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Table of Contents   
LETTER TO EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 746-747
Recommended strategies to respond to the challenge of poor immunization coverage in Low-and Middle-income nations


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication21-Aug-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Recommended strategies to respond to the challenge of poor immunization coverage in Low-and Middle-income nations. Ann Trop Med Public Health 2017;10:746-7

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Recommended strategies to respond to the challenge of poor immunization coverage in Low-and Middle-income nations. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 22];10:746-7. Available from: http://www.atmph.org/text.asp?2017/10/3/746/188501


Dear Sir,

Worldwide, immunization has been acknowledged as one of the most cost-effective mode of primary prevention to minimize sufferings, disabilities, and fatality among the under 5 aged children.[1],[2]

In fact, the global estimates suggest that immunization alone prevents almost 3 million deaths attributed to the diseases which can be prevented by vaccines.[3] Though, it is a fact that the immunization coverage remained constant over the last few years; nevertheless, the alarming public health concern is that each year in excess of 18.5 million infants is devoid of routine vaccination despite their availability across the globe.[3] Furthermore, 6 out of every 10 children who miss their immunization are from developing nations, which is again one of the biggest challenges that the program managers have to address.[1],[3]

A wide gamut of factors has been identified, such as low awareness among people, limited resources, competing health priorities, poor management of health system, literacy status of the parents, counseling during the antenatal period, the presence of a vaccination card, received scheduled postnatal check-up, socioeconomic status of the family, distance from the immunization center, myths associated with vaccines, the insensitive nature of health staff, history of adverse effect following immunization, and the absence of a streamlined mechanism to ensure proper monitoring and supervision, and all of them are the critical determinants for the poor immunization coverage across heterogeneous settings among the developing nations.[2],[3],[4],[5]

Out of the six targets under the Global Vaccine Action Plan, only one target pertaining to the initiation of one or more new or underutilized vaccine in at least 90 developing nations is progressing as per the desired plan.[3] Other than that the target of achieving 90% of immunization coverage with three doses of Diphtheria-Pertusis-Tetanus (not achieved in 65 nations), elimination of measles in at least four World Health Organization regions (only one region achieved elimination and 15% children fail to receive one dose of measles), elimination of rubella from at least two World Health Organization regions (50% of all children fail to receive the vaccine), elimination of maternal and neonatal tetanus from 59 high-risk nations (21 nations have not achieved), and living in a world free of polio (two nations are still endemic) are totally off-track.[1],[3]

However, in order to improve the immunization coverage and to avert millions of deaths, the ultimate target is to achieve vaccination coverage of ≥90% and ≥80% at the national and the district level by 2020.[2],[3]

This target of vaccination coverage or even the other specific disease-related targets can be achieved by integrating immunization with other welfare services, like antenatal or postnatal care, strengthening health care delivery systems, both for improving routine immunization and for being prepared to make sure that immunization services remain undisturbed during humanitarian emergencies or disasters, ensuring that everyone has an access to vaccines and the ability to afford, and continuing research activities for the development of newer vaccines.[1],[2],[3],[4],[5]

To conclude, realizing the wide immunization gap, there is a great need to strengthen immunization services and involve members of the community, especially in nations with very large number of unimmunized children.

Acknowledgements

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Shrivastava SR, Shrivastava PS, Ramasamy J. WHO UNICEF: Updates on immunization coverage and how can we improve upon? J Res Med Sci 2015;20:1216-7.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Mureed S, Somronghtong R, Kumar R, Ghaffar A, Chapman RS. Enhanced immunization coverage through interventions for childhood cluster diseases in developing countries. J Ayub Med Coll Abbottabad 2015;27:223-7.  Back to cited text no. 2
    
3.
World Health Organization. Immunization coverage-Fact sheet; 2016. Available from: http://who.int/mediacentre/factsheets/fs378/en/. [Last accessed on 2016 Apr 19].  Back to cited text no. 3
    
4.
Ebot JO. “Girl Power!”: The relationship between women's autonomy and children's immunization coverage in Ethiopia. J Health Popul Nutr 2015;33:18.  Back to cited text no. 4
    
5.
Lakew Y, Bekele A, Biadgilign S. Factors influencing full immunization coverage among 12-23 months of age children in Ethiopia: evidence from the national demographic and health survey in 2011. BMC Public Health 2015;15:728.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
3rd floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvanchery Main Road, Sembakkam Post, Kanchipuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.188501

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