Annual cluster (pulse) immunization experience in villages near Sevagram, India.

This simple study was undertaken in a 'Third World' rural area to find an appropriate strategy for mass vaccination. The low priority given to preventive health requirements, coupled with a lack of awareness of possible benefits, inaccessibility of vaccination facilities and misconceptions about vaccination, prevent poor, illiterate villagers from reaping these benefits. The 'cluster approach', utilizing locally available manpower, has been attempted. Availability of an immunization facility, free of charge, in a village, when required proved essential for wide coverage. Some 75.2% of children received three doses of polio vaccine, and 43.22% received five doses, in a total of five visits. With an additional (6th) visit, the figures rose to 80.66% receiving three doses and 55.06% receiving five doses. Results with single dose measles vaccine reached 95%. The reasons for defaulters have been investigated and remedial measures suggested. For five doses of polio vaccine the total man-hour requirement was 79 h, of which skilled manpower was employed for only 3 h, while the major share (33 h) fell to the village-level health worker. We consider that the 'cluster approach' is replicable and that it produces satisfactory results.