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Indian Journal of Community Medicine

Evaluation of Pulse Polio and Routine Immunization Coverage in the Urban and Rural Population of Ludhiana District

Author(s): S.Singh, A. Benjamin, P. Panda, A.S. Bhatia

Vol. 30, No. 3 (2005-07 - 2005-09)


Poliomyelitis is the commonest cause of Acute Flaccid Paralysis (AFP) in India, and polio eradication is an urgent necessity.1 The options for prevention are provision of safe water, proper sanitation and immunization.2 The impact of routine polio immunization and PPI on the incidence of poliomyelitis is well known.3


1. To assess the pulse polio and the routine polio immunization coverages in rural and urban communities.

2. To find out the sources of information for PPI and the causes of missed doses.

Material and Methods

This cross-sectional study was conducted in 8 villages and 6 urban areas of Ludhiana district. All the households in the surveyed villages/localities were included in the study. House-to-house survey was conducted using a three-part questionnaire and the respondents were the parents of the under-five year old children.


The details of population covereed, families surveyed, number of children and the PPI coverage are shown in the Table-1. The PPI coverage in the 0-5 year old children studied was found to be 93.41% in rural areas and 83.91% in urban areas, respectively.

Table I: Population Parameters and Coverage of Pulse Polio Immunization

Parameters Urban Rural
Total Population covered 25801 16094
Total number of families surveyed 4317 2892
Total no. of families with under-5 children 1926 1055
Total number of under-five children 2829 1563
No PPI dose received 204 (4.21%) 39 (2.20%)
Received Dose I only 115 (4.06%) 22 (1.41%)
Received Dose II only 136 (4.81%) 42 (2.69%)
Received Both doses 2374 (83.91%) 1460 (93.41%)

Routine primary (1-2 yrs age) and booster (2-5 yr age) polio immunization coverages were 89% and 76% respectively.

In urban areas, the main sources of information about PPI were mass media (54.93%), followed by health workers (23.68%) and neighbours (22.35%). In rual areas the main sources were Health workers (43.94%) followed by the mass media and announcement from the Gurudwaras and temples (33.65%).

The commonest causes of missed doses were 'unawareness' (41.10%), 'non-availability' (21.10%) and 'forgetfulness' (15.16%) in rural areas, while in the urban areas they were 'not-born at the tm of 1st dose' (49.51%), 'out of station' (32.03%) and 'no belief in immunization' (11.65%).

PPI Coverage

In the present study, the PPI coverage was higher in the rural children as compared to the urban.The urban children had a large proportion of immigrant population from adjoining states like Uttar Pradesh, Madhya Pradesh, Bihar and Rajasthan. This migrant population is not well covered by the existing health care system.The enumeration of rural children is better than the urban children. Despite good coverage 5-6% of children are missed in the PPI programme. Nandan D. et al4 reported the PPI coverage among children under 3 years of age, as: 1st dose-86.67%, 2nd dose-87.67%, both doses 83.17%, while 5.5% did not receive any dose.

Routine and Booster dose coverage reasonably satisfactory enumeration of target children in rural areas with the help of available infrastructure is nearly complete (over 95%).


Complete enumeration of the children is a must, which is presently unsatisfactory in the urban areas (migrant populations). The common sources of information should be effectively used in the urban and rural areas, not only for PPI but also for other vaccinations and preventive interventions in the communities. The causes of missed doses in the urban and rural areas needs to be addressed, to assure the maximum possible coverage of PPI, the routine primary immunization under the Universal Immunisation Programme (UIP) and the immunization efforts for control of other vaccine-preventable diseases.


  1. Basu R.N. Lameness survey, Indian Paediatrics 1984; 18; 507.
  2. Lal S. Towards Eradication of Poliomyelitis, Indian J Community Medicine; 1997; XXII, No. 4, 139-144.
  3. Soudarssanana M.B. Pulse Polio Immunization -Evolution of the Poliomyelitis programme in India using the oral polio vaccine. Indian J Community Medicine; 1997; XXII, No. 4, 178-183.
  4. Nandan D., Mishra S.K., Gupta Gajendra K., Gupta S., Maheshwari B.B. Pulse Polio Immunization Coverage Evaluation in a Rural Area of Agra District, Indian J Community Medicine; 1997; XXI, No. 1-4, 34-36.

Department of Community Medicine,
Christian Medical College, Ludhiana-141008
e-mail: [email protected]

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