ABSTRACT
The present study seeks to explore the concerns of urban immunization and study the need for urban specific strategies to reach the marginalized. Expensive private healthcare, lack of information and assistance, social exclusion and perceived poor service lead to poor performance of health indicators in urban areas compared to that in rural areas. Therefore it is imperative to understand the dynamics of health program implementation in cities. This study used qualitative methods of data collection. In-depth interviews and document analysis were used to gather primary data. The respondents listed many challenges including language, illegal settlements, multiple cultures, shortage of human resources, lack of efficiency in micro plans, monitoring and implementation, to name a few, in routine immunization implementation. The respondents also proposed solutions to address such problems. They stressed seeking inter-sectoral coordination, micro-planning, using multiple languages, training human resources to persuade the target groups and making provisions to reach the target groups with necessary facilities. The data revealed that micro-planning of communication should be done while mapping the target group about the health requirements. The research found that there is less preference for communication and over-emphasis is given to the resource allocation and supply chain for the vaccines. However, it is essential to give due importance to communication strategies to improve the immunization programmes’ performance and reach the underserved urban poor.
