Strengthening EPI Through Parental Engagement: Lessons from Dhaka Slums for IA-2030

Authors: Roy B , Mahmood A , Zaman RU , Ponni MA , Tabassum T and Bachhar CK

DOI: 10.23880/eij-16000287

Volume 9, Issue 2

Abstract

Childhood immunization is one of the most cost-effective public health interventions, preventing morbidity and mortality from vaccine-preventable diseases. In Bangladesh, the Expanded Programme on Immunization (EPI) offers free vaccination, yet children in urban slums remain at higher risk of incomplete or delayed immunization. This cross-sectional study investigates parental knowledge, attitudes, and perceptions regarding childhood immunization in selected Dhaka slums to identify strategies for strengthening vaccine coverage and supporting the goals of the Immunization Agenda 2030 (IA-2030). A total of 270 parents of children aged 0–5 years were recruited through purposive sampling, and data were collected using a semi-structured questionnaire administered face-to-face in Bengali. Socio-demographic data, awareness of immunization, knowledge of vaccine schedules, and parental attitudes were assessed. Results indicate that nearly all parents (99.3%) were aware of immunization, with health workers serving as the primary source of information (65.9%), while media and other sources contributed minimally. Most respondents (83.3%) recognized vaccination as protective against infectious diseases, and 75.2% acknowledged its role in reducing child mortality. Awareness of vaccine side effects was reported by 78.1%, and 70.7% were familiar with the term EPI. Knowledge gaps were observed regarding birth doses, multiple dose schedules, and contraindications, with only 11.5% aware of vaccines administered immediately after birth and 58.1% understanding the importance of dose intervals. Attitudes toward immunization were overwhelmingly positive: 80.7% considered EPI vaccines safe, 91.5% recognized their essentiality for child health, and 88.9% indicated willingness to encourage others to vaccinate. Immunization practices were strong, with 98.5% reporting regular vaccination and 86.1% of children aged two and above having completed the EPI schedule. However, 37% of children received additional non-EPI vaccines, highlighting increasing parental engagement beyond routine programs. The study underscores that while parental attitudes toward vaccination are favorable, gaps in knowledge may lead to missed opportunities. Targeted educational interventions, communitybased engagement, and reinforcement through health worker communication are recommended to improve coverage in slum populations. Understanding parental perceptions and addressing misconceptions are pivotal to achieving equitable immunization coverage and reducing preventable child mortality under IA-2030.

Keywords: Knowledge; Attitude; Perception; Children; Slum Dwellers; Immunization; Vaccine

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