Holipah Holipah, Maharani Asri, Sujarwoto Sujarwoto, Hinoura Takuji, Kuroda Yoshiki
Faculty of Medicine, Universitas Brawijaya, Malang, Jawa Timur 65145, Indonesia.
Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1962, Japan.
Vaccines (Basel). 2020 Sep 10;8(3):518. doi: 10.3390/vaccines8030518.
Although 91% of 12-23-month-old children in Indonesia received at least one immunization in 2013, only 76% completed DTP3 immunization. This percentage is below the UNICEF and WHO recommended standards. Thus, this study aims to investigate trends, spatial disparities, and social determinants related to low coverage of DTP3 immunization in Indonesia. Using a multilevel approach, we analyzed data from 305,090 12-23-month-old children living across approximately 500 districts in Indonesia to study demand and supply factors determining DTP3 immunization status. We examined unique, nationally representative data from the National Socioeconomic Survey ( or ) and Village Potential Census ( or ) from 2004 to 2016. The percentage of children receiving complete DTP3 immunization increased from 37.8% in 2004 to 75.9% in 2016. Primarily income, parity status, and education, showed influence on DTP3 coverage. Among individual-level factors, the presence of a professional birth attendant was the most influential factor. At the district level, the factors varied. Low progress in DTP3 immunization status in Indonesia is due to huge disparities across the country's islands, in the density of health services, and in household socioeconomic status.
尽管2013年印度尼西亚12至23个月大儿童中有91%至少接受过一次免疫接种，但只有76%完成了三联疫苗（DTP3）免疫接种。这一比例低于联合国儿童基金会和世界卫生组织推荐的标准。因此，本研究旨在调查印度尼西亚三联疫苗（DTP3）免疫接种覆盖率低的趋势、空间差异和社会决定因素。我们采用多层次方法，分析了印度尼西亚约500个地区305,090名12至23个月大儿童的数据，以研究决定三联疫苗（DTP3）免疫接种状况的需求和供应因素。我们研究了2004年至2016年全国社会经济调查（或 ）和村庄特征普查（或 ）中具有全国代表性的独特数据。接受完整三联疫苗（DTP3）免疫接种的儿童比例从2004年的37.8%增至2016年的75.9%。主要是收入、胎次状况和教育程度对三联疫苗（DTP3）覆盖率产生影响。在个体层面因素中，有专业助产人员是最具影响力的因素。在地区层面，影响因素各不相同。印度尼西亚三联疫苗（DTP3）免疫接种状况进展缓慢是由于该国各岛屿在卫生服务密度和家庭社会经济地位方面存在巨大差异。
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