Immunization coverage in tribal and rural areas of Visakhapatnam district of Andhra Pradesh, India.

This paper aims to report and compare the immunization coverage of various vaccines among tribal and rural children in a distinct socio-economic environment in India. The study was conducted in two tribal and two rural developmental blocks of Visakhapatnam district of Andhra Pradesh, India, by employing both qualitative and quantitative data collection techniques. Data collected included the immunisation coverage and the associated socio-demographic factors. The majority of mothers was aware of vaccination of children, and usually the primary heath centres and their health workers were the source of vaccination. Vaccination cards were received by 79.2% of tribal and 71.3% of rural children. Some of the socio-demographic characters of mothers, such as habitat, caste and occupation, were associated with the reception of a vaccination card. The coverage of various vaccines was higher among the tribal than among the rural population. Of the eligible children aged above 9 months, 63.3% of tribal children and only 14.5% of rural children were fully vaccinated [three doses of diphtheria, pertussis and tetanus (DPT), four doses of oral polio vaccine, Bacille Calmette Guerin (BCG) and measles vaccine]. The coverage of vaccination against measles and vitamin-A supplementation were very low among rural children (19.6% and 15.2%, respectively) when compared to tribal children (69.2% and 64.2%, respectively). The qualitative data indicated that the community was not satisfied with regard to vaccination services, particularly in the rural area. The coverage of various vaccines was moderate in tribal areas and poor in rural areas. The sole dependence on and demand for public health services was responsible for relatively better coverage of immunisation in tribal areas compared to rural areas where the private sector plays a major role. The existing strategies of health-care delivery including delivery of vaccination services need to be examined and improved. Improvements in physical access, infrastructure, quality of care and increased use of mass media and interpersonal communication are indispensable for improvement in the provision of services. [ABSTRACT FROM AUTHOR]