title: A new EPI strategy to reach high risk urban children in Bangladesh: urban volunteers.
abstract: Many community based outreach programs in low income countries utilize illiterate women to provide health services. However, illiteracy may present special problems in immunization or other programs requiring extensive record-keeping and follow-up. In a trial involving twenty-nine volunteers from urban slum communities in Dhaka, Bangladesh, a community-based referral and record-keeping system for use by semi-literate and illiterate volunteers in immunization outreach activities was evaluated over a thirteen month period. The women were uniformly, regardless of literacy, able to use the system to effectively refer and follow-up clients. Although volunteer performance as measured by numbers of referrals was below initial targets, completion rates were high; 87% of children and 96% of women referred completed the full series of immunizations. By facilitating active community participation, the system provides a feasible approach to reducing the high drop-out rates currently associated with immunization programs.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
authors.forename: N
authors.initials: N
authors.lastname: Hughart
authors.forename: D R
authors.initials: DR
authors.lastname: Silimperi
authors.forename: J
authors.initials: J
authors.lastname: Khatun
authors.forename: B
authors.initials: B
authors.lastname: Stanton
mesh_terms: D001459:Bangladesh; D003153:Community Health Services; D004522:Educational Status; D005240:Feasibility Studies; D006302:Health Services Research; D006801:Humans; D007114:Immunization; D008499:Medical Records / Q000592:standards*; D012017:Referral and Consultation; D014504:Urban Health; D014838:Volunteers / Q000193:education*; D000078329:Workforce