A comprehensive assessment of the quality of immunization services in one major area of Dhaka City, Bangladesh

Henry Perry, Robert Weierbach, Shams El-Arifeen, Iqbal Hossain

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


This report assesses the quality of service inputs, service processes and Service outcomes (with the exception of coverage and effectiveness) for immunization services in Zone 3 of Dhaka City. The results indicate that in general, the providers of immunization services are knowledgeable, friendly and give technically appropriate immunizations. Client ratings of the quality of services are quite good. Access is 90% for childhood immunizations and 89% for tetanus toxoid (TT) immunizations for women with a child < 1 year old. Three areas were identified as needing attention: frequently missed opportunities for the promotion or provision of immunizations; uneven distribution and utilization of immunization sites, and some fundamental weaknesses of the TT immunization programme (lack of awareness among women of reproductive age about the importance of TT immunization, low access to it among women of reproductive age who do not have a child < l year of age, and confusion among women and service providers about the purpose of TT immunization and the dosage schedule). Efforts to monitor and strengthen the quality of EPI activities will facilitate further decline in the numers of deaths and illnesses from vaccine-preventable diseases. The approaches used in this study and the typology for quality assessment are widely applicable elsewhere.

Original languageEnglish (US)
Pages (from-to)981-992
Number of pages12
JournalTropical Medicine and International Health
Issue number12
StatePublished - 1998
Externally publishedYes


  • Bangladesh
  • Immunization programmes
  • Quality
  • Urban

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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