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Increase in institutional delivery and child immunisation coverage through an appreciative inquiry-based community dialogue intervention in Afghanistan.


ABSTRACT:

Objective

A community dialogue intervention with an appreciative inquiry approach was undertaken to improve institutional delivery and child immunisation coverage in a hard-to-reach province, namely, Kandahar, in Afghanistan. This study aimed to evaluate the intervention's effectiveness in promoting institutional delivery and child immunisation.

Study design

A pre-post intervention evaluation study.

Methods

An intervention and a non-intervention district were selected in Kandahar. Children aged under 5 years participated in surveys at baseline (October 2018) and follow-up (Post-intervention: November 2019). We analysed age, sex, place of birth, and confirmed immunisation coverage data concerning 1046 and 927 children pre- and post-interventions, respectively. Changes in institutional delivery and confirmed immunisation status were evaluated using net intervention effect and difference-in-difference (DID) analysis.

Results

Institutional delivery rates increased from 66.3% to 83.6% (p = 0.016) in the intervention district and decreased from 71.3% to 46.7% (p < 0.001) in the non-intervention district, with a net intervention effect of 41.9%. Full immunisation coverage among children aged 12-23 months and 24-35 months significantly increased from 26.4% to 76.9% (p < 0.001) and from 40.0% to 78.6% (p < 0.001), respectively, in the intervention district, whereas coverage significantly decreased in the non-intervention district. The net intervention effects were 59.1% and 44.8% for children aged 12-23 months and 24-35 months, respectively. The DID analysis also revealed significant differences in outcomes after intervention at follow-up. The results concerning antigen-specific immunisation coverage indicated a significant increase in immunisation coverage in the intervention district.

Conclusions

The appreciative inquiry-based community dialogue intervention considerably increased institutional delivery and child immunisation coverage, even in a hard-to-reach province in Afghanistan.

SUBMITTER: Hemat S 

PROVIDER: S-EPMC10582473 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

Increase in institutional delivery and child immunisation coverage through an appreciative inquiry-based community dialogue intervention in Afghanistan.

Hemat Shafiqullah S   Alemi Sharifullah S   Ahmady Sadia S   Nakamura Keiko K  

Public health in practice (Oxford, England) 20231006


<h4>Objective</h4>A community dialogue intervention with an appreciative inquiry approach was undertaken to improve institutional delivery and child immunisation coverage in a hard-to-reach province, namely, Kandahar, in Afghanistan. This study aimed to evaluate the intervention's effectiveness in promoting institutional delivery and child immunisation.<h4>Study design</h4>A pre-post intervention evaluation study.<h4>Methods</h4>An intervention and a non-intervention district were selected in Ka  ...[more]

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