Northern Regional Health Directorate, Ghana Health Service, Tamale, Ghana.
Department of Nursing, Northern Regional Hospital, Ghana Health Service, Tamale, Ghana.
PLoS One. 2024 Feb 26;19(2):e0292765. doi: 10.1371/journal.pone.0292765. eCollection 2024.
The home-based vaccination card is an important health record for determining vaccination status of children during surveys, particularly in low- and middle-income countries. However, there are limited evidence on the factors that influence its retention in Ghana. We assessed the predictors of vaccination card retention in Tamale Metropolis, Ghana.
We conducted a cross-sectional study from 21st December 2022 to 10th January 2023 among children aged 0-59 months in the Tamale Metropolis. Multi-stage sampling was used to select caregivers of children aged 0-59 months for enrolment in the study. Data were collected using validated questionnaire through face-to-face interviews of caregivers. A vaccination card was retained if it was presented for physical inspection by research assistants. The factors that influence vaccination card retention were determined in a multivariate logistic regression analysis at p<0.05.
A total of 1,532 eligible children were enrolled in this study. Vaccination card retention was 91.5%. Negative predictors of card retention included: being resident in the Nyohini (AOR = 0.28; 95% CI = 0.15-0.50) and Tamale Central (AOR = 0.51; 95% CI = 0.29-0.90) sub-Metro areas and being caregivers of children aged 24-59 months (AOR = 0.39; 95% CI = 0.22-0.68). On the other hand, paying for the vaccination card (AOR = 5.14; 95% CI = 2.95-8.95) was a positive predictor of vaccination card retention.
In this study, vaccination card retention among children aged 0-59 months was higher than national estimates. Vaccination card retention was mainly influenced by sub-Metro area, age of child and mode of acquisition of the card such as out-of-pocket payment. There is need to design and deliver tailored messages including the importance of vaccination card retention to caregivers of children based on geographic context. Additionally, the policy on sale of vaccination cards should be revised to allow for cost sharing to enhance its retention.
家庭疫苗接种卡是确定儿童疫苗接种状况的重要健康记录，特别是在中低收入国家。然而，关于影响其在加纳保留的因素的证据有限。我们评估了加纳塔马利大都市中疫苗接种卡保留的预测因素。
我们于 2022 年 12 月 21 日至 2023 年 1 月 10 日期间在塔马利大都市中对 0-59 个月大的儿童进行了一项横断面研究。使用多阶段抽样选择 0-59 个月大的儿童的照顾者参加研究。数据通过照顾者的面对面访谈使用经过验证的问卷收集。如果研究助理对其进行了物理检查，则保留疫苗接种卡。在 p<0.05 的情况下，通过多变量逻辑回归分析确定影响疫苗接种卡保留的因素。
共有 1532 名符合条件的儿童参加了这项研究。疫苗接种卡的保留率为 91.5%。卡保留的负面预测因素包括：居住在 Nyohini（AOR = 0.28；95%CI = 0.15-0.50）和塔马利中央（AOR = 0.51；95%CI = 0.29-0.90）次大都市地区以及照顾 24-59 个月大的儿童（AOR = 0.39；95%CI = 0.22-0.68）。另一方面，支付疫苗接种卡的费用（AOR = 5.14；95%CI = 2.95-8.95）是疫苗接种卡保留的积极预测因素。
在这项研究中，0-59 个月大儿童的疫苗接种卡保留率高于全国估计数。疫苗接种卡的保留主要受次大都市地区、儿童年龄和获得卡片的方式（如自费）的影响。需要根据地理背景，为基于儿童照顾者设计和传递有关疫苗接种卡保留的重要性的定制信息。此外，应修订有关疫苗接种卡销售的政策，以允许成本分担，从而提高其保留率。
