Evaluating vaccination coverage and barriers to immunization among children less than 5 in remote area of Maharashtra, central India; a qualitative and quantitative study

BACKGROUND: The Jamkhed villages in Maharashtra, India, have maintained high vaccination rates for over two decades under the Comprehensive Rural Health Project (CRHP), which has handed over this responsibility to the Indian government. This study assesses children vaccination coverage and barriers to overall vaccination. METHODS: A cross-sectional study of vaccination coverage for 6 recommended vaccines under age of 1 was performed using in-person, household surveys in five villages outside of Jamkhed during August 2010. Randomly selected mothers of 242 children aged 1-5 from 190 households were surveyed. Subsequently, 8 focus groups were held to evaluate mothers' overall knowledge of vaccination and barriers to all immunization for children less than 5. Results were coded and analyzed for common themes. RESULTS: Of the 242 children assessed 100.0% received all 3 doses of Oral Polio, 99.2% all 3 doses of DPT, 99.2% Measles vaccine, and 98.8% BCG. The most common barriers for overall vaccination in children less than 5 were poor communication of the immunization schedule, parents' concerns over missed wages/workdays when accompanying children, and various challenges resulting from nomadic lifestyle. CONCLUSIONS: This study suggests that vaccination coverage for vaccines under age of 1 year has remained high after a transfer of responsibility to the government in Jamkhed. The identified barriers to overall immunization for children less than 5 should be effectively addressed to improve the current overall vaccination scheme. Further study, with a larger sample size and better access to immunization records, is warranted to define better evaluate these findings.