title: Lot quality assurance sampling for monitoring immunization coverage in Madras City.
abstract: OBJECTIVE
  To explore the usefulness of Lot Quality Assurance Sampling (LQAS) to identify divisions in a city that had immunization coverage levels of 80% for any of the four EPI vaccines.
  
  
  METHODS
  Only 43 divisions were considered for the study, the stratification factor being the death rate. The hypothesis that 80% coverage is 'unacceptable' was stipulated. Critical value (the number of unimmunized children) was chosen as 3. A simple random sample of 36 children in the age-group 12-23 months was taken from each selected division. Since sampling frames of children were not available, a simple random sample of 36 households was selected. Immunization status of each child was assessed by interviewing the child's mother/guardian. If the number of unimmunized children exceeded 3, then the division was regarded having coverage level 80% and rejected.
  
  
  RESULTS
  The coverage was classified as unacceptable(i. e., below 80%) in 19 divisions for Polio and DPT vaccines, in 26 divisions for Measles vaccine and in 4 divisions for BCG vaccine. The average time spent for undertaking the LQAS survey was 6 man-days per division.
  
  
  CONCLUSIONS
  This study demonstrated the utility of the LQAS technique in identifying 'unsatisfactory' pockets in Madras City, when the overall coverage was satisfactory. The technique will have greater application with an increase in the number of large units (cities/districts) having an overall coverage of 90% or more.
authors.affiliation: Institute for Research in Medical Statistics, Spur Tank Road, Chetput, Chennai 600 031, India.
authors.forename: B N
authors.initials: BN
authors.lastname: Murthy
authors.forename: S
authors.initials: S
authors.lastname: Radhakrishna
authors.forename: S
authors.initials: S
authors.lastname: Venkatasubramanian
authors.forename: V
authors.initials: V
authors.lastname: Periannan
authors.forename: A
authors.initials: A
authors.lastname: Lakshmi
authors.forename: V
authors.initials: V
authors.lastname: Joshua
authors.forename: R
authors.initials: R
authors.lastname: Sudha
mesh_terms: D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000592:standards*; D007194:India; D007223:Infant; D011785:Quality Assurance, Health Care / Q000379:methods*; D011786:Quality Control; D012494:Sampling Studies