ABSTRACT
BACKGROUND: The aim of this study is to assess the childhood immunization uptake and its determinants among the internal migrant population living in nonnotified slums of Hyderabad City, India. METHODOLOGY: This is a cross-sectional study of 768 rural-urban migrant mothers with a child under 2 years of age residing for period minimum of 30 days, but not more than 10 years. Data were collected for sociodemographic details, health-seeking behavior, antenatal, postnatal services, and reception of vaccines appropriate for age. RESULTS: Full immunization coverage among the children of migrants was same as the general population of the State of Telangana (66.7%). The likelihood of child's reception of full immunization decreases with age of the mother and rose with the attainment of higher education. The head of household of salaried class, expectant mothers utilizing antenatal services, and the visit of postnatal health worker for counseling of expectant mothers, were significantly associated with reception of full immunization. Immunization coverage rates of children of 12-23 months age is lower than the general population of Telangana. The frequency of visits by health worker is low. CONCLUSION: Immunization uptake among the migrants and vulnerable segments of the population can be increased by locating new settlements, improving utilization of services and capacity building of health staff.
ABSTRACT
BACKGROUND: Delivery of maternal health care services is a major challenge to the health system in developing countries. Provision of antenatal care (ANC) services is the major function of public health delivery system in India to improve maternal health outcomes and its impact on maternal morbidity and mortality. Studies are lack in documenting variation in utilization of ANC services between geographical regions of Andhra Pradesh (AP). OBJECTIVE: The objective of this study is to assess variation in utilization of ANC services stratified by geographical region, type of delivery and determinants of utilization of ANC services in AP. METHODOLOGY: It is a cross-sectional study of District Level Household and Facility Survey-4 of the state of AP. Multistage, stratified and probability proportional to size sample with replacement was used. Around 3982 women who delivered after the year 2007 were considered for analysis. Binomial logistic regression was carried out to determine association of demographic, system level variables with adequate ANC. RESULTS: Study reveals wide variation across four regions of AP in utilization of ANC services. Reception of adequate ANC was low in Rayalaseema region (27.9%) and high in North-coastal region (42.4%). The utilization of private health facilities for ANC services were highest in South-coastal region (73.2%) and lowest in North-coastal region (43.2%). CONCLUSION: Policy measures are to be adopted and implemented by government to address the demand-supply imbalance such as public health infrastructure and quality of services in underperforming districts of AP and to increase outreach of current programs by engaging communities.
