Sigdel Bina, Jin Yan, Dhakal Pushpa, Luitel Tika, Ghimire Pushpa Kumari, Wasti Sharada P
Kanti Children's Hospital, Kathmandu, Nepal.
Xiang Ya Nursing School, Central South University, Changsha, China.
Dialogues Health. 2023 May 29;2:100140. doi: 10.1016/j.dialog.2023.100140. eCollection 2023 Dec.
Childhood immunization is one of the most important public health interventions to reduce child morbidity and mortality. Reaching all children with full immunization services is critical to meet Nepal's commitment to Sustainable Development Goals (SDGs). This study aimed to identify factors affecting compliance with childhood immunization in children aged 16 to 36 months in Nepal. A community-based unmatched case-control study was conducted with 250 (83 cases and 167 controls) respondents in the Ilam district of Nepal. Respondents were randomly selected using a multi-stage cluster sampling technique. Data were collected using a structured questionnaire and analysed using SPSS version 16 statistical software. Bivariate and multivariate logistic regression analyses were done to identify the factors influencing compliance with childhood immunization of the sampled respondents. More than two-thirds (66.8%) of the sampled children were fully immunized, and 19.3% of the children defaulted to the Measles-Rubella vaccines. Only 19.2% of the respondents had good knowledge about the type of vaccine, and more than half (59.2%) of the respondents had a positive attitude towards immunization. Multivariate logistic regression analysis revealed that lack of knowledge about vaccines (AOR = 49.4, 95% CI = 12.94 to 188.59), father's level of education (AOR = 2.1, 95% CI = 1.05 to 4.30), not getting immunization on the day of the appointment (AOR = 4.8, 95% CI = 2.30 to 9.89), lack of knowledge about immunization schedule (AOR = 2.4, 95% CI = 1.14 to 4.84), and negative attitude towards immunization (AOR = 2.1, 95% CI = 1.03 to 4.19) were independently impeded on compliance on the childhood immunization. Targeted intervention in health promotion activities at the household level should be promoted and integrated immunization services into the existing primary health care services.
儿童免疫是降低儿童发病率和死亡率的最重要的公共卫生干预措施之一。为所有儿童提供全面的免疫服务对于尼泊尔履行对可持续发展目标（SDGs）的承诺至关重要。本研究旨在确定影响尼泊尔16至36个月儿童免疫接种依从性的因素。在尼泊尔伊拉姆区对250名（83例病例和167名对照）受访者进行了一项基于社区的非匹配病例对照研究。采用多阶段整群抽样技术随机选择受访者。使用结构化问卷收集数据，并使用SPSS 16版统计软件进行分析。进行双变量和多变量逻辑回归分析，以确定影响抽样受访者儿童免疫接种依从性的因素。超过三分之二（66.8%）的抽样儿童完成了全程免疫，19.3%的儿童未接种麻疹风疹疫苗。只有19.2%的受访者对疫苗类型有充分了解，超过一半（59.2%）的受访者对免疫接种持积极态度。多变量逻辑回归分析显示，对疫苗缺乏了解（比值比[AOR]=49.4，95%置信区间[CI]=12.94至188.59）、父亲的教育水平（AOR=2.1，95%CI=1.05至4.30）、未在预约当天接种疫苗（AOR=4.8，95%CI=2.30至9.89）、对免疫接种时间表缺乏了解（AOR=2.4，95%CI=1.14至4.84）以及对免疫接种持消极态度（AOR=2.1，95%CI=1.03至4.19）均独立阻碍了儿童免疫接种的依从性。应在家庭层面促进有针对性的健康促进活动干预，并将综合免疫服务纳入现有的初级卫生保健服务。
