title: Assessing providers' vaccination behaviors during routine immunization in India.
abstract: Progress has been made toward improving routine immunization coverage in India, but universal coverage has not been achieved. Little is known about how providers' vaccination behaviors affect coverage rates. The purpose of this study was to identify provider behaviors that served as barriers to vaccination that could lead to missed opportunities to vaccinate. We conducted a study of health-care providers' vaccination behaviors during clinic visits for children <3 years of age. Information on provider behaviors was collected through parent report and direct observation. Compared with illness visits, parents were eight times more likely to report vaccination status was verified (p < 0.001) and three times more likely to report receiving counseling on immunization (p = 0.022) during vaccination visits. Training of all vaccination practitioners should focus on behaviors such as the necessity of verifying vaccination status regardless of visit type, stressing the importance of counseling parents on immunization and emphasizing what is a valid contraindication to vaccination.
authors.affiliation: School of Medicine, Emory University, Atlanta, GA 30322, USA Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Cohen
authors.affiliation: School of Medicine, Emory University, Atlanta, GA 30322, USA lisa.gargano@gmail.com.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Gargano
authors.affiliation: Indian Academy of Pediatrics, Mumbai 400 007, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Thacker
authors.affiliation: Indian Academy of Pediatrics, Mumbai 400 007, India.
authors.forename: Panna
authors.initials: P
authors.lastname: Choudhury
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Weiss
authors.affiliation: St. Stephen's Hospital, New Delhi 110054, India.
authors.forename: Manisha
authors.initials: M
authors.lastname: Arora
authors.affiliation: School of Medicine, Emory University, Atlanta, GA 30322, USA.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Orenstein
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
authors.affiliation: School of Medicine, Emory University, Atlanta, GA 30322, USA Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Hughes
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007114:Immunization; D007194:India; D007223:Infant; D008297:Male; D010817:Physician-Patient Relations; D014611:Vaccination; D014612:Vaccines / Q000008:administration & dosage; D014777:Virus Diseases / Q000517:prevention & control*
chemical_list: D014612:Vaccines
keywords: India; children; disease prevention; health knowledge promotion