Abstract

PIP: In 1979, the immunization coverage of children under 5 was 40% in Malavani, a slum of Bombay with 100,000 inhabitants. During the period 1980-87 the percentage of children receiving a 3rd vaccination dose against diphtheria-pertussis-tetanus (DPT) and poliomyelitis increased from 66% in 1980 to 82% in 1983, and dropped again to 74% in 1987 resulting in an almost zero incidence of polio. Since 1979 various methods have been used to involve nursing mothers and their infants to reduce the rate of discontinuation between the 1st DPT and polio vaccination. 5 subcenters serve the weekly health care of children under 5 with vaccination, weighing, as well as the education of mothers about nutrition, immunization and family planning. 971 children obtained their vaccination with their older brothers in 3 phases in the course of 3 months. Community consultation for children under 5 and their mothers was also organized. 563 nursing infants were identified, of whom 502 received health care in the course of 6 months. 89% received DPT and antipolio vaccination. Under a scheme funded by the Aga Khan Foundation 200 children volunteers also paid door-to-door visits to 1200 families that comprised 6000 persons distributing UNICEF flyers and providing instruction in oral rehydration for diarrhea management. They achieved an 85% rate of 3rd vaccination dose completion. This grassroots community approach improved coverage at reduced costs indicating the value of voluntary community action.