Evaluation of Universal Immunization Program (UIP) in Botad District, Gujarat, India: A Cross-Sectional Study

Abstract

Introduction: The Universal Immunization Program (UIP) is a key public health intervention aimed at reducing morbidity and mortality from vaccine-preventable diseases. Despite substantial national progress in India, regional disparities in coverage and implementation still persist. Objective: To evaluate the implementation of the Universal Immunization Program in Botad district. Methods: A cross-sectional study was conducted in Botad district (Gujarat) from 2023 to 2025. Ten Primary Health Centres (8 rural and 2 urban) were selected using stratified random sampling, and 30 villages were chosen through WHO cluster sampling. Data were collected using structured checklist for facility assessments, immunization session observations, interviews, and household surveys of 150 children aged 12–23 months, 30 antenatal women, and 30 adolescents. Evaluation indicators included human resource availability, training status, microplanning, cold chain management, session quality, supervision, and immunization coverage. Results: The evaluation revealed absence of routine immunization training for healthcare workers in the past three years. Only 30% of PHCs had complete routine immunization microplans, supervision plans were available only in 10% of facilities. Cold chain maintenance was satisfactory. However, session observations identified gaps in safe injection practices (40%), post-vaccination observation (10%), and delivery of four key messages (20%). Full immunization coverage among children aged 12–23 months was 79.3%. Td coverage was 100% among pregnant women, while among adolescents it was 60% for Td1 and 40% for Td2. Conclusion: UIP implementation in Botad district showed moderate coverage and satisfactory cold chain management but was limited by gaps in training, supervision, microplanning, and session quality.