The immunization programme in Bangladesh: impressive gains in coverage, but gaps remain

Abstract

The paper reviews the achievements in tetanus immunization coverage and child immunization in Bangladesh. It uses data from the 1993-94 Bangladesh Demographic and Health Survey to identify and examine the programmatic and non-programmatic factors that influence the coverage of tetanus (TT) immunization during pregnancy, and full immunization among children 12-23 months old in rural Bangladesh. The purpose of this analysis is to identify the areas that need further programme attention. The logistic regression results show that the coverage of TT immunization was significantly associated with proximity to outreach clinics and the presence of a health worker in the community. Home visits by health/family planning fieldworkers and the proximity to outreach clinics had larger influences on TT coverage of poorer households compared to those better-off. The effect of distance to static clinics varied by regions. Among children, full immunization coverage (coverage of all of BCG, DPT1, DPT2, DPT3, Polio1 Polio2, Polio3) was significantly associated with distance to outreach clinics, the greater the distance to the clinics, the less the likelihood of immunization.

PIP: The authors review the achievements in tetanus immunization coverage and child immunization in Bangladesh, using data from the 1993-94 Bangladesh Demographic and Health Survey to identify and examine the programmatic and nonprogrammatic factors which influence the coverage of tetanus immunization (TT) during pregnancy, and full immunization among children aged 12-23 months old in rural Bangladesh. The research was conducted to identify which areas need additional program attention. According to logistic regression analysis, the coverage of TT immunization was significantly associated with proximity to outreach clinics and the presence of a health worker in the community. Home visits by health and family planning field workers, and the proximity to outreach clinics had more influence upon the TT coverage of poorer households than they did upon those which were more affluent. The effect of distance to static clinics varied by regions. Among children, full immunization coverage was significantly associated with distance to outreach clinics, with greater distance to the clinics reducing the likelihood of immunization.