Contextual Narratives Associated With Immunization Services During COVID-19 Disease Outbreak in Chennai, Tamil Nadu

Background: Essential health services including immunization were significantly impacted due to COVID-19 with devastating outcomes in low- and middle-income countries (LMIC). The disruption in immunization services due to global pandemic and measures undertaken at regional levels to overcome need to be studied as pandemic preparedness strategy. Objective: To document the contextual narratives related to immunization services during the Covid-19 disease outbreakby interviewing qualified paediatricians in the field practice area of private tertiary care teaching medical college Methodology: In-depth phone-based interviews were conducted with paediatricians in diverse settings during November 2020 to March 2021. Reflexive thematic analysis was performed, major themes identi-fied, and case studies documented. Results: Paediatricians shared rich experiences related to immunization services impacted due to COVID-19 especially during the earlier months due to imposition of lockdowns leading to discontinua-tion, disruption of services, decrease in volume of immunizations, modest transition to telehealth ser-vice delivery, facility-level changes brought in to ensure immunization services and capacity building measures for upskilling. Conclusions: Contextual narratives revealed in this study provide rich narrative about the disruption of immunization services due to COVID-19. These findings need to be understood and leveraged to be fu-ture ready and prevent further disruptions by identifying and scaling up key solutions piloted in this study.

Client satisfaction with immunization services in urban slums of Lucknow District.

Objective. To assess the satisfaction of parents with the immunization services and its association with their sociodemographic characteristics. Methods. The study was a part of the coverage evaluation survey conducted using the WHO 30 cluster sampling methodology in the Urban slums of Lucknow district, north India. Analysis for a total of 388 respondents of completely or partially immunized children, was done to assess the level of satisfaction and its determinants. Results.The overall satisfaction was more than 90% in the respondents of both the categories of the children, however the difference between the satisfaction rates was found to be significant. Also the satisfaction with accessibility (p<0.04) and information given by the health worker (p<0.00) differed significantly between completely and partially immunized. Most of the sociodemographic factors were not found to have a significant association with the satisfaction related to different parameters of the immunization services. Conclusion. The dissatisfaction regarding the various aspects of immunization services emphasizes the imperative need to intervene, for the achieving the goal of universal immunization.