Sharma Vikas, Singh Amarjeet, Sharma Vijaylakshmi
Centre for Public Health, IEAST, Panjab University, Chandigarh, India,
J Urban Health. 2015 Apr;92(2):304-12. doi: 10.1007/s11524-015-9939-2.
Strengthening routine immunization is a corner stone for countries to achieve the United Nations Millennium Development Goal 4 (MDG 4) which aims to reduce under-five mortality by two-thirds and MDG 5 improving maternal health compared to 1990 estimates by 2015. The poor urban newborns are more vulnerable to many health and nutrition problems compared to the non-poor urban counterparts. Therefore there is a need to strengthen health system to cater the needs of urban poor. Standardized WHO30*7 cluster sampling for slums and convenience sampling for construction sites. In depth interviews were conducted for user's as well as provider's perspective about immunization coverage. Two hundred ten children and 210 mothers were enrolled in slums and 100 were sampled from construction sites. The slum workers are considered as non-migratory groups whereas construction site workers are considered as migratory population. Among children, 23 % were fully immunized, 73 % were partially immunized and 3 % were unimmunized in non-migratory population whereas 3 % were fully immunized, 91 % were partially immunized and 6 % were unimmunized in migratory population. Among mothers, 43 and 39 % were fully immunized, 13 and 15 % partially immunized and 43 and 46 % were unimmunized in non-migratory and migratory population, respectively. The various reasons attributed for low coverage are (a) dissatisfaction of the users with the service delivery and procedural delays (bureaucracy), (b) lack of faith in health workers,
加强常规免疫是各国实现联合国千年发展目标4(MDG 4)的基石,该目标旨在到2015年将五岁以下儿童死亡率与1990年的估计数相比降低三分之二,以及实现千年发展目标5改善孕产妇健康。与非贫困城市新生儿相比,贫困城市新生儿更容易受到许多健康和营养问题的影响。因此,有必要加强卫生系统以满足城市贫困人口的需求。对贫民窟采用世卫组织标准化30*7整群抽样,对建筑工地采用便利抽样。从使用者和提供者的角度就免疫接种覆盖率进行了深入访谈。在贫民窟招募了210名儿童和210名母亲,从建筑工地抽取了100个样本。贫民窟工人被视为非流动群体,而建筑工人被视为流动人口。在儿童中,非流动群体中有23%完全免疫,73%部分免疫,3%未免疫;而流动群体中有3%完全免疫,91%部分免疫,6%未免疫。在母亲中,非流动群体和流动群体中分别有43%和39%完全免疫,13%和15%部分免疫,43%和46%未免疫。免疫接种覆盖率低的各种原因包括:(a)使用者对服务提供和程序延误(官僚作风)不满;(b)对卫生工作者缺乏信任。