Childhood immunization coverage in zone 3 of Dhaka City: the challenge of reaching impoverished households in urban Bangladesh

A household survey of 651 children aged 12-23 months in Zone 3 of Dhaka Cit y carried out in 1995 revealed that 51 % of them had fully completed the se ries of childhood immunizations, immunization coverage in slum households w as only half that in non-slum households. Apart from residence in a slum household other characteristics strongly ass ociated with the completion of the entire series of childhood immunizations included the following: educational level of the mother, number of childre n in the family household, mother's employment status, distance from the ne arest immunization site, and number of home visits from family-planning fie ld workers. The findings point to the need to improve childhood immunization promotion and service delivery among slum populations. Two promising strategies for i mproving coverage are to reduce the number of missed opportunities for immu nization promotion during encounters between health workers and clients, an d to identify through visits to households those children who need addition al immunizations. in the long run, increasing the educational level of wome n will provide a strong stimulus for improving childhood immunization cover age in the population.