Improving low coverage of child immunization in rural hard-to-reach areas of Bangladesh: Findings from a project using multiple interventions

The study was conducted to assess the impact of combined interventions to improve the child immunization coverage in rural hard-to-reach areas of Bangladesh. The valid coverage increased at endline compared to baseline in the study areas, and the difference of the increase was highly significant (p < 0.001). The findings also showed that the number of drop-outs, left-outs, and invalid doses decreased at endline compared to baseline in the study areas, and the difference was also highly significant (p < 0.001). The immunization coverage improved significantly in all the four study sub-districts that received interventions, although the relative contribution of each intervention is unknown. The interventions can be implemented in all other hard-to-reach areas of Bangladesh and other countries which are facing similar challenges.

► Child immunization coverage in rural hard-to-reach areas of Bangladesh is very low.
► We assessed the impact of combined interventions to improve coverage in those areas.
► Coverage improved significantly after implementation of the interventions.
► The interventions could be implemented in all other hard-to-reach areas.