According to the World Health Organization (WHO) constitution, health is a state of complete physical, mental and social well-being and should enable people to lead socially and economically productive lives (WHO 1976, 1983).
In 1977, the thirtieth World Health Assembly in a resolution decided that the main social target of govrnments and WHO in the coming decades should be the attainment for all the people of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. This is popularly known as Health for all by the year 2000." In 1978, the international conference held in Alma Ata accepted primary health care as the key approach to attaining the goal of Health For All (HFA).
In 1979, the Executive Board of WHO endorsed the report of the international conference of primary health care and suggested to the 32nd World Health Assembly to call upon member states for individually formulating national policies, strategies and plans of action and collectively formulating regional and global strategies for attaining an acceptable level of "Health For All by the Year 2000".
The Government of Bangladesh in 1980 prepared a country paper 011 HFA, which specifies the concepts and a number of indicators related to health status, health service provisions, coverage and quality of care to reflect the scenario desired by the year 2000 in the context of Bangladesh.
The Expanded Program on Immunization (EPI) follows the international guidelines recommended by the WHO. The guidelines recommended that all children receive a Bacillus Calmette Guerin (BCG) - anti tuberculosis vaccination; three doses of Diphtheria, Poliornyelitis, Tetanus. (DPT) vaccine and a vaccination against measles. WHO recommends that children receive all of these vaccines before their first birthday and that the vaccinations be recorded on a health card given to the parents.
In recent years, health researchers have paid increasing attention towards the study of immunization specially of six immunizable fatal diseases like Diphtheria, Polio, Tetanus, Measles, and BCG for children of age 00-23 months and tetanus toxoid immunization status for mothers'and married women aged 15-49 years through the analysis of data 011 EPI.
In this situation complete monitoring of immunization is indeed badly needed . To achieve this objective Bangladesh Bureau of Statistics has taken up "HEALTH' AND DEMOGRAPHIC SURVEY" (ADS), so as to provide statistically representative, dependable and reliable data at national and sub-national levels, disaggreated by gender. As a part of the Health and Demographic Survey conducted in January 1995, the module of coverage of immunization has also been incorporated to obtain nationally representative estimates on immunized children and their mothers and married women aged 15-49 years in Bangladesh.
The study population was categorized as follows:
1. Children of age two years, and below;
2. Pregnant mother and
3. Married women of age 15 - 49 years.
The general objective of the study was to ascertair the exact extent of immunization received by the children of two years or below and their mother and married women aged 15-49 years.
The specific objectives were as follows:
1. To estimate the coverage/completeness of the expanded program of immunization;
2. Assess the main sources of information on immunization;
3. Assess the attitude towards acceptance of immunization vaccinations;
4. To find out dropout rates of immunization vaccinations from one to another;
5. To find out mother's tetanus toxoid immunization status;
6. To find out reasons for non-immunization of target group.
This will help the decision-makers to adopt an appropriate control strategy to obtain the highest health benefits, consistent with the efforts and resources invested.
Kind of Data
Sample survey data [ssd]
The project covers 210 sample mauzas (Rural 150 and Urban 60) out of 372 sample mauzas drawn from all over Bangladesh following a scientific sampling procedure. A total of 8400 households containing 24,840 population with a sex ratio of 104 has been covered in this study. On an average, an enumeration area consists of 255 households and 1,333 population as per listing and mapping operation during January, 1995.
Producers and sponsors
Authoring entity/Primary investigators
BANGLADESH BUREAU OF STATISTICS
Statistics Division, Ministry of Planning
The Integrated Multi-purpose Sample (IMPS) design has been developed using the results of Population census 1991 and was used for conducting survey on coverage of immunization from January 1993 to December 1994 under HDS program.
The project activities are being undertaken using IMPS design. The IMPS has been developed on the result of Population census 1991. For the preparation of IMPS design,the country has been divided into five administrative divisions, 64 districts and 490 thanas. In rural areas, thanas are divided into wards and then mahallas. The IMPS is a nationally representative two-stage sampling based on results of population census 1991. Each of the five divisions was stratified into three groups, i.e., (i) Statistical Metropolitan Areas (SMAs), (ii) Municipalities (urban areas) and (iii) Rural areas. Statistical Metropolitan Areas and Municipalities constitute urban sample areas.
Deviations from the Sample Design
It was observed that slum population live on household basis and those households tend to form a cluster of households. It was thought that itwould be convenient to enumerate on household approach. Therefore, the household was preferred as unit of enumeration.
Dates of Data Collection (YYYY/MM/DD)
Mode of data collection
Ministry of Planning
Editing and coding at Regional Statistical Offices
Schedules enumerated were first submitted to the RSO office by the TSO. The submitted schedules were edited and coded by the officials at RSO office, before sending them to HDS HQs, Dhaka. The final editing and coding were performed at the HDS HQs by the officials of the project.
A centralized processing system was developed in the project office. The components of processing systems are:
- Inventory of documents and storage in geographical order.
- Data capture by computer.
- Computer editing.
The officials of HDS have used Integrated Micro-computer Processing Software (IMPS) for data entry and processing of the information of the surveys.