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Title: Alternative methods and sources for measuring vaccination coverage in rural Bangladesh
Author: Islam, M. D. S.
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2002
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Mothers (n=758) with children aged between 1-2 years from all eight rural unions of Kaliganj sub-district were surveyed. Only 51% of mothers possessed a vaccination card for the index child and 53% of children had a vaccination record in a health worker's register while 34% had both documentary sources. The more well-off, literate and Hindu families were more likely to have documentary evidence of their child's vaccinations. Comparison between health workers' records and vaccination cards showed very high consistency (over 98%) for BCG, lower for DPT and Polio (both about 80%) and lowest for Measles (69%). When all four vaccines were combined, 60% of health workers' records were consistent with the vaccination card, 33% showed over-reporting and 8% under-reporting. Comparison of mothers' recall and health workers' records indicated a very similar pattern to that found for vaccination cards except for greater under-reporting for DPT, Polio and Measles (range 14-24%). Heterogeneity in consistency/inconsistency was associated with union, ownership and recall period. Possession of either a vaccination card or of a health worker's record was associated with higher recalled vaccination histories on the basis of mother's recall. Inclusion of health workers' records in addition to vaccination card and mothers' recall history significantly improved percentage coverage. Use of all three sources increased vaccination coverage for Diphtheria, Pertussis and Tetanus by 9%, for Polio by 10% and for Measles by 17% compared with the current Bangladeshi method. Dropout rates were 23% between first and third (last) dose of the Diphtheria, Pertussis and Tetanus vaccine and between first and last dose of the Polio vaccine while the dropout rate between first and last vaccination was 42%. The major reasons for non- or partial-immunisation were lack of awareness of the need for immunisation, fear of side effects and inability of parents to take their child to the vaccination centre.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available