An effective and doable interventional strategy to enhance vaccination coverage - are we ready to change?

OBJECTIVE: To evaluate the effect of patient reminder calls on improvement of routine vaccination coverage. METHODS: This prospective, interventional study was conducted at Rawal Institute of Health Sciences, Islamabad, Pakistan, from December 2014 to August 2016, and comprised babies enrolled at the time of 1st vaccination. Babies who were given bacillus Calmette-Guérin, oral polio vaccine were included. Mobile phone numbers of parents were noted. The 1st reminder call was given after 7 days if a baby did not report on the scheduled date. Similarly, 2nd and 3rd reminder calls were made after waiting for 7 days each time in case of non-reporting. Record of reporting and reminder calls was reviewed daily till all the enrolled babies crossed 15 months of age (scheduled time for 2nd dose of measles) plus 4 weeks. RESULTS: A total of 150 babies were enrolled at the time of 1st vaccination. Reporting without call within 01 week of scheduled date ranged from 52(34.66%) to 99(66%) for different vaccines. The 1st reminder call showed maximum improvement in reporting rate. The range of vaccination rate reached from 91(60.66%) to 132(88%). The 2nd call improved coverage rate range from 108(71.99%) to 140(93.33%). The 3rd call improved coverage rate from 113(75.32%) to 144(96%). Overall coverage rate achieved ranged from 112.5(75%) to 144(96%). CONCLUSIONS: Patient reminder calls showed significant effect in improvement of vaccination coverage rate of all antigens.

Reasons for failure of exclusive breastfeeding in children less than six months of age.

BACKGROUND: Human milk is the natural food for full term infants and is the most appropriate milk for the human infants. The objective of the study was to determine the frequency of common reasons of failure of exclusive breastfeeding in children less than six months of age. METHODS: It was a cross-sectional study conducted at Rawal institute of health sciences (RIHS) from March to October 2013. Three hundred and ten infant-mother pairs not receiving exclusive breastfeeding were included. RESULTS: The mean infants' age was 99.2 +/- 57.9 days and 185 (59.7%) were male infants. The average number of children in the family was 2.74 +/- 1.86, the mean monthly income was 16,542 +/- 12,761 rupees: 169 (54.5%) infants belonged to urban areas, 122 (39.3%) babies were low birth weight: 241 (77.7%) infants were born in the hospital; majority. i.e.. 135 (43.5%) mothers were illiterate majority, i.e.. 282 (91%) mothers were housewives. In only 2 (0.6%) babies the breast feeding was started within < 1 hour after birth. Among the study group 246 (79.4%) were partially breastfed and 64 (20.6%) were completely bottle-fed, 90 (29%) were already started on complementary feeding and the mean age of starting complementary feeding was 4.54 +/- 0.783 months. The commonest reason of failure of exclusive breastfeeding was insufficient milk production in 289 (93.2%), working mother in 13 (4.2%) mothers, illness of baby in 2 (0.65%), illness of mother in 6 (1.9%) cases. CONCLUSION: The commonest reason of failure of exclusive breastfeeding was insufficient milk production in over 90% cases and was followed by working mother, illness of baby and illness of mother in the remaining.