Report of an immunisation coverage survey in tamil nadu

By JSA/ Makkal Nala Vazhvu Iyakkam

1. REPORT OF AN IMMUNISATION
COVERAGE SURVEY IN TAMIL NADU
Makkal Nalavazhvu Iyakkam & CHAD,
CMC Vellore

2. •Immunizations are the single most cost-
effective public health intervention.
• Universal childhood immunization has been
accepted by world public health leaders as
both an affordable and cost effective strategy
not only for child survival but also for
promoting primary health care.

3. • In India, the UIP was launched in 1985-86 to
extend immunization coverage among the
eligible children and to improve the quality of
services. The target now is to achieve 100 per
cent immunization coverage.

4. Immunization coverage in Tamil Nadu
according to DLHS 3(2007-2008)
Fully immunized 83.2%
BCG 99.6%
MEASLES 97.6%
DPT3 88.9%

5. •Though this is the picture on paper there are
many differences in the field reality in Tamil
Nadu.
•A major change happened when
immunizations were moved from the village
sub center level to the primary health centre
following the untoward incident of death of
two children following measles vaccination.

6. •The civil society in Tamil Nadu was
increasingly concerned about this and also felt
a need to evaluate the true immunization
scenario in the state at the field level. This
study was conducted by a non-governmental
organization in association with its network
partners

7. •The objectives of the current study were to
evaluate the immunization coverage of
children in Tamil Nadu state and to make
recommendations regarding strengthening of
immunization services based on the study
findings

8. •Ten districts in Tamil Nadu were selected
randomly. In each district 30 villages were
selected by a random process. In each village
14 children were selected-7 between age
group 6months to 11months and another 7
between age group 12 months to 17 months.

9. •Field workers received training on the
sampling procedure and information
collection. Information regarding the receipt
of BCG vaccine, three doses of OPV and DPT
and one dose of measles vaccine were
collected from the mothers of the selected
children.

10. •Among a total of 4096 children, data was
incomplete for 589 children(14.4%). These
children were not included in the primary
analysis.

11. NAME OF
DISTRICT
No. of children
aged 6-11
Months
No. of children
aged 12-17
months
Total
Dindikkal 210 190 400
Kanyakumari 113 110 223
Kovai thiruppur199 206 405
Krishnagiri 170 162 332
Nammakkal 143 115 258
Nilagiri 157 172 329
Perambalore 207 198 405
Theni 213 199 412
Dharmapuri 49 57 106
Thiruchi 109 119 228
Vellore 209 199 408
Total 1780 1727 3507

12. Sex 6-11months old12-17months oldTotal
Male 849(50.1%) 791(51.8%) 1640(50.9%)
Female 891(47.7%) 894(45.8%) 1786(46.8%)
Data missing 40(2.4%) 41(2.4%) 81(2.3%)
Total 1780 1727 3507

13. Vaccine 6-11 months12-17 monthsTotal
coverage
BCG 1775(99.7%)1721(99.7%)3496(99.7%)
DPT 1 1767(99.3%)1719(99.5%)3486(99.4%)
DPT 2 1751(98.4%)1689(98.3%)3449(98.3%)
DPT 3 1678(94.3%)1642(95.1%)3320(94.7%)
POLIO 1729(97.1%)1683(97.5%)3412(97.3%)
MEASLES - 1505(87.1%)

14. Proportion of children immunised
from Private
BCG 7.4%
OPV 5.1%
DPT 1 5.9%
DPT 2 6.06%
DPT 3 6.29%
Measles 5.59%

15. NAME OF DISTRICT Proportion of children immunised from
private
Dindikkal 4.72%
Kanyakumari 29.2%
Kovai thiruppur 2.31%
Krishnagiri 2.19%
Nammakkal 1.4%
Nilagiri 3.79%
Perambalore 5.59%
Theni 1.46%
Dharmapuri
Thiruchi 5.14%
Vellore 11.95%
Total 5.59%

16. Mean(Rs) Confidence intervalMedian(Rs)
Travel 31.9 26.2-37.6 7
Food 18.58 16.5-20.6 0
Wages lost 56.92 53.6-60.2 0
others 60.6 2.12-119.06 0
total 168.01 108.68-227.45 58

17. MEAN AMOUNT
SPENT(IN Rs)
CONFIDENCE
INTERVAL
MEDIAN AMOUNT
DHARMAPURI 52.2 47.3-57.2 55
DHINDIKAL 385.9 245.3-526.4 425
KANIYAKUMARI 179.5 138.8-220.2 30
KOVAI 223.6 211.5-235.6 211
KRISHNAGIRI 76 65.9-86.0 60
NAMAKKAL 184.9 176.7-193.1 170
NILAGIRI 191.2 172.6-211.2 220
PERAMBALORE 67.3 48.4-86.1 7
THENI 2.99 2.47-3.4 0
THIRUCHI 708.6 39-1377.5 55
VELLORE 162.8 143.3-182.3 120

18. •The total BCG immunization coverage according
to the current study is 99.70%.
•The coverage in Tamil Nadu according to the
NFHS 3 is 99.5% while according to DLHS 3 the
coverage is 99.6%.
• BCG mark was not present among 1.9% of
children among 6-11 months and 3.1% of
children among 12-17 months.
• 92.4% has reported to have got BCG from
Government facilities.

19. •Overall DPT 1, DPT 2 and DPT 3 coverage is
99.40%, 98.30% and 94,7% respectively.
•DPT 3 coverage in NFHS 3 is 95.7% while
according to DLHS 3 is only 88.9%

20. •97.3% of children have received 3 doses of
OPV.
• The coverage of measles vaccine among
children 12 -17 months in this survey is
87.1%which appears to be much lower than
Measles vaccine coverage of Tamil Nadu
according to NFHS 3(12-23months) which is
92.5% and DLHS 3 which is 97.6%.

22. •67.2% of mothers want their children to be
immunized at the village itself, while others said
that they want their children to be immunized in
PHCs.
• Even though around 5% are getting immunized
from private sector, only 0.6% of them want to
get immunized from there.
•It appears that they are forced to get immunized
from private sector for various reasons.
Qualitative analysis of this issue is needed before
commenting more.

23. •The immunization coverage of Tamil Nadu
obtained from this survey is almost similar to
the results obtained from other surveys like
NFHS3 and DLHS3 except for low
immunization coverage for measles vaccine.
•Actions are needed for improving DPT3 and
measles vaccine coverage in the state.

24. •Certain low performing districts needs
focused activities.
•Around 5% of the families depend on the
private sector for immunizing children.
• Two out of three mothers wish to immunize
their children in the village level itself.
•The indirect amount they spent for
immunizing children is not at all ignorable