Evaluating Immunisation Dropout Rates in Eight Hard to Reach Unions of Maulvibazar District, Bangladesh

In spite of major achievements in the immunisation sector challenges still remain for the program in Bangladesh, specially to maximize coverage and minimize dropout rates in its Hard to Reach areas. Maulvibazar, a northeastern district of the Bangladesh is one of the 64 districts in the country. In the year 2014 valid vaccination coverage by age of 12 months among 12-23 Month-Old Children in the district for Penta-1 and for Penta-3 was 89.3% and 89.6% respectively and for MR vaccine it was 80.3%. Dropout rate for Penta1-Penta3 vaccines was 3.9% and Penta1-MR vaccine was 8.7% in the same year, which is respectively 2% and 2.9% higher than national dropout rate. This study aims to determine the dropout rate for immunisation services in Maulvibazar district over a period of one year using Penta1 to Penta3 and Penta1 to MR vaccine. The study was carried out from January 2015 to December 2015 in eight hard to reach unions of Maulvibazar district over a period of one year. Using the individual union coverage data and immunisation monitoring chart, dropout rates have been calculated among children less than one year of age in the selected unions. When Penta1 and Penta3 vaccine dropout rate is calculated in four months interval it was not statistically significant (P=0.267). But when Penta1 and MR dropout rate has been calculated in the same period of time it has shown strong significance in dropout rate (P=0.012). When total number of children receiving Penta1, Penta3 and MR vaccines has been plotted, it has shown a gradual increase in vaccination coverage from January to December. Dropout rates found in this study in selected eight hard to reach unions are very minimal for Penta1-Penta3 vaccine. But for MR vaccine the dropout rates are much alarming. The reason for lower immunisation coverage and higher dropout rates could well be the distance of near by health facilities from these hard to reach areas, bad road conditions and lack of knowledge about vaccination and vaccine preventable diseases.