Vaccine
Volume 30, Issue 2 pp. 103-498 (5 January 2012)

Regular Papers
Improving low coverage of child immunization in rural hard-to-reach areas of Bangladesh: Findings from a project using multiple interventions
Pages 168-179
Md. Jasim Uddin, Nirod Chandra Saha, Ziaul Islam, Iqbal Ansary Khan, Shamsuzzaman, M.A. Quaiyum, Tracey Perez Koehlmoos

Abstract
The study was conducted to assess the impact of combined interventions to improve the child immunization coverage in rural hard-to-reach areas of Bangladesh. The valid coverage increased at endline compared to baseline in the study areas, and the difference of the increase was highly significant (p < 0.001). The findings also showed that the number of drop-outs, left-outs, and invalid doses decreased at endline compared to baseline in the study areas, and the difference was also highly significant (p < 0.001). The immunization coverage improved significantly in all the four study sub-districts that received interventions, although the relative contribution of each intervention is unknown. The interventions can be implemented in all other hard-to-reach areas of Bangladesh and other countries which are facing similar challenges.