Reasons for drop out of immunization in children aged between 0-12 months in diyarbakir

In this studey, the reasons for drop out of immunization ın children aged between 0-12months are dealt with. This survey was carried out at eight medical centers in the city centerof Diyarbakır and also at three medical centers, each in separate village. In collecting data,the records of ?the form 012 records? (the card for the registration of vaccination) that wereavailable at eight medical centers which were determined by lots were used. The children whostopped being vaccinated were taken as the facts of the survey. Through those records, 350children aged between 1,5 and 5 years, who remained droped out, were reached as a result offrom-house-to-house visits. As the control group, in such a way as to be one fully immunizedchild for another droped out , the children were picked up from the neighborhood of the samemedical center and also of the same age group. The socio-demographic data about themothers, their views of vaccination, and their babies? case of immunization were collected byface-to-face- interviews.In order to evaluate the service, the questionnaires were applied to the voluntary staffof health centers.The features of underimmunized and fully immunized children were comparedthrough the charts of frequency. Chi-square analysis was applied for the comparisons of thetwo group. For the factors that were considered to have effect on droping out, the odds ratiosand 95% confidence intervals were calculated.In the survey, it was seen that 62,3% of the mothers and 13,4% of the fathers of theunderimmunized children were illiterate. It was found that the literacy of the parents affectedthe ratio of the immunization of children. Also, lack of the economical means of the parentsand having no social security diminished the ratio of the immunization as well.It was also found that being the eighth child increased the risk of theunderimmunization 6,07 (%95 CI:2,85-13,09) folds in comparison to the first child. In fullyimmunized children, vaccination card application was better than droped out children. Of themothers of the underimmunized children, 13,1% believed that vaccination did not protect, thisXratio was determined to be as low as 3,1% for the mothers with fully immunized children(p<0,0001).Of the underimmunized children, 57,7% were vaccinated at the medical centers,while thisratio was 57,2% for fully immunized children; the difference between them was significant(p:0,007). Having vaccination at home increases the risk of underimmunization 1,77 folds(95% CI:1,14-2,75).Of the mothers of the underimmunized children, 25,0% did not know vaccination wasincompleted. In addition, although 4,0% of the children were underimmunized in the recordsof the medical center, their vaccination cards showed that they were fully immunized.According to views of the medical staff about immunization, 13,5% of them statedthat vaccines came to the medical center regularly, and 56,5 % of them said that they gotfurther instructions about vaccines after graduation.As a result of the observations made at the medical center, 98,8% of the medical staff notedthe vaccination on the vaccination card, 25,0% of them told mothers what kind of vaccinesthey applied to their children, 2,5% of them told mothers to bring the vaccination card of thebabies and refused to vaccine otherwise. All of those reasons result in the missedopportunities for the immunization of children, bring about less immunization ratios andincrease the risk of epidemic.Conclusion: It was seen that the poor education of the parents, lower socio-economicstatus, larger family size, the mothers? negative views of vaccination and their inadequateinformation about the importance of immunization, not knowing where to vaccine theirchildren are some of the factors that lead to underimmunization. The missed opportunities arethe most outstanding factor among the administrative factors that affect the drop-outs. Inorder to prevent the drop-out rate?s rising, the factors with regard to the mothers, fathers, andbabies must be analyzed well, and the medical staff at the medical centers must be reeducatedabout the missed opportunities.Key Words: Immunization, underimmunization, the obstacles for vaccination,education, the missed opportunities.