Quality of routine childhood immunization and mothers' satisfaction toward it in Gangajalghati block of Bankura district of West Bengal, India

Background: Auxiliary nurse midwife (ANM) provides immunization service at subcenter. This study aimed to assess the quality of care and client satisfaction toward immunization. Materials and Methods: A cross-sectional survey was conducted during January 2018 in three randomly selected subcenters of Gangajalghati block of Bankura district. Immunization services and client satisfaction were assessed by nonparticipant observation of immunization process in 86 “vaccination encounters” and exit interview of mothers of the same vaccinees selected randomly in equal number from each subcenter. Data were collected using checklist and questionnaire containing some questions with options on Likert scale. Clients' satisfaction was also explored through “focus group discussions” (FGDs) among randomly selected samples of eight mothers at each subcenter. Providers' perspective was grasped from an “FGD” conducted among a sample of accredited social health activists and in-depth interview of ANMs of selected subcenters. Verification of cold chain, logistics, and registers was done using checklist. Results: Coverage with appropriate vaccination was universal in each of the subcenters. The waiting time was 21.82 ± 15.37 (mean ± standard deviation) min. Postvaccination message was provided to 97.70% of mothers. Improper biomedical waste management was the rule. Cold chain was maintained properly. Only 45.30% of respondents knew the vaccine that was given in the session; however, 91.90% could utter the next date of vaccination. Sitting arrangement, cleanliness in clinic, attendance, timeliness of service, skill, and attitude of ANMs were labeled as “good” by 59.30%, 82.60%, 100%, 100%, 100%, and 98.80% of respondents, respectively, and overall, 94.00% was satisfied toward service. Conclusion: An overall good quality immunization service was found existing in the study area.