a Division of Epidemiology and Biostatistics , Cochrane South Africa, South African Medical Research Council , Tygerberg , South Africa.
b Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.
Hum Vaccin Immunother. 2019;15(5):1191-1198. doi: 10.1080/21645515.2019.1575163. Epub 2019 Apr 8.
In this study, we aimed to explore the rural-urban disparities in the magnitude and determinants of missed opportunities for vaccination (MOV) in sub-Saharan Africa.
This was a cross-sectional study using nationally representative household surveys conducted between 2007 and 2017 in 35 countries across sub-Saharan Africa. The risk difference in MOV between rural or urban dwellers were calculated. Logistic regression method was used to investigate the urban-rural disparities in multivariable analyses. Then Blinder-Oaxaca method was used to decompose differences in MOV between rural and urban dwellers.
The median number of children aged 12 to 23 months was 2113 (Min: 370, Max: 5896). There was wide variation in the the magnitude of MOV among children in rural and urban areas across the 35 countries. The magnitude of MOV in rural areas varied from 18.0% (95% CI 14.7 to 21.4) in the Gambia to 85.2% (81.2 to 88.9) in Gabon. Out of the 35 countries included in this analysis, pro-rural inequality was observed in 16 countries (i.e. MOV is prevalent among children living in rural areas) and pro-urban inequality in five countries (i.e. MOV is prevalent among children living in urban areas). The contributions of the compositional 'explained' and structural 'unexplained' components varied across the countries. However, household wealth index was the most frequently identified factor.
Variation exists in the level of missed opportunities for vaccination between rural and urban areas, with widespread pro-rural inequalities across Africa. Although several factors account for these rural-urban disparities in various countries, household wealth was the most common.
本研究旨在探讨撒哈拉以南非洲地区城乡之间疫苗接种错失机会（MOV）的严重程度和决定因素的差异。
这是一项使用 2007 年至 2017 年期间在撒哈拉以南非洲 35 个国家进行的全国代表性家庭调查的横断面研究。计算了农村和城市居民之间 MOV 的风险差异。使用逻辑回归方法在多变量分析中研究城乡之间的城乡差异。然后使用 Blinder-Oaxaca 方法对农村和城市居民之间 MOV 的差异进行分解。
12 至 23 个月大的儿童中位数为 2113 人（最小：370，最大：5896）。在 35 个国家中，农村和城市地区儿童 MOV 的严重程度存在很大差异。农村地区 MOV 的严重程度从冈比亚的 18.0%（95%CI 14.7 至 21.4）到加蓬的 85.2%（81.2 至 88.9）不等。在本分析中包含的 35 个国家中，有 16 个国家存在亲农村不平等（即 MOV 在生活在农村地区的儿童中更为普遍），5 个国家存在亲城市不平等（即 MOV 在生活在城市地区的儿童中更为普遍）。组成部分的“解释”和结构部分的“未解释”成分的贡献在各国之间有所不同。然而，家庭财富指数是最常被确定的因素。
农村和城市地区之间存在疫苗接种错失机会的水平差异，非洲各地广泛存在亲农村不平等现象。尽管有几个因素导致了这些城乡差异，但在不同国家中，家庭财富是最常见的因素。
