dr. harivansh chopra day to day problems in routine immunization

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

DR.HARIVANSH CHOPRAMD.,DCH

PROFESSORCOMMUNITY MEDICINE

LLRM MEDICAL COLLEGE, MEERUT



1. How many of you are involved in routine

immunization?



1. How many of you are trained in routine

immunization?



1. How many of you have read some special manual on immunization?.



1. Is the problems faced by the multipurpose

Workers and faced by you and me are

Similar or different?


DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION DIFFERENT

PROBLEMS

IN

DIFFERENT

SETTINGS

ETTINGS



1. OPERATIONAL

2. SKILL BASED

3. KNOWLEDGE

4. AEFI


OPERATIONAL PROBLEMS1. CONVEYANCE

2. VACCINE AVAILABILITY

3. STORAGE

4. A/D SYRINGE


OPERATIONAL PROBLEMS• INFRASTUCTURE• MANPOWER• GENERATOR• DISPOSAL


SKILL BASED PROBLEMS1. ADMINISTRATION OF VACCINE


KNOWLEDGE BASED PROBLEMS

1. WRONG USE OF VACCINE CARRIER



• WRONG USE OF ICE PACK



• USE OF FROZEN VACCINE OF T SERIES



• NO CHECKING OF VVM



• USE OF EXPIRED VACCINE



• WRONG RECONSTITUTION OF VACCINE


KNOWLEDGE BASED PROBLEMS• NOT WRITING THE TIME OF

RECONSTITUTION



• WRONG VACCINE ADMINISTRATION

• SIMILAR NAMES DIFFERENT AGES



• IMPROPER RECORD KEEPING


AEFI


AEFI• Emergency kit should provided to resuscitate the child in

case of life threatening reactions.• Supervised training for skill development to prevent and to

manage AEFI• Educate the mother about the possibilities and the

precautions to take in case of AEFI• Both clinical and PR skills development


SOLUTION

ALL OF THE ABOVE MENTIONED PROBLEMS CAN BE SOLVED BY1 PROPER LIASIONING WITH THE HEALTH SYSTEM.PUTTING MEDICAL COLLEGES IN THE DISTRICT ACTION PLAN UNDER NRHM.

2. TRAINING AND RETRAINING OF POST GRADUATES /FACULTY IN ROUTINE IMMUNIZATION.


CONCLUSIONACTION WITOUT KNOWLEDGE IS

USELESS AND KNOWLEDGE WITOUT ACTION IS FUTILE.SO LET US JOIN HANDS TO

TAKE ACTION…….


Conveyance problem


93.20%

5.30%1.50%

COMPLETELY IMMUNISED

PARTIALLY IMMUNISED

NOT IMMUNISED


ALWAYS AT UHC INITIALLY SOME-WHERE ELSE, NOW

AT UHC

ANYWHERE0

50

100

150

200

250

300

350

347

47

0

NU

MB

ER

ALWAYS AT UHC INITIALLY SOMEWHERE ELSE, NOW AT UHC

ANYWHERE

0

10

20

30

40

50

60

70

80

90

88

12

0

PE

RC

EN

TA

GE

(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)


45.90%

53.10%

FREE OF COST ?

82.60%

17.40%

PROXIMITY OF CENTRE ?

NO

NO

YES

YES



80.40%

19.60%

EXPERT HANDS?

82.70%

12.30%

MINIMUM SIDE EFFECTS ?

YES YES

NONO



83.90%

16.10%

PUNCTUALITY ?

66.10%

33.90%

PROPER SITTING ARRANGEMENT ?

YES YES

NO NO



80.90%

19.10%

EXPERT GUIDENCE ?

79.10%

20.90%

PROPER BABY CARE TIPS ?

YES YES

NO NO



Timely and punctual immunisation sessions are carried out by post graduate students and interns every Wednesday under expert guidance of senior faculty.

89%

11%

CARRIED OUT

MISSED**

** All the 11% sessions missed were due to national/gazetted holidays.


• Community meetings of all pregnant females and mothers to educate them the importance of immunisation, family planning, proper infant care – in past three years more than 30 such meetings have been held.

• Apart from these community meetings, the interns impart this knowledge house to house.

• Provision of comprehensive child health care.


Growth monitoring of all children coming for immunisation, proper record maintenance, education of parents on growth pattern of children, and assistance in maintaining a healthy

child.


CONCLUSION• Punctuality, Regularity and Maintaining Adequate Safety

Precautions resultsin the client satisfaction thereby

increasingthe utilisation of immunisation

services.


• The study was conducted in Urban Field Practice Area of LLRM Medical College, Meerut with a total population of 9816.

• Minimum sample size (n) = Z2 (pq) = 384 d2

n – Sample Size Z – Confidence Interval = 95%

p – Estimated Prevalence = 50% q – (100 – p) d – Relative precision = 10%• So for completing the sample size of 400(giving a

margin of non coverage), mother of every 2nd child was selected by systematic random sampling method and was interviewed.


4.50%

41.10%

37.70%

14.20%

2.50%

UPPER MIDDLELOWER MIDDLE

UPPER LOWER

LOWER UPPER

Modified classification of Kuppuswamy


ILL

ITE

RA

TE

PR

IMA

RY

SC

...

MID

DL

E S

C...

HIG

H S

CH

OO

L

INT

ER

ME

DIA

TE

GR

AD

UA

TE

PO

ST

GR

AD

...

PR

OF

ES

SIO

NA

L05

1015202530354045

46

8.8

40.7

1315.5

7.74.3

%


ILL

ITE

RA

TE

PR

IMA

RY

SC

...

MID

DL

E S

CH

OO

L

HIG

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CH

OO

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INT

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AD

UA

TE

PO

ST

GR

AD

...

PR

OF

ES

SIO

NA

L

0

5

10

15

20

25

30

35

63.8

13.5

34

14.516

10.5

1.7

%


EDUCATIONFATHER

(%)MOTHE

R(%)

ILLITERATE 4 6

PRIMARY SCHOOL 6 3.8

MIDDLE SCHOOL 8.8 13.5

HIGH SCHOOL 40.7 34

INTERMEDIATE 13 14.5

GRADUATE 15.5 16

POST GRADUATE 7.7 10.5

PROFESSIONAL 4.3 1.7

dr. harivansh chopra day to day problems in routine immunization

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