Barriers of Newborn Vaccination Coverage among Institutional Deliveries: A Mixed-method Study from Sonepat, Haryana

ABSTR ACT Introduction: World Health Organization (WHO) recommends the administration of three vaccines soon after birth, namely Hepatitis B Virus (HBV) vaccine, Bacillus Calmette-Guerin (BCG), and Oral Polio Vaccine (OPV). Various studies reported that early administration of these vaccines have a marked beneficial impact on infant survival. As birth is the most reliable point of healthcare contact worldwide and effective vaccination at birth would provide early protection for newborns. Hence, expanding and improving the available means of neonatal vaccination is an unmet medical need and a public health priority. Aim: To determine left-out vaccination rate for birth doses and the barriers of newborn vaccination coverage among institutional deliveries, in Sonepat District, Haryana. Materials and Methods: A mixed-method study (qualitative and quantitative) was conducted in rural tertiary healthcare institute and two secondary (district hospital Sonepat and sub-divisional hospital Gohana) public healthcare facilities of district Sonepat during 1st June 2019 to 31st July 2019. Records of live births that occurred during the study duration at selected facilities were taken to find out the left-out vaccination rate for birth doses. Focus Group Discussions (FGDs) of staff nurses posted at immunisation clinic, labour room, obstetrics and gynecology and paediatrics department were carried out to find the barriers of newborn vaccination. Results: Total 1943 live births occurred at selected public healthcare facilities during the study duration. Vaccination coverage of birth doses recorded among 1381 (71.1%) neonates and 562 (28.9%) were left-out. Barriers for newborn vaccination were non-availability of vaccine at birth places, training and skill to administer vaccine by staff, human resource constraints, and socio-demographic factors. Conclusion: This study provided a roadmap to develop a vision for strengthening newborn vaccination coverage among institutional deliveries