The immunization programme in Bangladesh: impressive gains in coverage, but gaps remain

The paper reviews the achievements in tetanus immunization coverage and chi ld immunization in Bangladesh. It uses data from the 1993-94 Bangladesh Dem ographic and Health Survey to identify and examine the programmatic and non -programmatic factors that influence the coverage of tetanus (TT) immunizat ion during pregnancy, and full immunization among children 12-23 months old in rural Bangladesh. The purpose of this analysis is to identify the areas that need further programme attention. The logistic regression results show that the coverage of TT immunization w as significantly associated with proximity to outreach clinics and the pres ence of a health worker in the community. Home visits by health/family plan ning fieldworkers and the proximity to outreach clinics had larger influenc es on TT coverage of poorer households compared to those better-off. The ef fect of distance to static clinics varied by regions. Among children, full immunization coverage (coverage of all of BCG, DPT1, DPT2, DPT3, Polio1 Pol io2, Polio3) was significantly associated with distance to outreach clinics , the greater the distance to the clinics, the less the likelihood of immun ization.