Barriers to childhood immunisation among women in an urban underprivileged area of Bangalore city, Karnataka, India: a qualitative study

Abstract

Background: Immunisation is one of the most cost-effective and safest public health interventions in reducing the childhood mortality and morbidity. National Family Health Survey- 3 reports that only 43.5% of children in India received all of the primary vaccines and the situation was worse among urban poor where the coverage was 39.9%. An earlier study in an underprivileged area of Bangalore found that only 53% of children aged 12-23 months had received full primary immunisation. This study aimed at understanding the barriers to immunisation among women residing in the same area. Methods: This was a community based qualitative study, in an urban underprivileged area of Bangalore city. Data was obtained from three focus group discussions with mothers of children less than five years of age and ten key informant interviews with mothers, mother-in law and other stakeholders like link worker, ANM and anganwadi worker of the area. Results: Barriers in knowledge among mothers included poor awareness of immunisation schedule and vaccine preventable diseases. Immunisation was delayed due to common childhood illness. Lack of family support, negative attitude of the elderly at home, poor male participation, gender bias, apprehension of giving many vaccines at one time and adverse rumours were the commonly mentioned attitudinal barriers to immunisation. Barriers to utilization of immunisation services included economic constraints, long distance to health facility, and loss of daily wages while attending immunisation clinic, inconvenient timings and lack of effective communication with health personnel. Conclusion: This study has identified barriers in knowledge, attitude and utilization of immunisation services in an urban underprivileged area which should be addressed while planning immunisation strategies at health system level.