Provider’s and User’s Perspective about Immunization Coverage among Migratory and Non-migratory Population in Slums and Construction Sites of Chandigarh

Abstract

Strengthening routine immunization is a corner stone for countries to achieve the United Nations Millennium Development Goal 4 (MDG 4) which aims to reduce under-five mortality by two-thirds and MDG 5 improving maternal health compared to 1990 estimates by 2015. The poor urban newborns are more vulnerable to many health and nutrition problems compared to the non-poor urban counterparts. Therefore there is a need to strengthen health system to cater the needs of urban poor. Standardized WHO30*7 cluster sampling for slums and convenience sampling for construction sites. In depth interviews were conducted for user’s as well as provider’s perspective about immunization coverage. Two hundred ten children and 210 mothers were enrolled in slums and 100 were sampled from construction sites. The slum workers are considered as non-migratory groups whereas construction site workers are considered as migratory population. Among children, 23 % were fully immunized, 73 % were partially immunized and 3 % were unimmunized in non-migratory population whereas 3 % were fully immunized, 91 % were partially immunized and 6 % were unimmunized in migratory population. Among mothers, 43 and 39 % were fully immunized, 13 and 15 % partially immunized and 43 and 46 % were unimmunized in non-migratory and migratory population, respectively. The various reasons attributed for low coverage are (a) dissatisfaction of the users with the service delivery and procedural delays (bureaucracy), (b) lack of faith in health workers, (c) insistence upon ID/vaccination card/aadhar card by the health worker before vaccinating child and (d) ignorance of the need of immunization by the people and migration of the population.