Low-cost Distraction Technique to Reduce Pain Perception among Infants and Improve Parents’ Satisfaction during the Immunisation Procedure: An Interventional Study from Assam, India

Introduction: Immunisation serves as a critical key indicator of community child health and plays a crucial role in reducing infant mortality. The Sample Registration System (SRS) 2021, Assam continues to report a higher Infant Mortality Rate (IMR-30) compared with the national average (IMR: 25). The aspirational district Programme emphasises strengthening maternal and child health outcomes through evidence-based interventions and local innovations. Aim: To explore the effect of oral sucrose and the 4S technique on infant pain perception and parent satisfaction during immunisation. Materials and Methods: The present facility-based experimental comparative study was conducted at the Immunisation Clinic of the Civil Hospital, Mangaldoi, Darrang (aspirational district), and Civil Hospital Karimganj (non-aspirational district) of Assam, India, The study is affiliated with Poornima University, Jaipur, and the University provided ethical approval through the JSPH Institutional Review Board (IRB) in Jodhpur and Ethics Committee No. JSPH/23/08/0, dated 29/08/2023. The duration of the study was from October 2023 to April 2024. The total sample size was 400, equally distributed between two study sites (200 each site), with participants at each site further divided into four groups of 50 participants each (Group A,B,C and the Control group). The 4S technique and oral sucrose were also used. The modified Riley pain scale was utilised to measure pain, and a 5-point Likert scale was used to measure parent satisfaction. Statistical analysis was performed using t-test, chi-square value and p-value <0.05 was considered statistically significant. Results: The study found that mothers in non-aspirational districts were more aware of Universal Immunisation Programme (UIP) Programmes compared to aspirational districts since infant immunisation begins at 1.5 months of age. Intervention Group C, which combined the 4S technique with oral sucrose, had the highest proportion of infants reported no pain in both aspirational 39 (78%) and non-aspirational 33 (66%) districts. Lower pain scores were positively associated with parental satisfaction, with Group C showing the highest level of satisfaction {32 (64%) in AD and 30 (60%) in non AD}. All intervention groups showed statistically significant improvement compared to the control group (p=0.001). Conclusion: Improving immunisation is crucial for reducing vaccine hesitancy and needle fear in aspirational and nonaspirational districts. Improving vaccination awareness can improve neonatal health and reduce the infant mortality rate. The results suggest the use of pharmaceutical and non pharmacological therapies, such as sucrose administration, to lessen vaccination-related pain, especially in children’s populations.