Improving Child Immunization Coverage in Underserved, Urban, Extreme Poor Populations of Bangladesh

Tapash Roy, Subhash Chandir and Toufiq Rahman of IRD Global in Singapore will improve child immunization coverage among the homeless, or floating, populations in urban slums in Bangladesh by offering vaccines during evening sessions at existing shelters. The mortality rate for children under five in Bangladesh is high, and many deaths would be preventable with better vaccination coverage. The lack of an integrated public healthcare delivery system in urban areas has resulted in a large inequity between the rich and poor, and the vaccination rate among the floating population of approximately 25,000 is well below the national average. They will develop and test a plan to provide vaccination services using an unconventional gathering place of the floating populations (called Pavement Dweller Centers) during convenient hours. PDCs have been established on city property to provide temporary shelter, safe drinking water, and sanitation services to the homeless. They will use this infrastructure to provide free, mobile phone-based digital immunization registry vaccinations during extended hour clinics with evening shifts, so visitors don't need to miss work to spend time traveling to a healthcare center. The program will be executed by personnel trained in communication to pre-empt any apprehensions by caregivers, and will involve educating visitors on the importance of vaccination. They will evaluate the feasibility and cost-effectiveness of the program in three PDCs in Dhaka and assess community response by a post-intervention survey.