Dataset Information

Immunization coverage of 12-23?months old children and its associated factors in Minjar-Shenkora district, Ethiopia: a community-based study.

ABSTRACT:

Background

Childhood vaccinations have been shown to be effective in protecting children against vaccine-preventable diseases. The systematic investigation of the causes of incomplete immunization is critical for the full immunization and develop health system interventions to improve immunization coverage. To date, no community-based immunization coverage assessment study was conducted in Minjar-shenkora district. Therefore, the aim of this study was to assess the immunization coverage and its factors among 12-23?months old children in Minjar-shenkora district, Ethiopia.

Methods

Community-based cross-sectional study was conducted from September to November 2017. A total of 566 children aged 12-23?months and their mothers/caregivers were successfully interviewed using structured and pre-tested questionnaire. A stratified sampling technique was employed. Study participants were selected systematically. Data were entered into Epi data version 3.1 and exported into SPSS version 21 for analysis. Logistic regression analyses were done. A significant association was declared at a p-value less than 0.05.

Results

Three fourth (75.6%) of 12-23?months old children were fully vaccinated. Incorrect appointment date (46.4%), the experience of child sickness with previous vaccination (35.2%) and disrespectful behavior of health professionals (14.3%) were the most common reasons cited by mothers/caregivers for incomplete vaccination of children. Being unmarried (AOR?=?3.52, CI?=?2.61, 9.15), not being a member of health development army (AOR?=?3.31, CI?=?2.01, 11.65) and traveling time greater than two hours on foot (AOR?=?2.46, CI?=?5.01, 17.18) were predictors of incomplete immunization.

Conclusions

Child immunization coverage was still below the governmental plan of 90% in 2020. Being unmarried, not being a member of health development army and traveling time greater than two hours on foot were predictors of incomplete immunization. Strengthen health development army programmatic interventions in the community will improve child vaccination completion in the district. The issue of long travel time should be addressed by increasing the number of new vaccination sites/clusters in the district.

SUBMITTER: Mekonnen AG

PROVIDER: S-EPMC6567439 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Immunization coverage of 12-23 months old children and its associated factors in Minjar-Shenkora district, Ethiopia: a community-based study.

Mekonnen Alemayehu Gonie AG Bayleyegn Alebachew Demelash AD Ayele Esubalew Tesfahun ET

BMC pediatrics 20190614 1

<h4>Background</h4>Childhood vaccinations have been shown to be effective in protecting children against vaccine-preventable diseases. The systematic investigation of the causes of incomplete immunization is critical for the full immunization and develop health system interventions to improve immunization coverage. To date, no community-based immunization coverage assessment study was conducted in Minjar-shenkora district. Therefore, the aim of this study was to assess the immunization coverage ...[more]

PMID: 31200690

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Project description:BackgroundImmunization is essential to prevent between 2 and 3 million deaths globally each year and it is widely accepted that it is one of the most cost-effective health interventions. Despite all its advantages, immunization in Ethiopia is still far from the target set by the United Nations Sustainable Development Goals to achieve universal immunization by all countries in 2030. The 2016 Ethiopian Demographic and Health Survey (EDHS) reported an overall full immunization rate of only 38.3%. The objective of this study was to evaluate the spatial distribution of under immunization in 12 to 23 months old children and further identify the determinants of under immunization clustering in the Butajira Health and Demographic Surveillance Site (HDSS).MethodsWe conducted a community based sectional survey from March to April, 2016 in Butajira HDSS. We collected data on immunization status from a total of 482 children between the age of 12 to 23 months. We randomly selected household and interviewed mothers and /or observed vaccination cards when available to collect data on child's immunization status. We also collected the geographic location of all villages within the ten Kebeles using a Handheld Global Positioning System (GPS) (Garmin GPSMAP®). We analyzed the spatial distribution of under immunization and clustering using the SatScan® software which employs a purely spatial Bernoulli's model. We also ran a logistic regression model to help evaluate the causes of clustering.ResultsWe found that only 22.4% [95% CI: 18.9, 26.4%] of children were fully immunized. This study identified one significant cluster of under immunization among children 12-23 months of age within the Butajira HDSS (relative risk (RR) = 1.24,P < 0·01). We found that children residing in this cluster had more than 1.24 times risk of under immunization compared with children residing outside of the identified cluster. We found significant differences with regard to Maternal Tetanus Toxoid immunization status and place of delivery between cases found within a spatial cluster and cases found outside the cluster. For example, the odds of home delivery is more than two times [AOR 2.21: 95%CI; 1.06, 4.63] among children within an identified spatial cluster than the odds among children found outside the identified cluster.ConclusionsUnder immunization of 12-23 months old children and under immunization with specific vaccines such as Polio, BCG, DPT (1-3) and Measles clustered geographically. Spatial studies could be effective in identifying geographic areas of under immunization for targeted intervention like in this study to gear health education to the specific locality.

Project description:ObjectiveDespite those efforts in expanded programs of immunization, nearly one fifth of children in developing countries miss out basic vaccines. Moreover, many children who started vaccination fail to complete immunization.Identifying associated factorswhich is scarce in the study area, is crucial for interventions. This study assessed full-immunization and associated factors among children aged 12-23 months in Somali region, Eastern Ethiopia.MethodsA community-based cross-sectional study design was conducted from October 1-30, 2018, in selected rural and urban kebeles in Somali regionamong 612 children. Cluster sampling was employed and data was collected using structured questionnaire. Full-immunization was measured by maternal recall and vaccination card.Data entry and analysis was done by EpiData3.1 and SPSSversion.20 respectively. Binary logistic regression with Bivariate and Multivariable model was usedto identify predictors of full-immunization. Odd ratios were computed and P-value <0.05 was considered as statistically significant.ResultsBased on maternal recall plus vaccination card 249(41.4%) of children were completed immunization, while vaccination only by card was 87(29.7%). Only 238(39.5%) of participants had good knowledge about vaccination. Not knowing to come back for next visits 197(55.8%) were the major reason for dropout. Residing in urban (AOR = 2.0, 95%CI: 1.0, 3.9),primary educated mothers(AOR = 2.2, 95%CI: 1.0, 5.0), married mothers (AOR = 4.2, 95%CI:1.0, 18), higher average monthly income (AOR = 2.5, 95%CI 1.1, 5.2)and delivered at health facilities (AOR = 3.8, 95%CI 1.9, 7.3)were significantly associated with full-immunization.ConclusionCoverage of full immunization was found to be low compared to the targets set in the Global Vaccine Action Plan(2011-2020).Two-third of the participants has poor knowledge about vaccination. Urban residence, mother education, higher family income, male child and institutional delivery were factors. This study suggests that awareness creation, behaviour change on vaccination and enhancing utilization of maternal health service including delivery service, should be stressed.

Project description:Background:Stunting and anemia are long-standing public health challenges which adversely affects the cognitive development and physical wellbeing of children in low income settings. The aim of this study was to assess the prevalence and associated factors of stunting and anemia among 6-23?months old children in Damot Sore District, Southern Ethiopia. Methods:Cross-sectional survey was conducted among 477 children aged 6-23?months, which were living in Damot Sore District, in April 2017. A multistage sampling technique was used. Villages were randomly selected and systematic random sampling method was used to select study participants. Data on socio-demographic, anthropometric, dietary, blood samples for hemoglobin were collected. Data were entered into EPI Data V. 3.1 and exported into SPSS Version 21.0 for analysis. A principal component analysis (PCA) was done to generate wealth score of households. Binary logistic regression model was used to identify factors associated with the outcome variables (stunting and anemia) separately, those variables having less than a p-value of 0.25 were chosen as candidate for multivariable analyses and finally multivariable logistic regression model was used to identify independent variables of each outcomes, with statistical significance set at p?<?0.05 (95% confidence interval (CI)). Results:Out of 477 children studied, 31.7% were stunted and 52% were anemic. In the multivariable analyses, the number of under five children within a household (AOR?=?4.18, 95% CI: 2.65-6.57), drinking water from unsafe source (AOR?=?4.08, 95% CI: 1.33-12.54) and anemia (AOR?=?3.13, 95% CI 2.00-4.92) were factors significantly associated with stunting. On the other hand, independent variables of anemia were early initiation of complementary feeding (AOR?=?2.96, 95% CI: 1.23-4.85), poor dietary diversity (AOR?=?2.95, 95% CI: 1.78-4.91), poor breast feeding practice (AOR?=?2.94, 95% CI: 1.63-5.32) and stunting (AOR?=?3.65, 95% CI: 2.15-6.19). Conclusion:This study revealed higher level of stunting and anemia among children aged 6-23?months than WHO (world health organization) criteria of public health importance. Sustainable promotion of diversified diet, optimal complementary feeding, optimal and complementary breast feeding practices, improving sanitation infrastructure are measures needed to tackle these severe public health challenges.

Project description:BackgroundThe Expanded Program on Immunization (EPI) is still in need of improvement. In Burkina Faso in 2003, for example, the Nouna health district had an immunization coverage rate of 31.5%, compared to the national rate of 52%. This study identifies specific factors associated with immunization status in Nouna health district in order to advance improved intervention strategies in this district and in those with similar environmental and social contexts.MethodsA cross-sectional study was undertaken in 41 rural communities and one semi-urban area (urban in the text). Data on 476 children aged 12 to 23 months were analyzed from a representative sample of 489, drawn from the Nouna Health Research Centre's Demographic Surveillance System (DSS) database. The vaccination history of these children was examined. The relationships between their immunization status and social, economic and various contextual variables associated with their parents and households were assessed using Chi square test, Pearson correlation and logistic regression.ResultsThe total immunization coverage was 50.2% (CI, 45.71; 54.69). Parental knowledge of the preventive value of immunization was positively related to complete immunization status (p = 0.03) in rural areas. Children of parents who reported a perception of communication problems surrounding immunization had a lower immunization coverage rate (p < 0.001). No distance related difference exists in terms of complete immunization coverage within villages and between villages outside the site of the health centres. Children of non-educated fathers in rural areas have higher rates of complete immunization coverage than those in the urban area (p = 0.028). Good communication about immunization and the importance of availability of immunization booklets, as well as economic and religious factors appear to positively affect children's immunization status.ConclusionVaccination sites in remote areas are intended to provide a greater opportunity for children to access vaccination services. These efforts, however, are often hampered by the poor economic conditions of households and insufficient communication and knowledge regarding immunization issues. While comprehensive communication may improve understanding about immunization, it is necessary that local interventions also take into account religious specificities and critical economic periods. Particular approaches that take into consideration these distinctions need to be applied in both rural and urban settings. ABSTRACT IN FRENCH: See the full article online for a translation of this abstract in French.

Project description:BACKGROUND:Immunization is the process by which a person is made immune or resistant to an infectious disease, typically by the administration of vaccine. Vaccination coverage for other single vaccines ranged from 49.1% for PCV to 69.2% for BCG vaccine. The vaccination coverage for basic vaccinations was 39.7% in Ethiopia. There have been epidemiological studies available on immunization in Ethiopia. Yet, these studies revealed a wide variation over time and across geographical areas. This systematic review and Meta-analysis aim to estimate the overall immunization coverage among 12-23?months children in Ethiopia. METHODS:Cross-sectional studies that reported on immunization coverage from 2003 to August 2019 were systematically searched. Searches were conducted using PubMed, Google Scholar, Cochrane library, and gray literature. Information was extracted using a standardized form of Joanna Briggs Institute. The search was updated 20 Jan 2020 to decrease time-lag bias. The quality of studies assessed using Joanna Briggs Institute cross-sectional study quality assessment criteria. I-squared statistics applied to check the heterogeneity of studies. A funnel plot, Begg's test, and Egger's regression test was used to check for publication bias. RESULTS:Out of 206 studies, 30 studies with 21,672 children with mothers were included in the Meta-analysis. The pooled full immunization coverage using the random-effect model in Ethiopia was 58.92% (95% CI: 51.26-66.58%). The trend of immunization coverage was improved from time to time, but there were great disparities among different regions. Amhara region had the highest pooled fully immunized coverage, 72.48 (95%CI: 62.81-82.16). The I2 statistics was I2?=?99.4% (p?=?0.0001). A subgroup meta-analysis showed that region and study years were not the sources of heterogeneity. CONCLUSION:This review showed that full immunization coverage in Ethiopia was 58.92% (95% CI: 51.26-66.58%). The study suggests that the child routine immunization program needs to discuss this low immunization coverage and the current practice needs revision.

Project description:BACKGROUND:Vaccination is one of the most cost-effective means of public health interventions to prevent childhood deaths from infectious diseases. Although several fragmented studies have been conducted concerning full vaccination coverage among children aged 12-23?months in Ethiopia, the pooled estimate has not been determined so far. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of full vaccination coverage among children aged 12-23?months in Ethiopian. METHODS:To find potentially relevant studies, we systematically searched five major databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, Google Scholar, and Science Direct). This review included community based cross-sectional studies reported in English language; had good quality, and published from the 1st of January 2000 to the 20th of November 2019. Data were analyzed using Stata™ Version 14.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. Higgins and Egger's tests were used to assess heterogeneity and publication bias, respectively. Primary estimates were pooled using a random effects meta-analysis model. RESULTS:Of the total of 851 identified articles 21 studies involving 12,094 children met the inclusion criteria and were included in this meta-analysis. The included studies sample size ranged from 173 to 923. The lowest proportion of full vaccination coverage was reported from Afar Region [21% (95% CI: 18, 24%)], whereas the highest proportion of full vaccination coverage was reported from Amhara Region [73% (95% CI: 67, 79%)]. The overall prevalence of full vaccination coverage among children in Ethiopia was 60% (95% CI: 51, 69%). CONCLUSIONS:Our finding suggested that six in every 10 children in Ethiopia were fully vaccinated. However, this finding is much lower than the World Health Organization recommended rate. Moreover, high regional variations in terms of full vaccination coverage across the country was observed. Therefore, a special attention should be given to improve the overall childhood vaccination coverage.

Project description:BackgroundChildhood immunization is one of the most cost effective health interventions but its rate has been declining recently in Ghana. Information on immunization coverage and determinants is needed to improve immunization programmes. The objective of this study was to determine the prevalence and factors associated with incomplete immunization of children (12-23 months) in Kwabre East District, Ghana.MethodsA cross-sectional, community-based survey involving 322 children and their mothers was carried out. Data were collected on socio-demographic characteristics of mothers, childhood immunization history and mothers' knowledge and practices of immunization using a structured questionnaire. Children were classified as incompletely immunized if they failed to receive at least one of 8 vaccine doses: - one dose of Bacillus Calmette-Guérin (BCG), 3 doses each of pentavalent, 3 doses of polio and one dose of measles per WHO/UNICEF definition. Chi-square and logistic regression analyses were used to identify the factors associated with incomplete immunisation.ResultsThe prevalence of incomplete immunization was low (15.5%) suggesting high immunisation coverage but the coverage of the second measles dose, taken at 18 months of age, was the lowest (23.9%). Most of the mothers knew the importance of immunisation (95.7%) and at least one vaccine-preventable disease or symptom (84.9%). Two factors associated with incomplete immunisation in bivariate analyses (community of residence, and mother's knowledge of number of oral polio vaccines given to children) were no longer significant in a logistic regression model. Compared to children in Aboaso, children in Gyamfi Wonoo (AOR = 1.81, 95% CI = 0.80-4.08), Mamponteng (Bonwunu) (AOR = 0.59, 95% CI = 0.24-1.48) and Mamponteng (Town) (AOR = 0.63, 95% CI = 0.26-1.55) had similar odds of incomplete immunisation. Similarly, mother's lack of knowledge of the number of doses of polio vaccine given to children had no effect on the odds of incomplete immunisation (AOR = 0.53, 95% CI = 0.22-1.26).ConclusionsImmunization coverage is high in the Kwabre East district but very few children received the second measles dose. None of the maternal and child factors assessed is associated with immunisation coverage. Further research is needed to identify the determinants of immunisation coverage and the reasons for the low uptake of second measles dose in the study area.

Project description:BACKGROUND:Immunization is one of the most cost-effective health intervention to halt the spread of childhood diseases, and improve child health. Yet, there is a substantial disparity in childhood immunization coverage. The overall objective of the study is to investigate the trends of within-country inequalities in childhood immunization coverage among children aged 12-23?months in Kenya, Ghana, and Côte d'Ivoire. The three countries included in this study are countries that are on the verge of entering the accelerated phase of the Gavi, the Vaccine Alliance's co-sharing of costs of vaccine and eventually assuming full costs of vaccines. Côte d'Ivoire is in the Gavi preparatory transition phase, entering the accelerated transition phase in 2020, with an expected transition to full self-financing in 2025. Ghana is expected to enter the accelerated transition phase in 2021 and to full self-financing in 2026 while Kenya will enter in 2022 and fully self-finance in 2027. We examine the pattern of inequality in childhood immunization coverage over time through an equity lens by mainly exploring the direction of inequality in coverage. METHODS:We use data from the Demographic Health Surveys and Multiple Indicator Cluster Surveys. The rate difference, rate ratio, and relative concentration index are used as measures of inequality. RESULTS:Results of the study suggest that in most years inequality in immunization coverage in the three countries persist over time, and it favors the most-advantaged households. However, there is a sharp decrease pattern in inequalities in childhood immunization coverage in Ghana over time. CONCLUSION:Policymakers could be more strategic in addressing pro-rich inequality in immunization coverage by designing health interventions through an equity lens. Using inequality data and putting disadvantaged households at the center of health intervention designs could increase the efficiency of the primary health care system and reduce the incidence of mortality and morbidity as a result of vaccine-preventable disease.

Project description:IntroductionImmunization is a cost-effective intervention that prevented more than 5 million deaths worldwide from 2010 to 2015. Despite increased vaccination coverage over the past four decades in many African countries, including Ethiopia, universal coverage has not yet been reached. Only 39% of children aged 12-23 months received full vaccinations in Ethiopia, according to the 2016 Ethiopian Demographic Health Survey. This study aimed to evaluate immunization coverage and identify individual and community factors that explain incomplete vaccination coverage among children aged 6-36 months in the Wonago district of southern Ethiopia.MethodsWe conducted a community-based, cross-sectional study in three randomly selected kebeles in the Wonago district from June to July 2017. Our nested sample of 1,116 children aged 6-36 months included 923 child-mother pairs (level 1) within kebeles (level 2). We conducted multilevel regression analysis using STATA software.ResultsAmong participants, 85.0% of children aged 12-36 months received at least one vaccine, and 52.4% had complete immunization coverage. After controlling for several individual and community variables, we identified six significant predictor variables for complete immunization: Older mothers' age (AOR = 1.05, 95% CI: 1.00-1.09), higher utilization of antenatal care (AOR = 1.36, 95% CI: 1.14-1.62), one or more tetanus-toxoid vaccination during pregnancy (AOR = 2.64, 95% CI: 1.43-4.86), mothers knowing the age at which to complete child's vaccinations (AOR = 2.00, 95% CI: 1.25-3.20), being a female (AOR = 0.64, 95% CI: 0.43-0.95), and child receiving vitamin A supplementation within the last 6 months (AOR = 2.79, 95% CI: 1.59-4.90). We observed a clustering effect at the individual and community levels with an intra-cluster correlation coefficient of 48.1%.ConclusionsWe found low immunization coverage among children in the Wonago district of southern Ethiopia, with significant differences across communities. Promoting maternal health care and community service could enhance immunization coverage.

Project description:Background:Dietary diversity (DD) is among the core infant and young child feeding (IYCF) indicators. However, in many developing countries, meeting the minimum standards of DD is challenging and information concerning its determinants is limited. Objective:To assess the level and predictors of DD among children aged 6-23 months in rural communities of Aleta Wondo district, Sidama zone, Southern Ethiopia. Method:A community-based cross-sectional study was conducted in rural Aleta Wondo in February 2016. Multistage sampling was employed to recruit 502 children aged 6-23 months. DD was assessed by asking the mother whether the index child had received food from the standard seven food groups in the previous day, without setting minimum intake restrictions. Ultimately, the dietary diversity score (DDS) was rated on a 7-point scale, and it was modeled using linear regression analysis. The outputs are presented using adjusted regression coefficients (?). Results:Only 12.0% (95% confidence interval: 9.0-15.0%) of the children met the minimum recommended DD, receiving from four or more from seven food groups. The analysis identified eleven significant predictors of DDS. As the maternal knowledge of IYCF increases by a unit, DDS raised by 0.21 units (p = 0.004). Unit increment in the husband's involvement in the IYCF score was linked with 0.32 units improvement in DDS (p = 0.016). One unit change in the ordinal category of household food insecurity was associated with 0.13 reduction in DDS (p = 0.001). Similarly, household wealth index (??=?0.54, p = 0.041), father's literacy (??=?0.48, p = 0.002), ownership of home garden (??=?0.38, p = 0.01), mother's participation in cooking demonstrations (??=?0.19, p = 0.036), and child age in months (??=?0.04, p = 0.001) were all positively associated with DDS. Furthermore, receiving IYCF information via mass media (??=?0.04, p = 0.001) and during antenatal (??=?0.91, p = 0.022) and postnatal checkups (??=?0.21, p = 0.043) were positive predictors of DDS. Conclusions:Promoting the socioeconomic status of the community, strengthening of home gardening, involving husbands in IYCF, and enhancing maternal knowledge of IYCF may advance DD.