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      Factors influencing full immunization coverage among 12-23 months of age children in Ethiopia: evidence from the national demographic and health survey in 2011.

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          Abstract

          Immunization remains one of the most important public health interventions to reduce child morbidity and mortality. The 2011 national demographic and health survey (DHS) indicated low full immunization coverage among children aged 12-23 months in Ethiopia. Factors contributing to the low coverage of immunization have been poorly understood. The aim of this study was to identify factors associated with full immunization coverage among children aged 12-23 months in Ethiopia.

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          Applied Logistic Regression

          David Hosmer, Stanley Lemeshow (2000)
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            Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated?

            Martin K. Mutua, Elizabeth Kimani-Murage, Remare Ettarh (2011)
            Background Recent trends in global vaccination coverage have shown increases with most countries reaching 90% DTP3 coverage in 2008, although pockets of undervaccination continue to persist in parts of sub-Saharan Africa particularly in the urban slums. The objectives of this study were to determine the vaccination status of children aged between 12-23 months living in two slums of Nairobi and to identify the risk factors associated with incomplete vaccination. Methods The study was carried out as part of a longitudinal Maternal and Child Health study undertaken in Korogocho and Viwandani slums of Nairobi. These slums host the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) run by the African Population and Health Research Centre (APHRC). All women from the NUHDSS area who gave birth since September 2006 were enrolled in the project and administered a questionnaire which asked about the vaccination history of their children. For the purpose of this study, we used data from 1848 children aged 12-23 months who were expected to have received all the WHO-recommended vaccinations. The vaccination details were collected during the first visit about four months after birth with follow-up visits repeated thereafter at four month intervals. Full vaccination was defined as receiving all the basic childhood vaccinations by the end of 24 months of life, whereas up-to-date (UTD) vaccination referred to receipt of BCG, OPV 1-3, DTP 1-3, and measles vaccinations within the first 12 months of life. All vaccination data were obtained from vaccination cards which were sighted during the household visit as well as by recall from mothers. Multivariate models were used to identify the risk factors associated with incomplete vaccination. Results Measles coverage was substantially lower than that for the other vaccines when determined using only vaccination cards or in addition to maternal recall. Up-to-date (UTD) coverage with all vaccinations at 12 months was 41.3% and 51.8% with and without the birth dose of OPV, respectively. Full vaccination coverage (57.5%) was higher than up-to-date coverage (51.8%) at 12 months overall, and in both slum settlements, using data from cards. Multivariate analysis showed that household assets and expenditure, ethnicity, place of delivery, mother's level of education, age and parity were all predictors of full vaccination among children living in the slums. Conclusions The findings show the extent to which children resident in slums are underserved with vaccination and indicate that service delivery of immunization services in the urban slums needs to be reassessed to ensure that all children are reached.
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              Access, utilization, quality, and effective coverage: an integrated conceptual framework and measurement strategy.

              Bakhuti Shengelia, Ajay Tandon, Orvill Adams … (2005)
              Health systems can primarily improve the health of individuals and populations by delivering high-quality interventions to those who may benefit from them. We propose a concept of effective coverage as the probability that individuals will receive health gain from an intervention if they need it. Understanding the extent to which health systems are delivering key interventions to those who will benefit from them and the factors that explain gaps in delivery are a critical input to decision-making at the local, national and global levels. We develop an integrated conceptual framework for monitoring and analyzing the delivery of high-quality interventions to those who need them. This framework can help clarify the inter-relationships between notions of access, demand for care, utilization, and coverage on the one hand and highlight the requirements for health information systems that can sustain this type of analysis. We discuss measurement strategies and demonstrate the concept by means of a simple simulation model.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC public health
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1471-2458
                ISSN (Print): 1471-2458
                Publication date (Electronic): Jul 30 2015
                Volume: 15
                Affiliations
                [1 ] Ethiopian Public Health Association (EPHA), P.O Box 7117, Addis Ababa, Ethiopia. yihunierh@yahoo.com.
                [2 ] Ethiopian Public Health Association (EPHA), P.O Box 7117, Addis Ababa, Ethiopia. alemayehubekele2002@yahoo.com.
                [3 ] Independent Public Health Research Consultant, P.O Box 24414, Addis Ababa, Ethiopia. sibhatu2010@gmail.com.
                Article
                Publisher Item ID: 10.1186/s12889-015-2078-6
                DOI: 10.1186/s12889-015-2078-6
                PMC ID: 4520202
                PubMed ID: 26224089
                SO-VID: cdde5d14-b1b7-4644-8db5-8ec92225cc14
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