Demand side barriers to immunization services in Terai districts of Nepal

Type Journal Article - Nepal Population Journal
Title Demand side barriers to immunization services in Terai districts of Nepal
Volume 17
Issue 16
Publication (Day/Month/Year) 2012
Page numbers 91-104
URL PAN Journal_Aug 29.pdf#page=97
This article explores awareness, knowledge and practices related to the recommended immunization schedule and demand side barriers associated with low immunization coverage drawing on data from a household survey conducted in three central Terai districts of Nepal. The survey collected data from 450 married women with at least one child aged 12-23 months from 30 clusters (10 clusters in each districts). Key findings include the following. Heard about children immunization among mothers is universal but immunization coverage ranges from 94 percent for vaccines of DPT 3 and measles to 99 percent for OPV. Muslims and girls tend to have lower immunization coverage compared to their corresponding counterparts. The common places for immunization of child were health institution (64%), immunization campaign place (39%) and at home (6%). Key demand side barriers to full immunization coverage are lack of knowledge and misconception about immunization, lack of access to services such as service centers, heavy household work and carelessness including culture/family barriers. The article concludes that full immunization coverage is still beyond in case of DPT1 and measles. This holds especially for Muslims and girl children. Some of these demand side barriers can be addressed through effective mobilization of FCHV including media while others such as heavy household work appears to be associated with poverty. Some of the cultural barriers such as no permission from family to visit the health facility to the young mothers, caste and gender discrimination warrant more complex interventions – the women empowerment, inclusiveness and male involvement in immunization coverage programs.

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