due to Pol io
4
Rate/1000 children
0.39
AGE & SEX DISTRIBUTION OF POLIO LAME CHILDREN
MALE
FEMALE
TOTAL
6 weeks
0
0
0
14 week s
0
0
0
0
0
0
0
1
1
2 years
1
0
1
3 years
0
1
1
4 years
1
0
1
5 years
0
0
0
2(50.00%)
2 (50.00%)
4
0
7
15 week s
7
6 months
12 months
Total
:
21
IMMUNISATION
STATUS
QF POLIO LAME CHILPREN
OF ATTACK
TIME
MALE
FEMALE
Nil
2
1
3 (75.00%)
1st dose only
0
0
0
2nd dose
0
1
1 (25.007.)
3rd dose
0
0
0
Booster
0
0
O
TOTAL
PROVOCATIVE POLIOMYELITIS
History o-f provocation
Number (%)
Yes
0
No
4
POLIO
OTHERS
TOTAL
Mai e
Female
Mai e
Female
6 weeks
0
1
2
1
4(44.447)
7 weeks 12 months
0
0
2
0
2(22.227)
2 years
2
0
O
0
2(22.227)
3 years
0
1
0
0
1(11 .117)
4 years
0
0
O
0
O
5 years
O
0
0
O
O
0
community health cat
326, V Main, I Block
Korininngaia
fiangaiore-560034
India
22
CALENDER YEAR OF SURVEY
Number (%)
1990
2 (50.00%)
1989
1 (25.00%)
1988
1 (25.00%)
1987
1988
NEONATAL TETANUS SURVEY
No.of live births in last one year
No.of Neonatal
deaths-Male 6, Femal e-6
No.of Neonatal
deaths due to Tetanus
Neonatal
death
2334
13
2 (Male-1, Female -1)
rate
— 5.56/1000 live births
Neonatal Tetanus rate
- 0.86/1000 live births
BIRTH attendants for nnt only
Number (%)
Health staff
Trained dai
Untrained dai
Family members
Others
None
0
0
0
2 (100.00%)
0
0
PLACE OF DELIVERY & N.N.T
Hospital/Heal th Centre
Home
Others
0
2 (100.00%)
0
MEDICAL CARE AT SICKNESS
Time interval
more than 1 day
Govt. Institution
‘N.G.O/Private Institution
Unqualified practioner
No treatment
1
0
0
1
IMMUNISATION STATUS OF MOTHERS
Not Immunised
1st dose
2nd dose
Booster dose
1 (50.00%)
0
1 (50.00%)
0
24
I.
CDMPAR SON QF CDVERAQE FICURES WITH REPORTED PERFORMANCE
S
B.C.G
OPV 3
DPT 3
Measl es
9
69-90
91.90%
81.90%
81.90%
66.66%
122.02%
96.79%
96.76%
66.68%
The coverage figures agree with reported performance only in
case
of measles,
Over-reporting is seen with respect
to
other
BANGALORE (URBAN)
WITH
antigens, especially B.C.G.
II .
COMPARISON OF COVERAGE FIGURES OF
BANGALORE (RURAL) DISTRICT.
CES-BANGALORE(URBAN)-91
B.C.G
OPV 3
DPT 3
Measl es
III. COMPARISON
REPORT
B.C.G
OPV 3
DPT 3
Measl es
CES-BANGALORE(RURAL) -91
91.90%
81.90%
81.90%
66.66%
BE
COVERAGE
87.62%
70.48%
70.00%
55.24%
FIGURES
WITH
PREVIOUS
CES 91
CES 89
91 .90-Z
81.90%
81.90%
66.66%
90.48%
88.33%
88.33%
70.71%
COVERAGE
24
IV.
COMPARISON OF LAMENESS AND NEONATAL TETANUS SURVEY
WITH BAN6ALQRE (RURAL) DISTRICT SURVEY z
»
RESULTS
Bangalore(Urban)
Bangalore(Rural )
Pol io Lameness/1000 0-5
year old children
0.39
1 .35
Neonatal Tetanus Rate/1000
1 ive births
0.86
0.93
V.
COMPARISON QF LAMENESS AND NEONATAL TETANUS SURVEY
WITH PREVIOUS SURVEY RESULTS
RESULTS
1991
1989
Pol io Lameness/1000 0-5
year old children
0.39
0.43
Neonatal Tetanus Rate/1000
1 ive births
0.86
N.A
25
SUMMARY
CHILD COVERAGE SURVEY (>2 z 23
months eh i1dren)
1.
Fully immunised children formed 63.812 of the
covered and 2.382 were not immunised.
210
2.
Hospital and private sources were the major source
antigens.
ch i1dren
for
al 1
3.
Among the reasons for immunisation failure 'mother being too
busy7 and 'child ill , not taken for immunisation7 were prominent-
4.
Initiation of immunisation was as per the recommended
schedule in 72.862 to 79.792 of children, Completion within the
recommended period was achieved in 95.712 of fully immunised
chi 1dren.
5.
Overal1 drop out rate was 14.002 and 14.002 respectively for
DPT & OPV.
6.
There is a significant improvement in coverage
compared to Bangal ore (rural ) District survey 1991.
iigures
7.
Comparison with reported coverage during the
shows agreement for measles antigen only.
same
as
period
8.
Knowledge of Diseases prevented by immunisation was low,
while the place (Mostly health centre) and time of immunisation
(mostly fixed day) was known to a majority of respondents.
The
decision to immunise was mostly made by the mother.
MOTHER COVERAGE i
1.
A low card availability (56.872), 88.632 fully immunised,
6.632 not immunised with a 4.742 partially immunised are the
prominent features.
2.
Hospitals and private sources were the leading
immunisation
with
private
sources
accounting
immunisation than hospitals.
sources
for
of
i
more
3.
(72.51’Z) received the minimum of 3
women (72.512)
only about 22.282 to 49.762 of them had
the basic examinations (Hb2 estimation, Urine examination and B.P
check-up) 3 times.
0-f the 21 1 pregnant
antenatal contacts while
4.
50.712 of the pregnant mothers consumed the requisite
minimum of hundred iron and folic acid tablets, 17.542 did not
receive any tablets.
26
5.
The usual place of delivery was Hospital/Heal th Centre
(59.247.) and it was usually attended by Doctors and Health Staff
(BO.107).
6.
By the 7th month 184 (87.247) of the 211 pregnant women were
given TT-1 and by 8th month 166 (78.677) had
been given
2nd/Booster dose.
INFANT COVERAGE j.
1 .
196 infants of the 211 pregnant women within the age
of 1 1/2 to 11 months were covered.
2.
group
Card availability was 60.20"Z.
3.
Taking the earliest recommended time of initiation as the
criteria 99 (50.517) of the partially immunised infants were
upto-date immunised 26 (13.277) were fully immunised.
4.
The source of immunisation was mostly either the Hospital or
private sources for all the antigens.
5.
Respondents of about 157 of infants were ignorant of the use
of injection/drops, while knowledge of diseases prevented was
incompl ete.
Government Hospital was the commonest source cited
and a fixed day of availability was widely known, Knowledge of
the correct age and correct number of doses of antigens was
present in about 507 of the respondents. Aided by information
mostly from the Medical Practitioner the mother was the usual
decider with regard to immunisation.
LAMENESS SURVEY 8
1 .
The No. of 0 - 5 year old children enumerated
with 9 of them being lame.
was
10,209
2.
pol io was found
-found in 4 (44.447)
Lameness due to polio
lameness rate was 0.39/1000 0-5 year old children.
and
pol io
7m
4
Pol io lame children were mostly in the age group
3.
Polio
years with the usual age of onset being 2-3 years.
4.
Only
Onl y one of the polio lame children had received 0PV(2
i
doses) at the time of attack, History of provocation was not
found in any child.
NEONATAL TETANUS SURVEY jl
1 .
Total number of live births enumerated for last one year was
found to be 2334.
2.
Neonatal death occured in 13 neonates, out of which 2
due to neonatal tetanus (N.N.T rate 0.86/1000 live births).
were
3.
Both N.N.T ideaths occured during home delivery by Fami1y
members with one mother being fully immunised and other not
immunised.
One neonate did receive treatment, but after 1 day
of onset illness.
27
RECOMMENDATIONS
1.
It is essential to stress to the Health Workers the need to
distribute cards to all beneficiaries including pregnant mothers.
2.
It is essential to improve outreach activities to
coverage to desired levels.
increase
3.
A simultaneous effort
to
increase
health
education
activities and research,to elicit reasons for law utilisation of
available services is needed to improve Antenatal care.
4.
It is essential to involve private practitioners to
coverage and in health education of the community.
improve
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