Barriers to childhood immunisation among women in an urban underprivileged area of Bangalore city, Karnataka, India: a qualitative study

Authors

  • Geethu Mathew Department of Community Medicine, Believers Church Medical College Hospital, Kuttapuzha PO, Thiruvalla, Kerala, India
  • Avita Rose Johnson Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India
  • Sulekha Thimmaiah Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India
  • Ratna Kumari Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India
  • Aby Varghese Department of Paediatrics, Believers Church Medical College Hospital, Thiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20161622

Keywords:

Immunisation, Qualitative study, Barriers, Urban underprivileged

Abstract

Background: Immunisation is one of the most cost-effective and safest public health interventions in reducing the childhood mortality and morbidity. National Family Health Survey- 3 reports that only 43.5% of children in India received all of the primary vaccines and the situation was worse among urban poor where the coverage was 39.9%. An earlier study in an underprivileged area of Bangalore found that only 53% of children aged 12-23 months had received full primary immunisation. This study aimed at understanding the barriers to immunisation among women residing in the same area.

Methods: This was a community based qualitative study, in an urban underprivileged area of Bangalore city. Data was obtained from three focus group discussions with mothers of children less than five years of age and ten key informant interviews with mothers, mother-in law and other stakeholders like link worker, ANM and anganwadi worker of the area.

Results: Barriers in knowledge among mothers included poor awareness of immunisation schedule and vaccine preventable diseases. Immunisation was delayed due to common childhood illness. Lack of family support, negative attitude of the elderly at home, poor male participation, gender bias, apprehension of giving many vaccines at one time and adverse rumours were the commonly mentioned attitudinal barriers to immunisation. Barriers to utilization of immunisation services included economic constraints, long distance to health facility, and loss of daily wages while attending immunisation clinic, inconvenient timings and lack of effective communication with health personnel.

Conclusion: This study has identified barriers in knowledge, attitude and utilization of immunisation services in an urban underprivileged area which should be addressed while planning immunisation strategies at health system level.

References

WHO/Europe. Vaccines and immunisation, 2015. Available at: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines and immunisation.

Global Immunisation Data. WHO 2014. Available at:http://www.who.int/immunisation/monitoring_surveillance/global_immunisation_data.pdf.

Bhutta ZA, Gupta I, de’ Silva H, Manandhar D, Awasthi S, Hossein SMM, Salam MA. Maternal and child health: is south asia ready for change? BMJ. 2004;328(7443):816-9.

National Family Health Survey (NFHS-3) India, 2005-06 : Volume 1. Ministry of Health and Family Welfare Government of India, International Institute for Population sciences (IIPS) and Macro International; 2007:231.

Primary Census Abstract for Slum. Office of the registrar general and census commissioner, India. Census of India 2011. Available at: http://www.censusindia.gov.in/2011Documents/Slum-26-09-13.pdf.

Coverage evaluation survey 2009: all india report. Ministry of health and family welfare, Government of India. United Nations Children’s Fund (UNICEF). 2010;33.

Global Routine Vaccination Coverage, 2011. CDC; 2015. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6143a5.htm.

Jose J, Lobo MR, Nisha K, Shilpa GS, Umarani J. Awareness on immunisation among mothers of under five children. IJIRD. 2013;2(6):620-27.

Available at: http://www.ijird.com/index.php/ijird/article/viewFile/36256/29378.

Sharma R, Bhasin SK. Routine immunization: do people know about it? A study among caretakers of children attending pulse polio immunization in east delhi. Indian J Community Med. 2008;33(1):31-4.

Ahmed SM, Tarek A, Masoed ES. Mothers awareness and knowledge of under five years children regarding immunisation in Minia city, Egypt. Life Sci. 2013;10(4):1224-32.

Salmon DA, Sotir MJ, Pan WK, Berg JL, Omer SB, Stokley S, et al. Parental vaccine refusal in wisconsin: a case-control study. Wisconsin Medical Journal. 2009;108(1):17-23. Available at:https://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/108/1/17.pdf.

Kimmel S, Burns IT, Wolfe RM, Zimmerman RK. Addressing immunization barriers, benefits, and risks. Journal of Family Practice. 2007;56 (2): S61-69. Available at: http://people.oregonstate.edu/~fishejos/content/H571/Vaccine/24126305.pdf.

Bailey HD, Kurinczuk JJ, Kusel MM, Plant AJ. Barriers to immunisation in general practice. Aust N Z J Public Health. 1999;23(1):6-10.

Prislin R, Dyer JA, Blakely CH, Johnson CD. Immunization status and socio-demographic characteristics: the mediating role of beliefs, attitudes, and perceived control. Am J Public Health. 1998;88(12):1821-6. Available at:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1509037/pdf/amjph00024-0075.pdf

Harris HP, Smith FG, Godinet S, Turner N. Barriers to childhood immunisation among new zealand mothers. New Zealand Family Physician. 2002;29:396-401. Available at: https://www.rnzcgp.org.nz/assets/documents/Publications/Archive-NZFP/Dec-2002-NZFP-Vol-29-No-6/PetousisHarris-December-02.pdf.

Hendriksz T, Malouf PJ, Sarmiento S, Foy JE. New emphasis on pediatric and adolescent vaccinations: Overcoming patient barriers to immunisation. AOA Health Watch. 2013;9-14. Available at: http://www.cecity.com/aoa/healthwatch/oct_13/print3.pdf

Wolff ER, Madlon-Kay DJ. Childhood vaccine beliefs reported by Somali and non-somali parents. Journal of American Board of Family Medicine. 2014;27(4):458-64.

Wolfe RM, Sharp LK, Lipsky MS, Content and design attributes of anti-vaccination websites. JAMA. 2002;287:3245-8. Available at: http://jama.jamanetwork.com/article.aspx?articleid=195044.

Melman ST, Nguyen TT, Ehrlich E, Schorr M, Anbar RD. Parental compliance with multiple immunization injections. JAMA Pediatrics. 1999;153(12):1289-91. Available at: http://archpedi.jamanetwork.com/article.aspx?articleid=348320.

Prusty RK, Kumar A. Socioeconomic dynamics of gender disparity in childhood immunization in India, 1992-2006. PLoS One. 2014;15:9(8):e104598.

Corsi DJ, Bassani DG, Kumar R, Awasthi S, Jotkar R, Kaur N, Jha P. Gender inequity and age-appropriate immunization coverage in India from 1992 to 2006. BMC International Health and Human Rights. 2009;9(Suppl 1):S3.

Gore P, Madhavan S, Curry D, McClung G, Castiglia M, Rosenbluth SA, et al. Predictors of childhood immunization completion in a rural population. Social Science and Medicine. 1999;48(8):1011-27.

Downloads

Published

2017-01-05

How to Cite

Mathew, G., Johnson, A. R., Thimmaiah, S., Kumari, R., & Varghese, A. (2017). Barriers to childhood immunisation among women in an urban underprivileged area of Bangalore city, Karnataka, India: a qualitative study. International Journal Of Community Medicine And Public Health, 3(6), 1525–1530. https://doi.org/10.18203/2394-6040.ijcmph20161622

Issue

Section

Original Research Articles