The Experts below are selected from a list of 11181 Experts worldwide ranked by ideXlab platform
Jasim Uddin - One of the best experts on this subject based on the ideXlab platform.
-
Improving low coverage of Child Immunization in rural hard-to-reach areas of Bangladesh: findings from a project using multiple interventions.
Vaccine, 2011Co-Authors: Jasim Uddin, Nirod Chandra Saha, Iqbal Ansary Khan, Shamsuzzaman, Ziaul Islam, M.a. Quaiyum, Tracey Perez KoehlmoosAbstract:Abstract The study was conducted to assess the impact of combined interventions to improve the Child Immunization coverage in rural hard-to-reach areas of Bangladesh. The valid coverage increased at endline compared to baseline in the study areas, and the difference of the increase was highly significant ( p p
-
Child Immunization coverage in rural hard-to-reach areas of Bangladesh.
Vaccine, 2009Co-Authors: Jasim Uddin, Tracey Perez Koehlmoos, Nirod Chandra Saha, Iqbal Ansary Khan, ShamsuzzamanAbstract:This article aimed to assess Child Immunization coverage in rural hard-to-reach hilly and low lying (haor) areas of Bangladesh. Status of fully immunized Children was significantly lower in haor areas compared to hilly areas. Fully immunized Children in both hilly and haor areas was significantly lower than concerned division as well as national level coverage. The results suggested that the traditional service delivery system is not sufficient for rural hard-to-reach areas of Bangladesh. The policy makers should come forward with innovative approaches for rural hard-to-reach areas of this country for improving Immunization coverage.
-
Child Immunization coverage in urban slums of Bangladesh: impact of an intervention package
Health policy and planning, 2009Co-Authors: Jasim Uddin, M.a. Quaiyum, Charles P. Larson, Elizabeth Oliveras, A. I. Khan, Nirod Chandra SahaAbstract:The study assessed the impact of an EPI (Expanded Programme on Immunization) intervention package, implemented within the existing service-delivery system, to improve the Child Immunization coverage in urban slums of Dhaka, Bangladesh. This intervention trial used a pre- and post-test design. An intervention package was tested from September 2006 to August 2007 in two urban slums. The intervention package included: (a) an extended EPI service schedule; (b) training for service providers on valid doses and management of side-effects; (c) a screening tool to identify Immunization needs among clinic attendants; and (d) an EPI support group for social mobilization. Data were obtained from random sample surveys, service statistics and qualitative interviews. Analysis of quantitative data was based on a 'before and after' assessment of selected Immunization-coverage indicators. Qualitative data were analysed using content analysis. Ninety-nine per cent of the Children were fully immunized after implementation of the interventions compared with only 43% before implementation. Antigen-wise coverage after implementation was also significantly higher compared with before implementation. Only 1% drop-out was observed after implementation of the interventions while it was 33% before implementation. At baseline, a significantly higher proportion of Children of non-working mothers (75%) were fully immunized compared with Children of working mothers (14%). Although the proportion of fully immunized Children of both non-working and working mothers was significantly higher at endline, fully immunized Children of working mothers dramatically improved at endline (99%) compared with baseline (14%). The findings suggest the effectiveness of a 'package of interventions' in improving Child Immunization coverage in urban slums. However, further research is needed to fully assess the effectiveness of the package, to assess the individual components in order to identify those that make the biggest contribution to coverage, and to assess the sustainability of this package within the existing service delivery system, particularly on a wider scale.
-
Coverage of Child Immunization in rural hard-to-reach haor areas of Bangladesh: acceptability of alternative strategies.
2008Co-Authors: Jasim Uddin, Iqbal Ansary Khan, M.a. Quaiyum, Charles P. Larson, Elizabeth Oliveras, A. I. Khan, Ahmed F, ShamsuzzamanAbstract:Immunization is essential to achieve the Millennium Development Goals (MDGs) of substantially reducing Child mortality rates. Results of some studies suggest that the coverage of Child Immunization is low in hard-to-reach areas of Bangladesh. Alternative strategies for improving the Immunization coverage in those remote areas have not been assessed. The study was conducted to assess the status of Childhood vaccination coverage in rural hard-to-reach haor areas of Bangladesh and also to assess the acceptability of selected alternative strategies in those areas. During September-November 2006 the acceptability study was carried out in a remote hard-to-reach haor (low-lying) upazila of Sunamgonj district under Sylhet division. The World Health Organization (WHO)-recommended 30 cluster-sampling methodology was used for determining the sample size. Seven Children aged 12-23 months were selected from each cluster. Data were collected through a survey in-depth interviews group discussions and observations of vaccination sessions. The chi-square tests were performed to compare the coverage in the study area with the national coverage. To ascertain the status of Child Immunization coverage by socioeconomic status univariate and bivariate analyses were performed. Qualitative data collected through in-depth interviews and group discussions were first transcribed and then translated into English. Data were then analyzed using content analysis. The complete Immunization coverage among Children aged 12-23 months was significantly lower in the hard-to-reach areas compared to the national coverage level. The drop-out rate was significantly higher in the hard-to-reach areas compared to the national level. The overall rate of invalid doses in the upazila was also higher (9%) compared to the national level (7%). Results of bivariate analysis showed that as expected Children with more educated parents were more likely to have complete Immunizations. The findings also showed that complete Immunization was significantly higher among Children of parents who had exposure to mass media than those who had not. The study identified the following reasons for low coverage of Child Immunization in the hard-to-reach areas: (a) irregular/cancelled EPI sessions; (b) less time spent in EPI spots by field staff; (c) absence of any alternative strategy for remote areas; (d) absence of any mechanism to involve the community with the EPI; (e) side-effects; (f) invalid doses; (g) poor knowledge of mothers about benefits of complete vaccination; (h) less/absence of supervision; (i) mothers did not get information about EPI sessions; (j) an inadequate number of field workers for the increased population; (k) the post of Health Assistant (HA) remained vacant; (l) geographical barriers; and (m) lack of money to meet necessary transportation costs. The findings indicated that the existing service-delivery strategy was not sufficient to improve the Immunization coverage in the hard-to-reach areas. However most strategies assessed such as modified EPI service schedules organizing EPI days EPI support groups use of a screening tool in health centres other than EPI spots training of service providers on invalid doses and elimination of geographical barriers were considered acceptable by healthcare providers for the hard-to-reach areas. The coverage of Child Immunization in the hard-to-reach haor areas was low and a number of strategies were acceptable for implementation for improving the coverage in those areas. Before implementing the alternative strategies in the hard-to-reach areas the feasibility and effectiveness of the acceptable strategies need to be tested to identify evidence-based strategies for scaling up in all hard-to-reach areas of Bangladesh. (authors)
-
Effectiveness of combined strategies to improve low coverage of Child Immunization in urban slums of Bangladesh.
2008Co-Authors: Jasim Uddin, Iqbal Ansary Khan, M.a. Quaiyum, Charles P. Larson, Elizabeth Oliveras, ShamsuzzamanAbstract:Rapid urbanization high density of population and low coverage of Immunization in urban slums call for the increased emphasis on Immunization coverage for vulnerable urban poor Children where spread of infection is faster. The study assessed the impact of an EPI intervention package to improve the coverage of Child Immunization in urban slums. This was an intervention trial with pre- and post-test design. The intervention package was tested for 12 months during September 2006-August 2007 in two purposively-selected urban slums of Dhaka city. The interventions package included: (a) a modified EPI service schedule (b) training for service providers on valid doses (c) a screening tool to identify Immunization needs among clinic attendants and (d) an EPI support groups for social mobilization. Data were drawn from the following three main sources: the random sample surveys to assess the Immunization coverage (interview with mothers of Children aged 12-23 months) service statistics and qualitative data. Analysis of quantitative data was based on a before and after assessment of the selected Immunization-coverage indicators by Pearsons chi-square test/proportions test and to compare means by t-test for continuous variables. Qualitative data collected through in-depth interviews and observations were analyzed using content analysis. The findings of the study revealed that 99% of 526 Children were fully immunized after the implementation of the interventions while it was only 43% before their implementation and the difference was highly significant. Antigen-wise coverage after the implementation of the interventions was also higher compared to before their implementation and the difference was also highly significant. Only 1% drop-out was found after the implementation of the interventions while it was 33% before their implementation and the difference was also highly significant. Not a single invalid dose was found after the implementation of the interventions while 22% of the Children had invalid doses before their implementation. Although it was not possible to assess the individual contribution of each component intervention with great accuracy because of overlapping effects the findings suggest that each intervention contributed to improving the coverage. Therefore the policy-makers and programme manages should implement the package of successful interventions in all the slums of Bangladesh for improving the coverage of Child Immunization among this marginalized group of people. Manuals and guidelines need to be developed and distributed among service providers and training for them is essential before scaling up of the interventions. Moreover a team consisting of the partners of the study should provide technical assistance in scaling up the interventions. (authors)
Shamsuzzaman - One of the best experts on this subject based on the ideXlab platform.
-
Improving low coverage of Child Immunization in rural hard-to-reach areas of Bangladesh: findings from a project using multiple interventions.
Vaccine, 2011Co-Authors: Jasim Uddin, Nirod Chandra Saha, Iqbal Ansary Khan, Shamsuzzaman, Ziaul Islam, M.a. Quaiyum, Tracey Perez KoehlmoosAbstract:Abstract The study was conducted to assess the impact of combined interventions to improve the Child Immunization coverage in rural hard-to-reach areas of Bangladesh. The valid coverage increased at endline compared to baseline in the study areas, and the difference of the increase was highly significant ( p p
-
Child Immunization coverage in rural hard-to-reach areas of Bangladesh.
Vaccine, 2009Co-Authors: Jasim Uddin, Tracey Perez Koehlmoos, Nirod Chandra Saha, Iqbal Ansary Khan, ShamsuzzamanAbstract:This article aimed to assess Child Immunization coverage in rural hard-to-reach hilly and low lying (haor) areas of Bangladesh. Status of fully immunized Children was significantly lower in haor areas compared to hilly areas. Fully immunized Children in both hilly and haor areas was significantly lower than concerned division as well as national level coverage. The results suggested that the traditional service delivery system is not sufficient for rural hard-to-reach areas of Bangladesh. The policy makers should come forward with innovative approaches for rural hard-to-reach areas of this country for improving Immunization coverage.
-
Coverage of Child Immunization in rural hard-to-reach haor areas of Bangladesh: acceptability of alternative strategies.
2008Co-Authors: Jasim Uddin, Iqbal Ansary Khan, M.a. Quaiyum, Charles P. Larson, Elizabeth Oliveras, A. I. Khan, Ahmed F, ShamsuzzamanAbstract:Immunization is essential to achieve the Millennium Development Goals (MDGs) of substantially reducing Child mortality rates. Results of some studies suggest that the coverage of Child Immunization is low in hard-to-reach areas of Bangladesh. Alternative strategies for improving the Immunization coverage in those remote areas have not been assessed. The study was conducted to assess the status of Childhood vaccination coverage in rural hard-to-reach haor areas of Bangladesh and also to assess the acceptability of selected alternative strategies in those areas. During September-November 2006 the acceptability study was carried out in a remote hard-to-reach haor (low-lying) upazila of Sunamgonj district under Sylhet division. The World Health Organization (WHO)-recommended 30 cluster-sampling methodology was used for determining the sample size. Seven Children aged 12-23 months were selected from each cluster. Data were collected through a survey in-depth interviews group discussions and observations of vaccination sessions. The chi-square tests were performed to compare the coverage in the study area with the national coverage. To ascertain the status of Child Immunization coverage by socioeconomic status univariate and bivariate analyses were performed. Qualitative data collected through in-depth interviews and group discussions were first transcribed and then translated into English. Data were then analyzed using content analysis. The complete Immunization coverage among Children aged 12-23 months was significantly lower in the hard-to-reach areas compared to the national coverage level. The drop-out rate was significantly higher in the hard-to-reach areas compared to the national level. The overall rate of invalid doses in the upazila was also higher (9%) compared to the national level (7%). Results of bivariate analysis showed that as expected Children with more educated parents were more likely to have complete Immunizations. The findings also showed that complete Immunization was significantly higher among Children of parents who had exposure to mass media than those who had not. The study identified the following reasons for low coverage of Child Immunization in the hard-to-reach areas: (a) irregular/cancelled EPI sessions; (b) less time spent in EPI spots by field staff; (c) absence of any alternative strategy for remote areas; (d) absence of any mechanism to involve the community with the EPI; (e) side-effects; (f) invalid doses; (g) poor knowledge of mothers about benefits of complete vaccination; (h) less/absence of supervision; (i) mothers did not get information about EPI sessions; (j) an inadequate number of field workers for the increased population; (k) the post of Health Assistant (HA) remained vacant; (l) geographical barriers; and (m) lack of money to meet necessary transportation costs. The findings indicated that the existing service-delivery strategy was not sufficient to improve the Immunization coverage in the hard-to-reach areas. However most strategies assessed such as modified EPI service schedules organizing EPI days EPI support groups use of a screening tool in health centres other than EPI spots training of service providers on invalid doses and elimination of geographical barriers were considered acceptable by healthcare providers for the hard-to-reach areas. The coverage of Child Immunization in the hard-to-reach haor areas was low and a number of strategies were acceptable for implementation for improving the coverage in those areas. Before implementing the alternative strategies in the hard-to-reach areas the feasibility and effectiveness of the acceptable strategies need to be tested to identify evidence-based strategies for scaling up in all hard-to-reach areas of Bangladesh. (authors)
-
Effectiveness of combined strategies to improve low coverage of Child Immunization in urban slums of Bangladesh.
2008Co-Authors: Jasim Uddin, Iqbal Ansary Khan, M.a. Quaiyum, Charles P. Larson, Elizabeth Oliveras, ShamsuzzamanAbstract:Rapid urbanization high density of population and low coverage of Immunization in urban slums call for the increased emphasis on Immunization coverage for vulnerable urban poor Children where spread of infection is faster. The study assessed the impact of an EPI intervention package to improve the coverage of Child Immunization in urban slums. This was an intervention trial with pre- and post-test design. The intervention package was tested for 12 months during September 2006-August 2007 in two purposively-selected urban slums of Dhaka city. The interventions package included: (a) a modified EPI service schedule (b) training for service providers on valid doses (c) a screening tool to identify Immunization needs among clinic attendants and (d) an EPI support groups for social mobilization. Data were drawn from the following three main sources: the random sample surveys to assess the Immunization coverage (interview with mothers of Children aged 12-23 months) service statistics and qualitative data. Analysis of quantitative data was based on a before and after assessment of the selected Immunization-coverage indicators by Pearsons chi-square test/proportions test and to compare means by t-test for continuous variables. Qualitative data collected through in-depth interviews and observations were analyzed using content analysis. The findings of the study revealed that 99% of 526 Children were fully immunized after the implementation of the interventions while it was only 43% before their implementation and the difference was highly significant. Antigen-wise coverage after the implementation of the interventions was also higher compared to before their implementation and the difference was also highly significant. Only 1% drop-out was found after the implementation of the interventions while it was 33% before their implementation and the difference was also highly significant. Not a single invalid dose was found after the implementation of the interventions while 22% of the Children had invalid doses before their implementation. Although it was not possible to assess the individual contribution of each component intervention with great accuracy because of overlapping effects the findings suggest that each intervention contributed to improving the coverage. Therefore the policy-makers and programme manages should implement the package of successful interventions in all the slums of Bangladesh for improving the coverage of Child Immunization among this marginalized group of people. Manuals and guidelines need to be developed and distributed among service providers and training for them is essential before scaling up of the interventions. Moreover a team consisting of the partners of the study should provide technical assistance in scaling up the interventions. (authors)
Nirod Chandra Saha - One of the best experts on this subject based on the ideXlab platform.
-
Improving low coverage of Child Immunization in rural hard-to-reach areas of Bangladesh: findings from a project using multiple interventions.
Vaccine, 2011Co-Authors: Jasim Uddin, Nirod Chandra Saha, Iqbal Ansary Khan, Shamsuzzaman, Ziaul Islam, M.a. Quaiyum, Tracey Perez KoehlmoosAbstract:Abstract The study was conducted to assess the impact of combined interventions to improve the Child Immunization coverage in rural hard-to-reach areas of Bangladesh. The valid coverage increased at endline compared to baseline in the study areas, and the difference of the increase was highly significant ( p p
-
Child Immunization coverage in rural hard-to-reach areas of Bangladesh.
Vaccine, 2009Co-Authors: Jasim Uddin, Tracey Perez Koehlmoos, Nirod Chandra Saha, Iqbal Ansary Khan, ShamsuzzamanAbstract:This article aimed to assess Child Immunization coverage in rural hard-to-reach hilly and low lying (haor) areas of Bangladesh. Status of fully immunized Children was significantly lower in haor areas compared to hilly areas. Fully immunized Children in both hilly and haor areas was significantly lower than concerned division as well as national level coverage. The results suggested that the traditional service delivery system is not sufficient for rural hard-to-reach areas of Bangladesh. The policy makers should come forward with innovative approaches for rural hard-to-reach areas of this country for improving Immunization coverage.
-
Child Immunization coverage in urban slums of Bangladesh: impact of an intervention package
Health policy and planning, 2009Co-Authors: Jasim Uddin, M.a. Quaiyum, Charles P. Larson, Elizabeth Oliveras, A. I. Khan, Nirod Chandra SahaAbstract:The study assessed the impact of an EPI (Expanded Programme on Immunization) intervention package, implemented within the existing service-delivery system, to improve the Child Immunization coverage in urban slums of Dhaka, Bangladesh. This intervention trial used a pre- and post-test design. An intervention package was tested from September 2006 to August 2007 in two urban slums. The intervention package included: (a) an extended EPI service schedule; (b) training for service providers on valid doses and management of side-effects; (c) a screening tool to identify Immunization needs among clinic attendants; and (d) an EPI support group for social mobilization. Data were obtained from random sample surveys, service statistics and qualitative interviews. Analysis of quantitative data was based on a 'before and after' assessment of selected Immunization-coverage indicators. Qualitative data were analysed using content analysis. Ninety-nine per cent of the Children were fully immunized after implementation of the interventions compared with only 43% before implementation. Antigen-wise coverage after implementation was also significantly higher compared with before implementation. Only 1% drop-out was observed after implementation of the interventions while it was 33% before implementation. At baseline, a significantly higher proportion of Children of non-working mothers (75%) were fully immunized compared with Children of working mothers (14%). Although the proportion of fully immunized Children of both non-working and working mothers was significantly higher at endline, fully immunized Children of working mothers dramatically improved at endline (99%) compared with baseline (14%). The findings suggest the effectiveness of a 'package of interventions' in improving Child Immunization coverage in urban slums. However, further research is needed to fully assess the effectiveness of the package, to assess the individual components in order to identify those that make the biggest contribution to coverage, and to assess the sustainability of this package within the existing service delivery system, particularly on a wider scale.
Prashant Singh - One of the best experts on this subject based on the ideXlab platform.
-
Sibling composition and Child Immunization in India and Pakistan, 1990–2007
World journal of pediatrics : WJP, 2014Co-Authors: Prashant Singh, Sulabha ParsuramanAbstract:Background This study aimed to assess trends in gender differentials in Child Immunization beyond the conventional male-female dichotomy, by considering gender, surviving siblings, birth order and different compositions of older siblings in tandem, during 1990–2007 in India and Pakistan.
-
'Looking beyond the male-female dichotomy' - sibling composition and Child Immunization in India, 1992-2006.
Social science & medicine (1982), 2014Co-Authors: Prashant Singh, Sulabha ParasuramanAbstract:This study examines trends in gender differentials in Child Immunization beyond the conventional male–female dichotomy, by considering older surviving sibling composition between 1992 and 2006 in India. The present study adopts the World Health Organization (WHO) guidelines for appraising full Immunization among Children utilising three rounds of the National Family Health Survey. Twelve combinations of sex composition of surviving older siblings were constructed. Bivariate differentials and pooled multilevel logistic regression analysis were conducted to assess the trends and patterns of Child Immunization with respect to various categories of older surviving sibling composition. Although Child Immunization increased between 1992 and 2006, majority of all eligible Children did not receive the recommended Immunization. Further, full Immunization significantly varies by twelve categories of siblings composition during 1992–2006. The probability of full Immunization among male Children who did not have any older surviving sibling was 60% in 2005–06, while it was just 26% among female Children who had 1+ older surviving sister and brother. This study emphasizes the need to integrate sibling issues in Child Immunization as a prioritized component in the ongoing Universal Immunization Programme, which could be an effective step towards ensuring full Immunization coverage among Indian Children.
-
Trends in Child Immunization across geographical regions in India: focus on urban-rural and gender differentials.
PloS one, 2013Co-Authors: Prashant SinghAbstract:Background Although Child Immunization is regarded as a highly cost-effective lifesaver, about fifty percent of the eligible Children aged 12–23 months in India are without essential Immunization coverage. Despite several programmatic initiatives, urban-rural and gender difference in Child Immunization pose an intimidating challenge to India’s public health agenda. This study assesses the urban-rural and gender difference in Child Immunization coverage during 1992–2006 across six major geographical regions in India. Data and Methods Three rounds of the National Family Health Survey (NFHS) conducted during 1992–93, 1998–99 and 2005–06 were analyzed. Bivariate analyses, urban-rural and gender inequality ratios, and the multivariate-pooled logistic regression model were applied to examine the trends and patterns of inequalities over time. Key Findings The analysis of change over one and half decades (1992–2006) shows considerable variations in Child Immunization coverage across six geographical regions in India. Despite a decline in urban-rural and gender differences over time, Children residing in rural areas and girls remained disadvantaged. Moreover, northeast, west and south regions, which had the lowest gender inequality in 1992 observed an increase in gender difference over time. Similarly, urban-rural inequality increased in the west region during 1992–2006. Conclusion This study suggests periodic evaluation of the health care system is vital to assess the between and within group difference beyond average improvement. It is essential to integrate strong Immunization systems with broad health systems and coordinate with other primary health care delivery programs to augment Immunization coverage.
Akhilesh Yadav - One of the best experts on this subject based on the ideXlab platform.
-
Gaps in infant and Child mortality among social groups and its linkages with institutional delivery and Child Immunization using census and National Family Health Survey (2015-16)
Journal of Public Health, 2019Co-Authors: Minakshi Vishwakarma, Chander Shekhar, Mili Dutta, Akhilesh YadavAbstract:Introduction Infant and Child mortality are considered as one of the most important indicators of social and economic development of the nation. This paper intends to shed light on the prevalence of infant and under-five death rates with special reference to differentials in SCs, STs, and non-SCs/STs population in India. In addition, to determine the factors affecting Child Immunization and institutional delivery by different background characteristics. Data source and methods The present study has used Census 2001 and 2011 for estimating the infant and under-five mortality. The National Family Health Survey (2015–16) has been used to assess the gaps in institutional delivery and coverage of Child full Immunization between SC, ST, and other caste population and also to assess the covariates of insitutional delivery and full Immunization. Results The study observed the high infant mortality rate and under-5 mortality among Scheduled Caste and Scheduled Tribe, while it is much lower among non-SC/ST population in 2011 census. The result of logistic regression suggests that caste has significant impact on access to institutional delivery and Child Immunization, adjusted for other socio-economic variables. All the castes are more likely to gain access to both institutional delivery and Child Immunization compared to scheduled tribe population. Conclusion The study result shows the persistent poor health outcome among the SC/ST population in India. There is need to focus on this section of the population to achieve the sustainable development goals of Child health and its core agenda “No one left behind”.
-
Gaps in infant and Child mortality among social groups and its linkages with institutional delivery and Child Immunization using census and National Family Health Survey (2015-16)
Journal of Public Health, 2019Co-Authors: Minakshi Vishwakarma, Chander Shekhar, Mili Dutta, Akhilesh YadavAbstract:Introduction Infant and Child mortality are considered as one of the most important indicators of social and economic development of the nation. This paper intends to shed light on the prevalence of infant and under-five death rates with special reference to differentials in SCs, STs, and non-SCs/STs population in India. In addition, to determine the factors affecting Child Immunization and institutional delivery by different background characteristics.