Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION
DR.HARIVANSH CHOPRAMD.,DCH
PROFESSORCOMMUNITY MEDICINE
LLRM MEDICAL COLLEGE, MEERUT
Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION
1. How many of you are involved in routine
immunization?
Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION
1. How many of you are trained in routine
immunization?
Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION
1. How many of you have read some special manual on immunization?.
Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION
1. Is the problems faced by the multipurpose
Workers and faced by you and me are
Similar or different?
Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION DIFFERENT
PROBLEMS
IN
DIFFERENT
SETTINGS
ETTINGS
Dr. Harivansh Chopra
DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION
1. OPERATIONAL
2. SKILL BASED
3. KNOWLEDGE
4. AEFI
Dr. Harivansh Chopra
OPERATIONAL PROBLEMS1. CONVEYANCE
2. VACCINE AVAILABILITY
3. STORAGE
4. A/D SYRINGE
Dr. Harivansh Chopra
OPERATIONAL PROBLEMS1. CONVEYANCE
2. VACCINE AVAILABILITY
3. STORAGE
4. A/D SYRINGE
Dr. Harivansh Chopra
KNOWLEDGE BASED PROBLEMS
• WRONG VACCINE ADMINISTRATION
• SIMILAR NAMES DIFFERENT AGES
Dr. Harivansh Chopra
AEFI• Emergency kit should provided to resuscitate the child in
case of life threatening reactions.• Supervised training for skill development to prevent and to
manage AEFI• Educate the mother about the possibilities and the
precautions to take in case of AEFI• Both clinical and PR skills development
Dr. Harivansh Chopra
SOLUTION
ALL OF THE ABOVE MENTIONED PROBLEMS CAN BE SOLVED BY1 PROPER LIASIONING WITH THE HEALTH SYSTEM.PUTTING MEDICAL COLLEGES IN THE DISTRICT ACTION PLAN UNDER NRHM.
2. TRAINING AND RETRAINING OF POST GRADUATES /FACULTY IN ROUTINE IMMUNIZATION.
Dr. Harivansh Chopra
CONCLUSIONACTION WITOUT KNOWLEDGE IS
USELESS AND KNOWLEDGE WITOUT ACTION IS FUTILE.SO LET US JOIN HANDS TO
TAKE ACTION…….
Dr. Harivansh Chopra
ALWAYS AT UHC INITIALLY SOME-WHERE ELSE, NOW
AT UHC
ANYWHERE0
50
100
150
200
250
300
350
347
47
0
NU
MB
ER
ALWAYS AT UHC INITIALLY SOMEWHERE ELSE, NOW AT UHC
ANYWHERE
0
10
20
30
40
50
60
70
80
90
88
12
0
PE
RC
EN
TA
GE
(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)
Dr. Harivansh Chopra
45.90%
53.10%
FREE OF COST ?
82.60%
17.40%
PROXIMITY OF CENTRE ?
NO
NO
YES
YES
(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)
Dr. Harivansh Chopra
80.40%
19.60%
EXPERT HANDS?
82.70%
12.30%
MINIMUM SIDE EFFECTS ?
YES YES
NONO
(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)
Dr. Harivansh Chopra
83.90%
16.10%
PUNCTUALITY ?
66.10%
33.90%
PROPER SITTING ARRANGEMENT ?
YES YES
NO NO
(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)
Dr. Harivansh Chopra
80.90%
19.10%
EXPERT GUIDENCE ?
79.10%
20.90%
PROPER BABY CARE TIPS ?
YES YES
NO NO
(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)
Dr. Harivansh Chopra
Timely and punctual immunisation sessions are carried out by post graduate students and interns every Wednesday under expert guidance of senior faculty.
89%
11%
CARRIED OUT
MISSED**
** All the 11% sessions missed were due to national/gazetted holidays.
Dr. Harivansh Chopra
• Community meetings of all pregnant females and mothers to educate them the importance of immunisation, family planning, proper infant care – in past three years more than 30 such meetings have been held.
• Apart from these community meetings, the interns impart this knowledge house to house.
• Provision of comprehensive child health care.
Dr. Harivansh Chopra
Growth monitoring of all children coming for immunisation, proper record maintenance, education of parents on growth pattern of children, and assistance in maintaining a healthy
child.
Dr. Harivansh Chopra
CONCLUSION• Punctuality, Regularity and Maintaining Adequate Safety
Precautions resultsin the client satisfaction thereby
increasingthe utilisation of immunisation
services.
Dr. Harivansh Chopra
• The study was conducted in Urban Field Practice Area of LLRM Medical College, Meerut with a total population of 9816.
• Minimum sample size (n) = Z2 (pq) = 384 d2
n – Sample Size Z – Confidence Interval = 95%
p – Estimated Prevalence = 50% q – (100 – p) d – Relative precision = 10%• So for completing the sample size of 400(giving a
margin of non coverage), mother of every 2nd child was selected by systematic random sampling method and was interviewed.
Dr. Harivansh Chopra
• The study was conducted in Urban Field Practice Area of LLRM Medical College, Meerut with a total population of 9816.
• Minimum sample size (n) = Z2 (pq) = 384 d2
n – Sample Size Z – Confidence Interval = 95%
p – Estimated Prevalence = 50% q – (100 – p) d – Relative precision = 10%• So for completing the sample size of 400(giving a
margin of non coverage), mother of every 2nd child was selected by systematic random sampling method and was interviewed.
Dr. Harivansh Chopra
4.50%
41.10%
37.70%
14.20%
2.50%
UPPER MIDDLELOWER MIDDLE
UPPER LOWER
LOWER UPPER
Modified classification of Kuppuswamy
Dr. Harivansh Chopra
ILL
ITE
RA
TE
PR
IMA
RY
SC
...
MID
DL
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C...
HIG
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CH
OO
L
INT
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ME
DIA
TE
GR
AD
UA
TE
PO
ST
GR
AD
...
PR
OF
ES
SIO
NA
L05
1015202530354045
46
8.8
40.7
1315.5
7.74.3
%
Dr. Harivansh Chopra
ILL
ITE
RA
TE
PR
IMA
RY
SC
...
MID
DL
E S
CH
OO
L
HIG
H S
CH
OO
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PO
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...
PR
OF
ES
SIO
NA
L
0
5
10
15
20
25
30
35
63.8
13.5
34
14.516
10.5
1.7
%