Missed opportunities in full immunization coverage: findings from low- and lower-middle-income countries

Restrepo‐Méndez, María Clara; Barros, Aluísio J D; Wong, Kerry L. M.; Johnson, Hope L.; Pariyo, George; Wehrmeister, Fernando César; Victora, Cesar G

doi:10.3402/gha.v9.30963

Cited by 70 publications

(82 citation statements)

References 8 publications

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“…Also, adequate immunization is considered as a proxy for childcare. Strategies need to be implemented to vaccinate all children who visit health services for other interventions 13 .…”

Section: Discussionmentioning

confidence: 99%

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study

Pina

Moraes

Freitas³

et al. 2017

Rev. Latino-Am. Enfermagem

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Objective:to evaluate the association of primary health care and other potential factors in relation to hospitalization due to pneumonia, among children aged under five years. Method:epidemiological study with a case-control, hospital-based design, which included 345 cases and 345 controls, matched according to gender, age and hospital. Data were collected using a pre-coded questionnaire and the Primary Care Assessment Tool, analyzed by means of multivariate logistic regression, following the assumptions of a hierarchical approach. Results:the protective factors were: family income >US$216.12 (OR=0.68), weight gain during pregnancy ≥10 kg (OR=0.68), quality of Primary Health Care (OR for scores >3.41=0.57; OR for scores >3.17 and ≤3.41=0.50), gastro-esophageal reflux (OR=0.55), overweight (OR=0.37) and birth interval ≥48 months (OR=0.28). The risk factors included: parity (2 childbirths: OR=4.60; ≥3 childbirths: OR=3.25), out-of-date vaccination (OR=2.81), undernutrition (OR=2.53), history of wheezing (≥3 episodes OR=2.37; 1 episode: OR=2.13), attendance at daycare center (OR=1.67), and use of medicines over the past month (OR=1.67). Conclusion:primary health care and its child health care practices, such as nutritional monitoring, immunization, care to prevalent illnesses, prenatal care and family planning need to be prioritized to avoid child hospitalization due to pneumonia.

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“…Also, adequate immunization is considered as a proxy for childcare. Strategies need to be implemented to vaccinate all children who visit health services for other interventions 13 .…”

Section: Discussionmentioning

confidence: 99%

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study

Pina

Moraes

Freitas³

et al. 2017

Rev. Latino-Am. Enfermagem

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“…Essential interventions to be delivered during antenatal care, for example, are often provided inconsistently, 72 basic resources needed for safe and effective delivery care are often absent, 73 74 opportunities for immunization are missed 75 and misdiagnosis and incorrect treatment of childhood illnesses are common. 76 77 Gaps between coverage levels of receipt of antenatal care (four or more visits) and coverage levels adjusted to take into consideration available service inputs can be as large as 30-45 percentage points.…”

Section: Panel 2: Major Gaps In the Quality Of Carementioning

confidence: 99%

Countdown to 2030: tracking progress towards universal coverage for reproductive, maternal, newborn, and child health

Boerma¹,

Requejo²,

Victora³

et al. 2018

The Lancet

343

295

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Building upon the successes of Countdown to 2015, Countdown to 2030 aims to support the monitoring and measurement of women's, children's, and adolescents' health in the 81 countries that account for 95% of maternal and 90% of all child deaths worldwide. To achieve the Sustainable Development Goals by 2030, the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children younger than 5 years of age needs to accelerate considerably compared with progress since 2000. Such accelerations are only possible with a rapid scale-up of effective interventions to all population groups within countries (particularly in countries with the highest mortality and in those affected by conflict), supported by improvements in underlying socioeconomic conditions, including women's empowerment. Three main conclusions emerge from our analysis of intervention coverage, equity, and drivers of reproductive, maternal, newborn, and child health (RMNCH) in the 81 Countdown countries. First, even though strong progress was made in the coverage of many essential RMNCH interventions during the past decade, many countries are still a long way from universal coverage for most essential interventions. Furthermore, a growing body of evidence suggests that available services in many countries are of poor quality, limiting the potential effect on RMNCH outcomes. Second, within-country inequalities in intervention coverage are reducing in most countries (and are now almost non-existent in a few countries), but the pace is too slow. Third, health-sector (eg, weak country health systems) and non-health-sector drivers (eg, conflict settings) are major impediments to delivering high-quality services to all populations. Although more data for RMNCH interventions are available now, major data gaps still preclude the use of evidence to drive decision making and accountability. Countdown to 2030 is investing in improvements in measurement in several areas, such as quality of care and effective coverage, nutrition programmes, adolescent health, early childhood development, and evidence for conflict settings, and is prioritising its regional networks to enhance local analytic capacity and evidence for RMNCH.

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“…MOV may be preventing countries from reaching their immunization targets. By ensuring that children who are already receiving health services are screened and vaccinated during regular health service encounters, addressing the underlying causes of MOV can significantly increase coverage and timeliness with minimal and sustainable cost [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

Tabu

Shendale

et al. 2020

PLoS ONE

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Background In 2016, Kenya conducted a study of missed opportunities for vaccination (MOV)-when eligible children have contact with the health system but are not fully vaccinated-to explore some of the reasons for persistent low vaccination coverage. This paper details the qualitative findings from that assessment. Methods Using the World Health Organization MOV methodology, teams conducted focus group discussions among caregivers and health workers and in-depth interviews of key informants in 10 counties in Kenya. Caregivers of children <24 months of age visiting the selected health facilities on the day of the assessment were requested to participate in focus group discussions. Health workers were purposively sampled to capture a broad range of perspectives. Key informants were selected based on their perceived insight on immunization services at the county, sub-county, or health facility level. Results Six focus group discussions with caregivers, eight focus group discussions with health workers, and 35 in-depth interviews with key informants were completed. In general, caregivers had positive attitudes toward healthcare and vaccination services, but expressed a desire for increased education surrounding vaccination. In order to standardize vaccination checks at all health facility visits, health workers and key informants emphasized the need for additional trainings for all staff members on immunization. Health workers and key informants

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Missed opportunities in full immunization coverage: findings from low- and lower-middle-income countries

Cited by 70 publications

References 8 publications

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study

Countdown to 2030: tracking progress towards universal coverage for reproductive, maternal, newborn, and child health

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

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