Improving immunization in Afghanistan: results from a cross-sectional community-based survey to assess routine immunization coverage

Mugali, Raveesha R.; Mansoor, Farooq; Parwiz, Sardar M.; Ahmad, Fazil; Safi, Najibullah; Higgins-Steele, Ariel; Varkey, Sherin

doi:10.1186/s12889-017-4193-z

Cited by 35 publications

(45 citation statements)

References 23 publications

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“…The percentage of non-vaccinated children in the rural areas of Afghanistan was higher than in urban areas. Similar findings were presented by a study in 2013 among Afghan children age 12-23 months, where the prevalence of full vaccination was found to be 62% in urban areas versus 49% in rural areas [17]. These findings were consistent with studies conducted in Pakistan [4], India [18], and Ethiopia [24].…”

Section: Plos Onesupporting

confidence: 90%

“…Understanding factors that influence vaccination coverage is important to increase the vaccination coverage rate. Numerous investigations have found that the factors influencing vaccination coverage among children include sex of child, place of birth, maternal and paternal education, maternal and paternal occupation, number of antenatal care (ANC) visits, household characteristics, and sociocultural factors [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Factors influencing vaccination coverage among children age 12–23 months in Afghanistan: Analysis of the 2015 Demographic and Health Survey

2020

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Background Childhood vaccination plays a key role in reducing morbidity and mortality from vaccine-preventable diseases. Numerous studies have assessed the influence of demographic and socioeconomic factors on child immunization around the world. There are few such studies in Afghanistan, however. Therefore, this study aimed to identify factors influencing vaccination status among children age 12-23 months in Afghanistan. Materials and methods Nationally representative data from the 2015 Afghanistan Demographic and Health Survey were used for this study. A sample of 5,708 children age 12-23 months with a vaccine card and immunization history was analyzed. Multinomial logistic regression was used to identify significant relationships between cofactors and vaccination status. Results In the study, 51% the subjects were boys, 48% were born at home, and 76% were residents of rural areas. Background characteristics positively associated with vaccination status included delivery in a health facility (RRR = 2.5, 95% CI = 1.9-3.3), maternal age of 30-39 years (RRR = 2.2, 95% CI = 1.2-4.1), attending at least four visits for antenatal care (RRR = 2.7, 95% CI = 1.7-4.5), health facility visit in the past 12 months (RRR = 1.9, 95% CI = 1.4-2.5), paternal professional occupation (RRR = 4.9, 95% CI = 2.0-12.3), family with richer wealth index (RRR = 2.4, 95% CI = 1.4-4.1), and living in the northeast region (RRR = 2.2, 95% CI = 1.2-3.9)were positively associated with vaccination status. Living in the southern region (RRR = 0.3, 95% CI = 0.2-0.5) was negatively associated with vaccination status.

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Section: Plos Onesupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Factors influencing vaccination coverage among children age 12–23 months in Afghanistan: Analysis of the 2015 Demographic and Health Survey

2020

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“…In this study, the poorest and poorer mothers were less likely to have a fully vaccinated child. Similar findings have reported on the association between lower socio-economic status and the lesser likelihood of a fully vaccinated child (8,12,41,42). One explanation was that poorer mothers had less time or "multiple livelihood activities which deter clinic attendance" (43).…”

Section: Socio-economic Status and Healthcare Utilizationsupporting

confidence: 73%

Potential of improving full vaccination status of children in Niamey, Niger; a randomized cluster survey

Kunieda¹,

Jimba²,

Shibanuma³

et al. 2019

Preprint

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Background and Objectives: Economically-disadvantaged Sub-Saharan African children are not fully protected from vaccine-preventable diseases. Maternal education is a promoting factor associated with child vaccination. However, both socio-economic status and maternal education factors are not easily modifiable. This study aimed to identify factors associated with full vaccination status of children in Niamey, Niger.　Methods: A cross-sectional, multi-stage randomized cluster survey was conducted in Niamey’s five health districts. Data on vaccination coverage and socio-economic household characteristics were collected. Logistic regression analysis was conducted with data on 445 pairs of mothers and their children aged 12-23 months.Results: Of 445 children, 38% were fully vaccinated. Mothers who were satisfied with their health worker’s attitude and had correct vaccination calendar knowledge (AOR 5.32, 95% CI 2.05-13.82) were more likely to have fully vaccinated children. Mothers who had completed secondary school (AOR 2.04, 95% CI 1.17-3.55) were also associated with fully vaccinated children. Conclusions: Low coverage of full vaccination could be improved through modifiable factors in resource-limited settings such as Niger. Communication interventions may be effective, including improving mothers’ knowledge about vaccination timing and intervals between appointments. Health workers’ attitudes should also be improved with better interpersonal communication with the mothers.

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“…Consequently, the region may witness a setback in the advances made in polio eradication and measles elimination as a result of low vaccination coverage and breakdown of surveillance systems. Polio endemicity in Pakistan, Afghanistan and Nigeria is partly attributed to the protracted armed conflict in these countries [32,33].…”

Section: Discussionmentioning

confidence: 99%

Health Services Utilisation before and during an Armed Conflict; Experiences from the Southwest Region of Cameroon

Haddison¹,

Chia²,

Kagina³

2020

TOPHJ

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Introduction: Armed conflicts are a threat to the health of populations in affected areas. The threat can have several forms, such as direct injury or disruption of health service delivery and utilisation. There has been an armed conflict (Anglophone crisis) in the English-speaking regions of Cameroon since 2017. We assessed the utilisation of health services before and during the armed conflict s in the Southwest region of Cameroon. Methods: A retrospective study of surveillance data was carried out between 2016 and 2018. Regional data for selected routine immunisation, reproductive health, disease surveillance and HIV/AIDS indicators were retrieved. The data were presented as frequencies and described narratively. Results: In general, there was a difference in the utilisation of health services before and during the armed conflict. Specifically, there was an improvement in health service utilisation indicators from 2016 to 2017, followed by a decline in 2018. The DPT3 vaccination coverage dropped from 90% in 2017 to 55% in 2018; deliveries attended by qualified personnel dropped from 46% in 2017 to 26% in 2018; the absolute number of people tested for HIV dropped from 20,3987 in 2017 to 18,3654 in 2018. Conclusion: The utilisation of health services by the population of the Southwest region declined during the armed conflict. This decline could have a significant impact on the population’s health and potentially affect the set global health targets such as improved vaccination coverage in all districts. Due to the armed conflict, there were challenges with regard to accessing health services. Local, national, regional and global authorities must work together to develop risk mitigating interventions in settings with armed conflicts to preserve the delivery and utilisation of health services.

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Improving immunization in Afghanistan: results from a cross-sectional community-based survey to assess routine immunization coverage

Cited by 35 publications

References 23 publications

Factors influencing vaccination coverage among children age 12–23 months in Afghanistan: Analysis of the 2015 Demographic and Health Survey

Factors influencing vaccination coverage among children age 12–23 months in Afghanistan: Analysis of the 2015 Demographic and Health Survey

Potential of improving full vaccination status of children in Niamey, Niger; a randomized cluster survey

Health Services Utilisation before and during an Armed Conflict; Experiences from the Southwest Region of Cameroon

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