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INTEGRATION OF BCG VACCINATION IN GENERAL HEALTH
SERVICES IN RURAL AREAS |
Baily GVJ, Kul Bhushan, GE Rupert Samuel & BK Keshav
Murthy : Indian J TB 1973, 20, 155-60. |
BCG vaccination is being conducted as a mass campaign.
It is difficult to maintain a high coverage of the population at
risk i.e., new borns. This can best be done by integrating the BCG
vaccination services with the general health services. The present
investigation was planned to study the feasibility of routine BCG
vaccination of the new borns by the Primary Health Centre
personnel using the normal records maintained by them. In a rural
population of 33,128 persons (1971 census), served by PHC Bettahalasur
of Bangalore district, BCG vaccination was administered to 0-15
months old children by 2 Block Health Workers (BHWs) and 3 Auxiliary
Nurse Midwives (ANMs) after training them for about 3 weeks. They
used a compact specially designed BCG kit and employed a conventional
intradermal technique for BCG vaccination. Routine work was not
to be disturbed in any way. Each worker prepared a list of children
eligible for BCG vaccination from the register of unprotected children
and updated the list for those not found registered. National Tuberculosis
Institute (NTI) field staff registered a sample population, allotted
to each worker for estimation of eligibles. Three months later they
also examined BCG vaccination lesions in a sample of children. BHWS
and ANMS were interviewed by a medical officer from NTI regarding
their opinion on integrated work.
The findings showed that the ANMS and BHWS had already registered
nearly 50% of the new borns in their records with variation in registration
from 21 to 80% by the field workers; ANMS understandably having
registered lesser numbers. All of them were, however, able to update
the registrations to a level of 82%. They could pick up the BCG
vaccination technique easily. Of the total eligibles, ANMS and BHWS
could contact 86.4% and vaccinate 77%; remaining 23% either refused
or were excluded from vaccination. In the total eligibles registered,
however, the vaccination coverage was 66.6%. Of the children reported
vaccinated, 96% had evidence of BCG vaccination indicating a high
degree of reliability of reporting. The opinion of all the
5 field workers on integration was favourable. All the ANMS and
BHWS workers, on interview, stated that they had done BCG work without
detriment to their other duties and would be easily able to do so
in future. The field workers can accumulate the new borns for a
year and vaccinate them during a month. This has mainly operational
advantages including less vaccine wastage. For urban areas a
different operational design with the same principles may become
necessary.
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KEY WORDS: INTEGRATION, BCG VACCINATION, HEALTH
SERVICES, RURAL POPULATION. |