Missed opportunities for immunization in children under 2 years attending an urban teaching hospital
Deivanayagam, N.; Nedunchelian, K.; Mala, N.; Ashok, T.P.; Rathnam, S.R.; Ahmed, S.S.
Indian Pediatrics 32(1): 51-57
1995
ISSN/ISBN: 0019-6061 PMID: 8617535 Document Number: 625820
In November 1991, a baseline survey was conducted to examine missed opportunities for immunization (MOI) in 634 children aged under 2 years attending the outpatient clinic, newborn follow-up service, and the immunization clinic of the Institute of Child Health in Madras, India. The proportion of MOIs stood at 35.5% in the outpatient clinic, 23.1% in the newborn follow-up service, and 9.7% in the immunization clinic. Shortly after the baseline survey, clinicians received education and increased awareness of immunization. This intervention was evaluated in January 1992. The proportion of MOIs after the first intervention was 24.5% for the outpatient clinic, 12.2% for the newborn follow-up service, and 0 in the immunization clinic. In May 1992, clinicians were instructed to attach an immunization slip to the outpatient form. This intervention was evaluated in June 1992. After the second intervention, the proportion of MOIs was 18.4% in the outpatient clinic, 8% in the newborn follow-up service, and 0 in the immunization clinic. In the outpatient department, MOIs decreased significantly between the baseline and the two interventions (p = 0.003). They did not fall significantly between the two interventions, however. In the immunization clinic, the MOIs also declined significantly between the baseline and the two interventions (p = 0.001). Throughout the study period, the immunization clinic had a lower MOI rate than the outpatient clinic (p 0.001). These findings indicate that periodic sessions creating awareness about immunization (e.g., once every 2-3 months) for health personnel in hospitals and attaching immunization data details to the outpatient forms of the health facility effectively reduces MOIs.