Migration and immunization: determinants of childhood immunization uptake among socioeconomically disadvantaged migrants in Delhi, India.
OBJECTIVE
To determine the coverage of childhood immunization appropriate for age among socioeconomically disadvantaged rural-urban migrants living in Delhi and to identify the determinants of full immunization uptake among these migrant children.


METHODS
This is a cross-sectional survey of 746 rural-urban migrant mothers with a child aged up to 2 years, who were interviewed with a pretested questionnaire. Data pertaining to the reception of various vaccines, migration history and some other social, demographic and income details were collected. Multiple logistic regression analyses were performed to identify the determinants of full immunization status.


RESULTS
Immunization coverage rates were lower among migrants than the general population of Delhi and even lower among recent migrants. The likelihood of a child receiving full immunization rose with age of the mother, her educational attainment and the frequency of her use of health care. The head of household having a secured salaried job also significantly increased the likelihood of full immunization, as did post-natal visits by a health worker.


CONCLUSIONS
Migrant status favours low immunization uptake particularly in the vulnerability context of alienation and livelihood insecurity. Services must be delivered with a focus on recent migrants; investments are needed in education, socio-economic development and secure livelihoods to improve and sustain equitable health care services.
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India. kusumays@gmail.com
Yadlapalli S
YS
Kusuma
Rita
R
Kumari
Chandrakant S
CS
Pandav
Sanjeev K
SK
Gupta
D000293:Adolescent; D000328:Adult; D004522:Educational Status; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007115:Immunization Schedule; D007194:India; D007223:Infant; D008423:Maternal Age; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011157:Population Dynamics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D055815:Young Adult