Ababu Yohannes, Braka Fiona, Teka Aschalew, Getachew Kinde, Tadesse Tefera, Michael Yohannes, Birhanu Zewdie, Nsubuga Peter, Assefa Tersit, Gallagher Kathleen
Immunization program, World Health Organization, Addis Ababa, Ethiopia.
Jimma University, Ethiopia.
Pan Afr Med J. 2017 Jun 9;27(Suppl 2):2. doi: 10.11604/pamj.supp.2017.27.2.10635. eCollection 2017.
According to the Ethiopian Health Sector Development Plan IV annual performance report (HSDP IV), Ethiopia targeted to reach 90% coverage with DPT-Hib-HepB 3 (Pentavalent3) vaccine and 86% coverage with measles vaccine in 2010- 2011. However, the actual performance fell-short of the intended targets due to several reasons. Therefore, a nationwide comprehensive study was conducted to examine the behavioral determinants of immunization practices in the Ethiopian context. The study employed the Modified Steps of Behavioral Change (SBC) Model as a theoretical lens.
A cross-sectional study was conducted in May 2012 in all the nine regions and the two city administrations of Ethiopia. The study used a community-based quantitative survey design comprising of multistage cluster sampling to draw relevant data from a sample of 2,328 caretakers whose children were 12-23 months of age at the time of data collection.
Overall, the multivariate analysis findings revealed that caretakers, who had high knowledge were 2.24 times more likely to vaccinate their children than participants had low knowledge (OR= 2.24, 95%CI: 1.68-2.98). Participants who had high approval were 2.45 times more likely to vaccinate their children than participants who had unfavorable approval (OR= 2.45, 95%CI: 1.67-3.59); and participants who had high intention were 6.49 times more likely to vaccinate their children with pentavalent3 vaccines than participants who had low intention(OR= 6.49, 95%CI: 4.83-8). Also, it was clear from the regression analysis that aspects of caretakers' demographic characteristics were significant predictors of their immunization practice for the sample group.
We identified that caretakers' knowledge, approval, intention, parents' residence, and religious backgrounds were associated with immunization service utilization. To achieve sustainable behavioral change on immunization service utilization of the caretakers in Ethiopia, this study suggests investing in activities that enhance caretakers' knowledge, approval, intention, and practice components represented in the behavioral change model.
根据埃塞俄比亚卫生部门发展计划四年度绩效报告（HSDP IV），埃塞俄比亚的目标是在2010 - 2011年实现白喉、百日咳、破伤风、B型流感嗜血杆菌、乙肝联合疫苗（五价疫苗3）90%的覆盖率以及麻疹疫苗86%的覆盖率。然而，由于多种原因，实际绩效未达到预期目标。因此，开展了一项全国性综合研究，以考察埃塞俄比亚背景下免疫接种行为的决定因素。该研究采用修正的行为改变步骤（SBC）模型作为理论视角。
2012年5月在埃塞俄比亚所有九个地区和两个市辖区开展了一项横断面研究。该研究采用基于社区的定量调查设计，包括多阶段整群抽样，以便从数据收集时孩子年龄在12 - 23个月的2328名看护人中抽取相关数据。
总体而言，多变量分析结果显示，知识水平高的看护人给孩子接种疫苗的可能性是知识水平低的参与者的2.24倍（比值比=2.24，95%置信区间：1.68 - 2.98）。认可度高的参与者给孩子接种疫苗的可能性是认可度低的参与者的2.45倍（比值比=2.45，95%置信区间：1.67 - 3.59）；意愿高的参与者给孩子接种五价疫苗3的可能性是意愿低的参与者的6.49倍（比值比=6.49，95%置信区间：4.83 - 8）。此外，回归分析表明，看护人的人口统计学特征方面是样本组免疫接种行为的重要预测因素。
我们发现看护人的知识、认可度、意愿、父母居住地和宗教背景与免疫接种服务的利用有关。为在埃塞俄比亚实现看护人免疫接种服务利用方面的可持续行为改变，本研究建议对增强行为改变模型中所体现的看护人的知识、认可度、意愿和行为的活动进行投资。
