ABSTRACT
Background: Immunization prevents approximately 4 lakh under-five deaths from vaccine preventable diseases in India. Immunization is a proven cost-effective and relatively inexpensive public health intervention for improving child survival. Under the national immunization program infants are immunized against 7 vaccine preventable disease namely diphtheria, pertussis, tetanus, polio, hepatitis B, tuberculosis and measles. In India, inequity in the coverage of immunization persists within and between states, emphasizing the continuing need of coverage assessment surveys with a focus on quality of the health service. Aims & Objective: (1) To assess the primary immunization coverage of children aged 12-23 months; and (2) To know the reasons for partially or not immunizing the child. Materials and Methods: This was a cross sectional study. The method was adapted from WHO 30 cluster sampling, a two stage sampling technique involving a random selection of clusters based on probability proportional to size and then a random selection of households in the selected clusters. Mothers of the children were interviewed using a pretested and semi- structured questionnaire. Results: Out Of the 210 surveyed children, 104 (49.5%) were males and 106 (50.5%) were females. Coverage was highest for BCG (100%) followed by DPT1 (99.5%), DPT3 (95.7%) and lowest for Measles (93.8%). As far as the dropout rate is concerned, it was 3.83% for both DPT1 to DPT3, 3.38% for OPV1 to OPV3, 4.83% for HEP1 to HEP3 and 6.19% for both BCG to measles and 5.74% for DPT1 to Measles. Amongst the various reasons main reasons for dropout or non-immunization of children were the lack of awareness about the need for immunization in 38.70% and unawareness of the need to return for 2nd or 3rd doses in 25.58%. Conclusion: Improvement should focus on reducing the dropout rate from DPT1/OPV1/HepB1 to DPT3/OPV3/HepB3 and improving coverage of measles and also Vitamin A.
ABSTRACT
Background: Young age at pregnancy carries significant risk for the mother and baby, adding to the burden of maternal and child mortality. Aims & Objective: (1) To study the socio-demographic factors influencing adolescent pregnancy; (2) To take an account of the awareness among women about the right age for child-bearing. Materials and Methods: A hospital-based study was undertaken during September to December 2013 among mothers attending the antenatal clinic, in Mc Gann Hospital, Shimoga. The study group comprised of 214 mothers aged 15–18 years. Data was collected about the socio-demographic variables, tabulated on Microsoft Excel spreadsheet and analysed using EpiInfo application. Results: All women were married. The mean age at marriage was 17.4 years, and mean interval between marriage and conception was 1 year. All were primigravids. 185 (86%) women were 18 years old and 29 (14%) were 17 years old. 15 (7%) women were married at 16 years, 92 (43%) at 17 years and 107 (50%) at 18 years. Non-consanguineous marriages were 122 (57%), while 92 (43%) were consanguineous. 172 (80%) women were Hindu, 34 (16%) were Muslim and 8 (4%) were Christian. 107 (51%) women belonged to socio-economic Class V, 22 (10%) to Class IV, and 37 (18%), 24 (11%) and 21 (10%) to classes III, II and I respectively. 75 (35%) women discontinued education after 10th standard and 100 (47%) before 10th standard. 39 (18%) studied up to the Pre-University course. Reasons cited were marriage by 41 (19%), poverty by 62 (29%) and 111 (52%) for disinterest. Among the husbands, 4 (2%) had never been to a school, 131 (61%) studied up to 9th standard, 60 (28%) quit after 10th standard and 19 (9%) studied beyond 10th standard, which included 4 graduates. 77 (36%) women were of first birth order of their mothers, while 80 (37%) of birth order 2. Anemia was detected in 128 (60%), 7 had bronchial asthma and 3 had congenital cardiac valve diseases. 17-19 years was the common age at pregnancy in the community and families of 188 (88%) women. 26 (12%) women said that the common age at first pregnancy was above 20 years in their community. 60 (28%) were forced into wedlock. 17 (8%) admitted were facing domestic pressure. 167 (78%) preferred to have the first child delivered before 19 years, 26 (12%) said after 20 years of age and 21 (10%) after 22 years. 126 (59%) women said early pregnancy is good, 56 (26%) took the opposite stand and 31 (15%) women were indifferent. 205 (96%) women were aware about contraception, but practice was zero. None had received sex education. Conclusion: Observations throw light on the fact that knowledge about the risks involved in adolescent pregnancy is lacking among the adolescent mothers. Contraception is not being practised. Also, the average educated and adequately aware women, were falling preys to poverty, traditions and domestic pressure, when it came to deciding the right age for child-bearing.