Institute of Population Studies, Hacettepe University, Ankara, Turkey.
Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
BMC Infect Dis. 2022 May 2;22(1):421. doi: 10.1186/s12879-022-07416-0.
Immunization plays a vital role in child health and survival. Zero-dose children are coming increasingly into focus as part of the global Immunization Agenda 2030. Although the percentage of zero-dose children has decreased in Turkey over time, regional/socioeconomic inequalities persist. This study aims to analyze the trend in zero-dose children and the factors associated with this problem in Turkey in light of regional inequalities.
Six data sets (1993, 1998, 2003, 2008, 2013, and 2018) were pooled from the last six Turkey Demographic and Health Surveys (TDHSs). The vaccination module for children aged 12-35 months and variables related to household characteristics, socio-economic, cultural characteristics of parents, bio-demographic/health-related factors were taken from the DHS data. Binary logistic regression analyses were carried out by taking into account the complex sample design of surveys for Turkey in general, the East region, and other regions.
Significant progress has been made in reducing the number of zero-dose children in Turkey over the last three decades, as it has dropped from 3.2 to 0.9%. The results of multivariate analyses revealed that survey year, household wealth, the mother's level of education, payment of bride price, mother's native language, place of delivery, and the number of antenatal care visits are associated with zero-dose children. Factors associated with zero-dose children also differ between the East region, and other regions.
Public health programs targeting uneducated parents, poor households, lack of social security, Kurdish-speaking mothers, older mothers and those without antenatal care should be implemented to promote childhood immunization.
免疫接种在儿童健康和生存中起着至关重要的作用。作为 2030 年全球免疫议程的一部分，零剂量儿童越来越受到关注。尽管土耳其的零剂量儿童比例随着时间的推移有所下降，但仍存在地区/社会经济不平等。本研究旨在分析土耳其零剂量儿童的趋势以及与该问题相关的因素，以了解地区不平等情况。
从最近六次土耳其人口与健康调查（TDHS）中汇集了六个数据集（1993 年、1998 年、2003 年、2008 年、2013 年和 2018 年）。从 DHS 数据中获取了 12-35 个月儿童的疫苗接种模块以及与家庭特征、社会经济、父母文化特征、生物人口/健康相关因素相关的变量。考虑到土耳其调查的复杂样本设计，对整个土耳其、东部地区和其他地区进行了二元逻辑回归分析。
在过去的三十年中，土耳其在减少零剂量儿童数量方面取得了重大进展，从 3.2%降至 0.9%。多变量分析的结果表明，调查年份、家庭财富、母亲受教育程度、支付彩礼、母亲母语、分娩地点和产前护理次数与零剂量儿童有关。与零剂量儿童相关的因素在东部地区和其他地区也有所不同。
应针对未受过教育的父母、贫困家庭、缺乏社会保障、说库尔德语的母亲、年龄较大的母亲和没有产前护理的母亲实施公共卫生计划，以促进儿童免疫接种。
