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      Determinants of complete immunization among senegalese children aged 12–23 months: evidence from the demographic and health survey

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          Abstract

          Background

          The expanded Programme on Immunization (EPI) is one of the most cost-effective interventions to reduce childhood mortality and morbidity. However, determinants of childhood immunization have not been well studied in Senegal. Thus, the aim of our study is to assess routine immunization uptake and factors associated with full immunization status among Senegalese children aged 12–23 months.

          Methods

          We used the 2010–2011 Senegalese Demographic and Health Survey data. The DHS was a two stages cross-sectional survey carried out in 2010–2011. The analysis included 2199 children aged 12–23 months. The interviewers collected information on vaccine uptake based on information from vaccination cards or maternal recall Univariate and multivariable logistic regressions models were used to identify the determinants of full childhood immunization.

          Results

          The prevalence of complete immunization coverage among boys and girls based on both vaccination card information and mothers’ recall was 62.8%. The immunization coverage as documented on vaccination cards was 37.5%. Specific coverage for the single dose of BCG at birth, the third dose of polio vaccine, the third dose of pentavalent vaccine and the first dose of measles vaccine were 94.7%, 72.7%, 82.6%, and 82.1%, respectively. We found that mothers who could show a vaccination card [AOR 7.27 95% CI (5.50–9.60)], attended at least secondary education level [AOR 1.8 95% CI (1.20–2.48)], attended four antenatal visits [AOR 3.10 95% CI (1.69–5.63)], or delivered at a health facility [AOR 1.27 95% CI (1–1.74)] were the predictors of full childhood immunization. Additionally, children living in the eastern administrative regions of the country were less likely to be fully vaccinated [AOR 0.62 95% CI (0.39–0.97)].

          Conclusions

          We found that the full immunization coverage among children aged between 12 and 23 months was below the national (> 80%) and international targets (90%). Geographic area, mother’s characteristics, antenatal care and access to health care services were associated with full immunization. These findings highlight the need for innovative strategies based on a holistic approach to overcome the barriers to childhood immunization in Senegal.

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          Most cited references10

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          Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review

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            Why children are not vaccinated: a review of the grey literature.

            In collaboration with WHO, IMMUNIZATION basics analyzed 126 documents from the global grey literature to identify reasons why eligible children had incomplete or no vaccinations. The main reasons for under-vaccination were related to immunization services and to parental knowledge and attitudes. The most frequently cited factors were: access to services, health staff attitudes and practices, reliability of services, false contraindications, parents' practical knowledge of vaccination, fear of side effects, conflicting priorities and parental beliefs. Some family demographic characteristics were strong, but underlying, risk factors for under-vaccination. Studies must be well designed to capture a complete picture of the simultaneous causes of under-vaccination and to avoid biased results. Although the grey literature contains studies of varying quality, it includes many well-designed studies. Every immunization program should strive to provide quality services that are accessible, convenient, reliable, friendly, affordable and acceptable, and should solicit feedback from families and community leaders. Every program should monitor missed and under-vaccinated children and assess and address the causes. Although global reviews, such as this one, can play a useful role in identifying key questions for local study, local enquiry and follow-up remain essential.
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              The global value of vaccination.

              J Ehreth (2003)
              While most agree that vaccination is one of the most important public health practices, vaccines continue to be underused and undervalued, and vaccine-preventable diseases remain a threat to world health. Perhaps one reason this gap remains is that decision-making generally is made on a vaccine-by-vaccine basis. There has been less attention to the value of vaccination in general. To more clearly identify this value, this paper reviews the cost-effectiveness literature and calculates the annual benefits of vaccination on a global scale.
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                Author and article information

                Contributors
                221-338225919 , 221 77 4167521 , abdousalam.mbengue@iressef.org , 830582@students.wits.ac.za
                SARRM@WESTAT.com
                solaye2@yahoo.com
                ouzbad@hotmail.com
                Fatou.NIANG@ansd.sn , fabiniangcamara@gmail.com
                souleymane.mboup@iressef.org
                tandakha.dieye@ucad.edu.sn
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                6 July 2017
                6 July 2017
                2017
                : 17
                : 630
                Affiliations
                [1 ]IRESSEF: Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formations-Dakar, Arrondissement 4 Rue 2 D1. Pole urbain de Diamniadio, 7325 Dakar, BP Senegal
                [2 ]ISNI 0000 0004 1937 1135, GRID grid.11951.3d, , University of the Witwatersrand, Faculty of Health Sciences. School of Public Health, ; Johannesburg, South Africa
                [3 ]ISNI 0000 0000 9270 6633, GRID grid.280561.8, , Westat, ; Rockville, Maryland USA
                [4 ]ISNI 0000 0001 2186 9619, GRID grid.8191.1, , Department of Public Health and Preventive Medicine Cheikh Anta Diop University- Dakar, ; Dakar, Senegal
                [5 ]Division of Immunization / Expanded Program on Immunization, Ministry of Health-Dakar, Dakar, Senegal
                [6 ]Agence National de la Statistique et de la Démographie-Dakar, Dakar, Senegal
                [7 ]ISNI 0000 0001 2186 9619, GRID grid.8191.1, Laboratory of Immunology, , Cheikh Anta Diop University- Dakar, ; Dakar, Senegal
                Article
                4493
                10.1186/s12889-017-4493-3
                5501441
                28683781
                f4da6b14-e286-4c61-8c38-e65f738ebbc6
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 July 2016
                : 9 June 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Public health
                childhood,immunization,coverage,vaccines,epi,senegal
                Public health
                childhood, immunization, coverage, vaccines, epi, senegal

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