Evaluation of a community-based intervention to improve routine childhood vaccination uptake among migrants in urban slums of Ludhiana, India.

ABSTRACT

Background: Evidence on the effectiveness of community-based interventions in improving vaccination uptake in migrant populations is limited. This study aims to evaluate the effectiveness of a community-based intervention to improve access to and uptake of childhood vaccinations among urban slum-dwelling migrant communities in Ludhiana, India. Methods: A mixed-methods evaluation was conducted involving a post-intervention comparison of vaccination uptake in six randomly selected intervention and control slum communities. Multilevel logistic regression to account for clustering of effects was used to investigate the impact of the intervention on vaccination uptake. Thematic analysis was used to analyse qualitative data. Results: Overall, vaccination uptake was significantly higher in the intervention clusters and the likelihood of full immunization by the age of 1 year was more than twice that in the control clusters [OR 2.27 (95%CI 1.12-4.60); P = 0.023]. Qualitative findings showed that stakeholders felt ownership of the intervention and that it was effective in increasing accessibility to and uptake of vaccinations. However, they emphasized the importance of continued government support for the intervention. Conclusions: Community-based interventions can significantly increase vaccination coverage in deprived populations with previously low uptake of childhood immunization but such initiatives need to be delivered in partnership with the government.