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[塞内加尔考拉克地区12至23个月儿童常规免疫接种覆盖率的社会决定因素]

[Social Determinants of Routine Immunization Coverage of Children Aged 12 to 23 Months in the Kaolack Region of Senegal].

作者信息

Seck Ibrahima, Diop Boly, Leyé Mamadou Makhar, Mbacké Mboup Balla, Ndiaye Assane, Seck Papa Abdoulaye, Doucoure Amadou, Ba Tacko Aly, Diongue Mayacine, Faye Adame, Tal Dia Anta

出版信息

Sante Publique. 2016 Dec 19;28(6):807-815.

Abstract

Introduction: The lowest immunization coverages (IC) are recorded in Africa, where health systems fail to take geographical disparities into account. The objective of this study was to identify the social determinants of routine immunization coverage for children aged 12 to 23 months in the Kaolack region.Methodology: A cross-sectional, descriptive and analytical study was conducted in four health districts of Kaolack region from 1 to 30 June 2014. A cluster survey was conducted. Data collection was based on a pretested questionnaire administered to mothers or guardians of children aged 12 to 23 months by trained and supervised interviewers. Bivariate analysis was performed using Epi Info 3.5.4 software.Results: The sample included 849 mothers or guardians between the ages of 15 and 70 years with a mean age of 26.8 years (± 6.9). The majority of these women lived in rural areas (73.3%), were married (96.3%), with no income-generating activities (79.7%), literacy (62.5%) and had at least 4 children (75.1%). 20.1% of them were familiar with the immunization schedule, 87.9% could name at least one adverse event following injection (AEFI), 63.3% knew the EPI target diseases. The majority of women (91.3%) complied with the immunization schedule and attended the facility in case of missed appointments (52.3%). Only 39.1% of them reported AEFI and 59.7% provided home care.Those who lived in rural areas and who had income-generating activities (IGA) knew more about the immunization schedule (p<0.05). Those who lived in rural areas reported more AEFI (p<0.05). Children of mothers educated in French, urban inhabitants with an IGA had better routine immunization coverage (p<0.05).Conclusion: Social determinants such as education, economy and governance contribute to improved routine immunization coverage of children aged 12-23 months.

摘要

引言

非洲的免疫接种覆盖率最低,该地区的卫生系统未能考虑到地理差异。本研究的目的是确定考拉克地区12至23个月儿童常规免疫接种覆盖率的社会决定因素。

方法

2014年6月1日至30日在考拉克地区的四个卫生区进行了一项横断面、描述性和分析性研究。开展了一项整群调查。数据收集基于经过预测试的问卷,由经过培训和监督的访谈员向12至23个月儿童的母亲或监护人发放。使用Epi Info 3.5.4软件进行双变量分析。

结果

样本包括849名年龄在15至70岁之间的母亲或监护人,平均年龄为26.8岁(±6.9)。这些女性大多数生活在农村地区(73.3%),已婚(96.3%),没有创收活动(79.7%),有读写能力(62.5%)且至少有4个孩子(75.1%)。其中20.1%熟悉免疫接种时间表,87.9%能说出至少一种注射后不良事件(AEFI),63.3%知道扩大免疫规划(EPI)的目标疾病。大多数女性(91.3%)遵守免疫接种时间表,错过预约时会前往医疗机构(52.3%)。只有39.1%报告了AEFI,59.7%提供了家庭护理。

居住在农村地区且有创收活动的人对免疫接种时间表了解更多(p<0.05)。居住在农村地区的人报告的AEFI更多(p<0.05)。母亲接受法语教育、有创收活动的城市居民的孩子常规免疫接种覆盖率更高(p<0.05)。

结论

教育、经济和治理等社会决定因素有助于提高12至23个月儿童的常规免疫接种覆盖率。

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