Gelaye Smeneh Sintayehu, Yenit Melaku Kindie, Baraki Adhanom Gebreegziabher
Department of Maternal and Child Health, BenshangulGumuz Health Office, BenshangulGumuz, Ethiopia.
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Pediatric Health Med Ther. 2021 Mar 19;12:119-127. doi: 10.2147/PHMT.S299064. eCollection 2021.
In developing countries like Ethiopia, about 3 million children's deaths are attributed to vaccine-preventable diseases. Studies especially that try to explain the urban to rural vaccination coverage discrepancy are limited in the study area. This study aimed to assess full vaccination coverage and associated factors among children aged 12-23 months in rural and urban kebeles of Pawi district.
A community-based comparative cross-sectional study among urban and rural kebeles was conducted. A multistage sampling method was used to select 456 rural and 229 urban. Data were collected from mothers/caregivers using interviewer-administered questionnaires and vaccination cards. Full vaccination coverage was estimated for both urban and rural kebeles. Multivariable logistic regression analysis was used to identify factors associated with full vaccination. Adjusted Odds Ratio with a 95% confidence interval was reported.
Full vaccination coverage was 67% (95% CI 63% -71%) and 60% (95% CI: 54% -66%) among rural and urban residents, respectively. Educational status of the father (AOR=2.69; 95% CI, 1.61-4.48), using postnatal care (PNC) (AOR=2.60; 95% CI, 1.58-4.29), discussion on side effect and contraindications of vaccines (AOR=1.82 95% CI, 1.16-2.88), and Institutional delivery (AOR=4.39, 95% CI 2.17-8.87) were factors significantly associated with full vaccination among rural children, whereas using Knowledge on immunization schedules (AOR=1.92 95% CI, 1.03-3.60), PNC (AOR=3.19; 95% CI, 1.57-6.47), discussion on side effects and contraindications of vaccines (AOR=2.75; 95% CI, 1.4-5.3) were notably associated with full vaccination among urban children.
The study reveals vaccination coverage was higher in rural compared to urban kebeles but it is still far below the WHO recommended target. Therefore interventions shall be made to improve the coverage especially by using the identified factors like improving PNC service and promoting institutional delivery and health education.
在埃塞俄比亚这样的发展中国家,约300万儿童的死亡归因于疫苗可预防疾病。在研究区域,尤其是试图解释城乡疫苗接种覆盖率差异的研究有限。本研究旨在评估帕维区城乡社区12至23个月儿童的全程疫苗接种覆盖率及相关因素。
在城乡社区开展了一项基于社区的比较横断面研究。采用多阶段抽样方法,选取了456名农村儿童和229名城市儿童。通过访谈员管理的问卷和疫苗接种卡从母亲/照顾者处收集数据。对城乡社区的全程疫苗接种覆盖率进行了估计。采用多变量逻辑回归分析来确定与全程疫苗接种相关的因素。报告了调整后的比值比及95%置信区间。
农村和城市居民的全程疫苗接种覆盖率分别为67%(95%CI 63% -71%)和60%(95%CI:54% -66%)。农村儿童中,父亲的教育程度(AOR=2.69;95%CI,1.61 - 4.48)、接受产后护理(PNC)(AOR=2.60;95%CI,1.58 - 4.29)、关于疫苗副作用和禁忌的讨论(AOR=1.82,95%CI,1.16 - 2.88)以及机构分娩(AOR=4.39,95%CI 2.17 - 8.87)是与全程疫苗接种显著相关的因素,而城市儿童中,对免疫接种时间表的了解(AOR=1.92,95%CI,1.03 - 3.60)、PNC(AOR=3.19;95%CI,1.57 - 6.47)、关于疫苗副作用和禁忌的讨论(AOR=2.75;95%CI,1.4 - 5.3)与全程疫苗接种显著相关。
该研究表明,农村社区的疫苗接种覆盖率高于城市社区,但仍远低于世界卫生组织推荐的目标。因此,应采取干预措施来提高覆盖率,特别是利用已确定的因素,如改善产后护理服务、促进机构分娩和健康教育。