On-site assessments of private sector immunization practices were conducted in the second and third most populous cities of Gujarat, India to identify areas for improvement to increase vaccination coverage in low- and middle-income countries. According to the results, a key change of practitioner attitudes towards immunization is needed in order to lower MOV (missed opportunities for vaccinations). There is an urgent need to improve vaccine storage and to maintain cold-chain supply quality, and a need to adopt standards for record-keeping.
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