- Vellara Francis.pdf (1010k)
Oslo and Akershus University College
Master in International Social Welfare and Health Policy
UNICEF reported that only less than fifty percent of children in India receive full immunization. It indicates that majority of children are not protected against vaccine preventable diseases. High infant mortality rate of sixty three deaths for every thousand live birth also points to the neglected child health activities in India. The thesis explores strategies which are needed for improving child immunization in India. Hence the purpose this study is to understand the current state of immunization in India, the reasons of poor coverage if any, and the rational strategy to improve vaccination coverage. This thesis report is a qualitative study and is based on literature reviews. The nature of this qualitative study is explorative. The main data sources for this study were official documents, private and public reports, academic and other sources. The current status of child immunization in India was analysed based on NFHS 3 and CES 2009 survey reports. The reasons for poor immunization rates in least performing states and the special features that make the better performing states to be in high immunization coverage states was explored from NRHM studies. The least performing states were characterized by poor health facilities and other infrastructure facilities, lack of awareness about the immunization programs among people and general low income, literacy and gender inequality. On the other hand, the factors associated with high immunization performance in better performing states are active involvement of health sector, good health infrastructure and people’s knowledge and awareness. The pulse polio programme which was a large success in India was considered in this thesis as an example program. The main factors which made the program a success were monitoring and supervision of the programme, wide mass campaign and immunization services at all levels including remote and marginalized sections. The main measures should be included to strengthen immunization coverage are prioritization of programme, strengthening of health infrastructure, improve communication and training of health care providers, strengthening of VPD and AEFI surveillance system, access for rural and marginalized section, supervision monitoring and micro planning, mass campaign, reminder\ recall, incentives, and flexible services.
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