Bangladesh 1993-1994 Demographic and Health ... - Measure DHS

5 percent were assisted by doctors, nurses, midwives, or family welfare visitors, compared to 54 percent ofthe births whose mothers had four or more antenatal visits. Also of interest in Table 8.5 is the relatively highproportion of births in Chittagong Division that are assisted by traditional birth attendants and the highproportion of births in Rajshahi Division that are assisted by relatives and friends only.There has been a slight increase over time in the proportion of births assisted by medical personnel.Data from the 1989 BFS shows that less than 2 percent of births in the late 1980s were assisted at deliveryby a doctor, while about 3 percent were assisted by a nurse or family welfare visitor (Huq and Cleland,1990:111). According to B DHS data, these figures had increased to 4 percent and 5 percent, respectively,for births in the three years prior to the survey (roughly 1991-93). What is more surprising is that, accordingto the BFS, only slightly over one-quarter of births are assisted by traditional birth attendants, while abouttwo-thirds were assisted by relatives. According to the BDHS, these proportions are reversed, with about 60percent of births assisted by birth attendants and 29 percent assisted by relatives.8.3 Childhood VaccinationThe Expanded Programme on Immunization (EPI) follows the intemational guidelines recommendedby the World Health Organization (WHO). The guidelines recommend that all children receive a BCGvaccination against tuberculosis; three doses of DPT vaccine for the prevention of diphtheria, pertussis(whooping cough), and tetanus; three doses of polio vaccine, and a vaccination against measles. WHOrecommends that children receive all of these vaccines before their first birthday and that the vaccinationsbe recorded on a health card given to the parents.In the B DHS, mothers were asked to show the interviewer the health cards of all children born in thethree years before the survey. The interviewer copied from the card the date each vaccine was received. Ifa child never received a health card or if the mother was unable to show the card to the interviewer, themother was asked to recall whether the child had received BCG, polio, DPT (including the number of dosesfor polio and DPT), and measles vaccinations. Mothers were able to produce health cards for 46 percent ofthese children.Vaccination CoverageInformation on vaccination coverage is presented in Table 8.6, according to the source of inform ationused to determine coverage, i.e., the vaccination card or mother's report. Data are presented for children age12-23 months, thereby including only those children who have reached the age by which they should be fullyvaccinated. The first indicator shows the proportion of these children who bad been vaccinated at any ageup to the time of the survey. These results are presented according to the source of the information used todetermine coverage, i.e., vaccination record or mother's report. The second indicator shows the proportionof children who had been vaccinated by age 12 months, the age at which vaccination coverage should becomplete. Figure 8.2 presents coverage figures as assessed from both vaccination cards and mothers' reports.According to information from both the vaccination records and mothers' recall, 85 percent ofchildren age 12-23 months have received a BCG vaccination and 84 percent the first doses of DPT and polio.Coverage declines for subsequent doses of DPT and polio. Only 67 percent of children receive the third dosesof DPT and polio; dropout rates 2 between the first and third doses of DPT and of polio are thus 21 percent.The coverage rate for measles (69 percent) is similar to that for the third doses of DPT and polio. Overall,2 Dropout rate = (Dose 1 - Dose 3) * 100 / Dose 1106