Holte Jon H, Mæstad Ottar, Jani Jagrati V
University of Oslo, Faculty of Medicine, Institute of Health and Society, Department of Community Medicine, Norway.
Soc Sci Med. 2012 Jul;75(2):384-91. doi: 10.1016/j.socscimed.2012.03.015. Epub 2012 Apr 20.
The dynamics of childhood vaccination uptake in developing countries are unclear. Numerous studies document the relationship between vaccination coverage and access, socio economic and demographic factors. However, there is less knowledge about the relationship between vaccination coverage and carers' motivation and willingness to seek childhood vaccinations. The aim of this paper is to introduce a framework for studying demand for childhood vaccination and to examine the coherence between theoretical predictions and empirical findings in a rural area in Malawi. We interviewed 635 carers with children aged 18-59 months. About 96 percent of the respondents reported to have fully vaccinated their youngest eligible child for all routine vaccinations scheduled in the Expanded Program on Immunization. This paper concludes that easy access to vaccination services cannot explain why demand is high. Many carers had to travel long distances to reach vaccination delivery points and a considerable share of the respondents scored waiting and travelling time as long. Results from the present study, in combination with theoretical predictions, suggest that a high level of trust in distributors of information and vaccines may be an essential explanatory factor for why carers seek immunization for their children, even in the presence of considerable costs. Trust may be an important explanatory factor as it can be seen to generate positive perceived benefits.
发展中国家儿童疫苗接种的动态情况尚不清楚。众多研究记录了疫苗接种覆盖率与可及性、社会经济和人口因素之间的关系。然而，关于疫苗接种覆盖率与照顾者为儿童寻求疫苗接种的动机和意愿之间的关系，了解较少。本文的目的是引入一个研究儿童疫苗接种需求的框架，并检验马拉维一个农村地区理论预测与实证结果之间的一致性。我们采访了635名有18至59个月大孩子的照顾者。约96%的受访者报告称已为其最小的符合条件的孩子完成了扩大免疫规划中所有常规疫苗的全程接种。本文得出结论，疫苗接种服务的便捷可及性无法解释为何需求如此之高。许多照顾者不得不长途跋涉才能到达疫苗接种点，而且相当一部分受访者认为等待和路途时间很长。本研究结果与理论预测相结合表明，即使存在相当大的成本，对信息和疫苗分发者的高度信任可能是照顾者为子女寻求免疫接种的一个重要解释因素。信任可能是一个重要的解释因素，因为它可以带来积极的感知收益。
