Evaluation

Infant Mortality Rate (IMR) in Uttar Pradesh is 85 per thousand live births. Of this, about 40% is estimated to be due to neo-natal tetanus. As per figures available from the Central Bureau of Health Investigations, UP contributes 21% of the total neo-natal deaths in India. The Maternal Mortality Ratio (MMR) is also high in UP at about 5 per thousand births. The idea of conducting a Tetanus Toxoid (TT) Campaign to immunize pregnant women was mooted by SIFPSA in 1999 and adopted by the Government of Uttar Pradesh. It was to form the cornerstone of an accelerated strategy for reducing infant mortality in UP.

The first tetanus toxoid immunization campaign was conducted in two phases in May and June, 1999 and the second in April and May, 2000. These campaigns were independently evaluated by Population Resource Centre (PRC), Lucknow and ORG Centre for Social Research, Delhi respectively.

The study was carried out in ten districts of the state randomly selected, of which five districts were SIFPSA NGO districts.

By following the WHO 30 cluster sampling system, a total of 2109 eligible women (pregnant for 5 or more months or who had delivered a child after completion of current year's TT campaign) were covered from 300 rural and urban clusters of the 10 selected districts.

Evaluation findings of the two campaigns showed some striking results. The proportion of currently pregnant women, who received two doses of TT, increased by 20 percentage points (from 13% to 33%) during the first campaign conducted in the year 1999. The same indicator increased to 59 percentage points in the second campaign in the year 2000. The findings also showed that the coverage in NGO project areas was 7 percentage points more than that in others.

In SIFPSA NGO districts awareness levels were higher at 47 percent, compared to only 11 percent in other districts. Most of the women in these districts got information about the TT campaign from NGOs. Nearly one-third of these women were visited at home by the CBD workers. IEC material was provided by the CBD worker and a significantly higher proportion of women in these districts (33 percent) than in non SIFPSA districts (7 percent) were aware about the exact dates and place of immunization.