day to day problems in routine immunization

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Dr. Harivansh Chopra DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION DR.HARIVANSH CHOPRA MD.,DCH PROFESSOR COMMUNITY MEDICINE LLRM MEDICAL COLLEGE, MEERUT

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DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION. DR.HARIVANSH CHOPRA MD.,DCH PROFESSOR COMMUNITY MEDICINE LLRM MEDICAL COLLEGE, MEERUT. DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION. How many of you are involved in routine immunization?. DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION. - PowerPoint PPT Presentation

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Page 1: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

DR.HARIVANSH CHOPRAMD.,DCH

PROFESSORCOMMUNITY MEDICINE

LLRM MEDICAL COLLEGE, MEERUT

Page 2: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

1. How many of you are involved in routine immunization?

Page 3: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

1. How many of you are trained in routine immunization?

Page 4: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

1. How many of you have read some special manual on immunization?.

Page 5: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

1. Is the problems faced by the multipurpose Workers and faced by you and me are Similar or different?

Page 6: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION DIFFERENT PROBLEMS IN DIFFERENT

SETTINGS

ETTINGS

Page 7: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

1. OPERATIONAL

2. SKILL BASED3. KNOWLEDGE

4. AEFI

Page 8: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

OPERATIONAL PROBLEMS1. CONVEYANCE2. VACCINE

AVAILABILITY3. STORAGE4. A/D SYRINGE

Page 9: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

OPERATIONAL PROBLEMS1. CONVEYANCE2. VACCINE

AVAILABILITY3. STORAGE4. A/D SYRINGE

Page 10: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

OPERATIONAL PROBLEMS• INFRASTUCTURE• MANPOWER• GENERATOR• DISPOSAL

Page 11: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

SKILL BASED PROBLEMS1. ADMINISTRATION OF VACCINE

Page 12: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

SKILL BASED PROBLEMS1. ADMINISTRATION OF VACCINE

Page 13: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

SKILL BASED PROBLEMS1. ADMINISTRATION OF VACCINE

Page 14: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS

1. WRONG USE OF VACCINE CARRIER

Page 15: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS

1. WRONG USE OF VACCINE CARRIER

Page 16: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• WRONG USE OF ICE PACK

Page 17: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• WRONG USE OF ICE PACK

Page 18: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• USE OF FROZEN VACCINE OF T

SERIES

Page 19: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• NO CHECKING OF VVM

Page 20: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• USE OF EXPIRED VACCINE

Page 21: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• WRONG RECONSTITUTION OF

VACCINE

Page 22: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• NOT WRITING THE TIME OF

RECONSTITUTION

Page 23: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• WRONG VACCINE ADMINISTRATION

• SIMILAR NAMES DIFFERENT AGES

Page 24: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

KNOWLEDGE BASED PROBLEMS• IMPROPER RECORD KEEPING

Page 25: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

AEFI

Page 26: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

AEFI• Emergency kit should provided to resuscitate the child in

case of life threatening reactions.• Supervised training for skill development to prevent and to

manage AEFI• Educate the mother about the possibilities and the

precautions to take in case of AEFI• Both clinical and PR skills development

Page 27: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

SOLUTIONALL OF THE ABOVE MENTIONED PROBLEMS CAN BE SOLVED BY1 PROPER LIASIONING WITH THE HEALTH SYSTEM.PUTTING MEDICAL COLLEGES IN THE DISTRICT ACTION PLAN UNDER NRHM.

2. TRAINING AND RETRAINING OF POST GRADUATES /FACULTY IN ROUTINE IMMUNIZATION.

Page 28: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

CONCLUSIONACTION WITOUT KNOWLEDGE IS

USELESS AND KNOWLEDGE WITOUT ACTION IS FUTILE.SO LET US JOIN HANDS TO

TAKE ACTION…….

Page 29: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 30: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Conveyance problem

Page 31: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

93.20%

5.30%1.50%

COMPLETELY IMMUNISED

PARTIALLY IMMUNISED

NOT IMMUNISED

Page 32: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

ALWAYS AT UHC INITIALLY SOME-WHERE ELSE, NOW

AT UHC

ANYWHERE0

50

100

150

200

250

300

350

347

47

0

NU

MB

ER

ALWAYS AT UHC INITIALLY SOMEWHERE ELSE, NOW AT UHC

ANYWHERE0

10

20

30

40

50

60

70

80

90

88

12

0

PERC

ENTA

GE

(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)

Page 33: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

45.90%

53.10%

FREE OF COST ?

82.60%

17.40%

PROXIMITY OF CENTRE ?

NO

NO

YES

YES

(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)

Page 34: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

80.40%

19.60%

EXPERT HANDS?

82.70%

12.30%

MINIMUM SIDE EFFECTS ?

YES YES

NONO

(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)

Page 35: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

83.90%

16.10%

PUNCTUALITY ?

66.10%

33.90%

PROPER SITTING ARRANGEMENT ?

YES YES

NO NO

(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)

Page 36: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

80.90%

19.10%

EXPERT GUIDENCE ?

79.10%

20.90%

PROPER BABY CARE TIPS ?

YES YES

NO NO

(BASED ON THE INTERVIEW OF MOTHERS OF 1 – 6 YRS CHILDREN IN COMMUNITY)

Page 37: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Timely and punctual immunisation sessions are carried out by post graduate students and interns every Wednesday under expert guidance of senior faculty.

89%

11%

CARRIED OUT

MISSED**

** All the 11% sessions missed were due to national/gazetted holidays.

Page 38: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

• Community meetings of all pregnant females and mothers to educate them the importance of immunisation, family planning, proper infant care – in past three years more than 30 such meetings have been held.

• Apart from these community meetings, the interns impart this knowledge house to house.

• Provision of comprehensive child health care.

Page 39: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Growth monitoring of all children coming for immunisation, proper record maintenance, education of parents on growth pattern of children, and assistance in maintaining a healthy

child.

Page 40: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 41: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 42: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

CONCLUSION• Punctuality, Regularity and Maintaining Adequate Safety

Precautions resultsin the client satisfaction thereby

increasingthe utilisation of immunisation

services.

Page 43: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 44: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 45: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 46: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

Page 47: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

• The study was conducted in Urban Field Practice Area of LLRM Medical College, Meerut with a total population of 9816.

• Minimum sample size (n) = Z2 (pq) = 384 d2

n – Sample Size Z – Confidence Interval = 95%

p – Estimated Prevalence = 50% q – (100 – p) d – Relative precision = 10%• So for completing the sample size of 400(giving a

margin of non coverage), mother of every 2nd child was selected by systematic random sampling method and was interviewed.

Page 48: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

• The study was conducted in Urban Field Practice Area of LLRM Medical College, Meerut with a total population of 9816.

• Minimum sample size (n) = Z2 (pq) = 384 d2

n – Sample Size Z – Confidence Interval = 95%

p – Estimated Prevalence = 50% q – (100 – p) d – Relative precision = 10%• So for completing the sample size of 400(giving a

margin of non coverage), mother of every 2nd child was selected by systematic random sampling method and was interviewed.

Page 49: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

4.50%

41.10%

37.70%

14.20%

2.50%

UPPER MIDDLELOWER MIDDLE

UPPER LOWER

LOWER UPPER

Modified classification of Kuppuswamy

Page 50: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

ILLI

TER

ATE

PRIM

AR

Y SC

...

MID

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SC

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OO

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POST

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...

PRO

FESS

ION

AL05

1015202530354045

46

8.8

40.7

1315.5

7.74.3

%

Page 51: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

ILLI

TER

ATE

PRIM

AR

Y SC

...

MID

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5101520253035

6 3.8

13.5

34

14.5 16

10.5

1.7

%

Page 52: DAY TO DAY PROBLEMS IN ROUTINE IMMUNIZATION

Dr. Harivansh Chopra

EDUCATIONFATHER

(%)MOTHE

R(%)

ILLITERATE 4 6PRIMARY SCHOOL 6 3.8MIDDLE SCHOOL 8.8 13.5

HIGH SCHOOL 40.7 34INTERMEDIATE 13 14.5GRADUATE 15.5 16

POST GRADUATE 7.7 10.5PROFESSIONAL 4.3 1.7