Access to childhood immunisation services and its determinants among recent and settled migrants in Delhi, India

Abstract

Objectives: Childhood immunisation is one of the important public health interventions, and poor migrants are vulnerable to forego these services. The objective of the study is to understand the access of childhood immunisation services to the socio-economically disadvantaged migrants and the determinants of full immunisation uptake up to the age of 1 year.

Methods: In a cross-sectional survey, 458 migrant households with a child aged up to 2 years were identified. Data on sociodemographics, migration history, receipt of various vaccines and maternal healthcare services were collected through interviewer-administered pretested questionnaires. Multiple logistic regression analysis was performed to identify the determinants of full immunisation status.

Results: Childhood immunisation coverage rates were low as only 31% of recent-migrant children and 53% of settled-migrant children were fully immunised against seven vaccine-preventable diseases (VPDs) by 12 months of age. Lack of awareness of the immunisation schedule and location of health facilities, mobility, illness of the child, fear of vaccines and side-effects were the main reasons for incomplete or no immunisation. Mother's educational attainment, TV viewership, hospital birth and receipt of information on childhood immunisation from the health workers during postnatal visits increased chances of getting the child fully immunised against seven VPDs by 1 year of age.

Conclusion: The migrants, particularly the recent migrants, are at the risk of foregoing immunisation services because of livelihood insecurity, mobility and non-familiarity of services in the new urban environment. There is a need to deliver services with a focus on recent migrants. Investing in education and socio-economic development and providing secured livelihoods and equitable services are important to improve and sustain access to healthcare services in the long run.

Keywords: Child health; Determinants; Healthcare access; Immunisation; India; Migrants.