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Dummy tables MCM vaccine coverage State 1 4 years Card Card+ history No. % No.

. % 5 14 years Card Card+ history No. % No. % 15 29 years Card Card+ history No. % No. % Total Card No. %

Card+ history No. %

Source of MCM State History plus card No.

Reason card not available State Lost No. Not given No. % Not vaccinated No. % Other No.

Side effects State Side No. effect Total No. %

No.

No.

No.

No.

No.

No.

Reasons for not receiving MCM vaccine State Reason


Lack of information Unaware of need for immunization Place and/or time of immunization unknown Fear of side reactions Wrong ideas about contraindications Other

No.

No.

No.

No.

No.

No.

No.

Sub-total
Lack of motivation Postponed until another time No faith in immunization Rumours Other

Sub-total
Obstacles Place of immunization too far Time of immunization inconvenient Vaccinator absent Vaccine not available Too busy Ill Long waiting time Other

Sub-total

Coverage by BCG State Card only No. History plus card No.

BCG scar State Card only No. History plus card No.

Source of BCG State History plus card No.

DPT-Hep DPT-Hep1 Card only No. % DPT-Hep2 Card only No. % DPT-Hep3 Card only No. %

State

History plus card No. %

History plus card No. %

History plus card No. %

Source of DPt-Hep State History plus card No.

OPV coverage OPV0 State Card only No. % OPV1


History plus card Card only History plus card

OPV2
Card only History plus card

OPV3
Card only History plus card

No.

No.

No.

No.

No.

No.

No.

Source of OPV State History plus card No.

Rota virus coverage Rota 1 Card only No. Rota 2 Card only No. %

State

History plus card No. %

History plus card No. %

Source of Rota State History plus card No.

Measles coverage State Card only No. History plus card No.

Source of measles State History plus card No.

Immunization status (card plus history) State Not immunized No. % Partially immunized No. % Fully immunized No. %

Immunization by the time of the survey (card plus history) State Fully immunized by one year of age (card only) No. % Fully immunized by the time of the survey (card plus history) No. %

Average number of households per cluster State Average number of households per cluster

Reasons for failure to immunization (lack of information) State Reason


Lack of information Unaware of need for immunization b. Unaware of need to return for 2nd or 3rd dose Place and/or time of immunization unknown d. Fear of side reactions Wrong ideas about contraindications Other

No.

No.

No.

No.

No.

No.

No.

Sub-total
Lack of motivation Postponed until another time No faith in immunization Rumours Other

Sub-total
Obstacles Place of immunization too far Time of immunization inconvenient Vaccinator absent Vaccine not available Mother too busy Family problem, including illness of mother Child ill not brought Child ill brought but not given Long waiting time Other

Sub-total