Missed opportunities in full immunization coverage: findings from low- and lower-middle-income countries
An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions. Fourteen countries with Demographic and...
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| Published in: | Global health action Vol. 9; no. 1; p. 30963 |
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01.01.2016
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| Abstract | An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions.
Fourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis) vaccine below 70% were selected. We defined full immunization coverage (FIC) as having received one dose of BCG (bacille Calmette-Guérin), one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC), skilled birth attendance (SBA), postnatal care for the mother (PNC), vitamin A supplementation (VitA) for the child, and sleeping under an insecticide-treated bed-net (ITN). Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions.
Children who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp) between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute difference: 16 pp.
Our results show the need to develop and implement strategies to vaccinate all children who contact health services in order to receive other interventions. |
|---|---|
| AbstractList | An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions.
Fourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis) vaccine below 70% were selected. We defined full immunization coverage (FIC) as having received one dose of BCG (bacille Calmette-Guérin), one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC), skilled birth attendance (SBA), postnatal care for the mother (PNC), vitamin A supplementation (VitA) for the child, and sleeping under an insecticide-treated bed-net (ITN). Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions.
Children who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp) between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute difference: 16 pp.
Our results show the need to develop and implement strategies to vaccinate all children who contact health services in order to receive other interventions. BackgroundAn estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions.DesignFourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis) vaccine below 70% were selected. We defined full immunization coverage (FIC) as having received one dose of BCG (bacille Calmette-Guérin), one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC), skilled birth attendance (SBA), postnatal care for the mother (PNC), vitamin A supplementation (VitA) for the child, and sleeping under an insecticide-treated bed-net (ITN). Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions.ResultsChildren who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp) between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute difference: 16 pp.ConclusionsOur results show the need to develop and implement strategies to vaccinate all children who contact health services in order to receive other interventions. Background: An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions. Design: Fourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis) vaccine below 70% were selected. We defined full immunization coverage (FIC) as having received one dose of BCG (bacille Calmette-Guérin), one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC), skilled birth attendance (SBA), postnatal care for the mother (PNC), vitamin A supplementation (VitA) for the child, and sleeping under an insecticide-treated bed-net (ITN). Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions. Results: Children who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp) between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute difference: 16 pp. Conclusions: Our results show the need to develop and implement strategies to vaccinate all children who contact health services in order to receive other interventions. |
| Author | Wehrmeister, Fernando C. Pariyo, George Restrepo-Méndez, María Clara Victora, Cesar G. Barros, Aluísio J. D. Wong, Kerry L. M. Johnson, Hope L. |
| AuthorAffiliation | 3 Gavi, The Vaccine Alliance, Geneva, Switzerland 4 Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA 1 International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil 2 International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil |
| AuthorAffiliation_xml | – name: 2 International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil – name: 1 International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil – name: 3 Gavi, The Vaccine Alliance, Geneva, Switzerland – name: 4 Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA |
| Author_xml | – sequence: 1 givenname: María Clara surname: Restrepo-Méndez fullname: Restrepo-Méndez, María Clara email: mcrestrepo@equidade.org organization: International Center for Equity in Health, Federal University of Pelotas – sequence: 2 givenname: Aluísio J. D. surname: Barros fullname: Barros, Aluísio J. D. organization: International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas – sequence: 3 givenname: Kerry L. M. surname: Wong fullname: Wong, Kerry L. M. organization: International Center for Equity in Health, Federal University of Pelotas – sequence: 4 givenname: Hope L. surname: Johnson fullname: Johnson, Hope L. organization: Gavi The Vaccine Alliance – sequence: 5 givenname: George surname: Pariyo fullname: Pariyo, George organization: Johns Hopkins UniversityBloomberg School of Public Health, Baltimore – sequence: 6 givenname: Fernando C. surname: Wehrmeister fullname: Wehrmeister, Fernando C. organization: International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas – sequence: 7 givenname: Cesar G. surname: Victora fullname: Victora, Cesar G. organization: International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27146444$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.4103/0019-5359.37046 10.1016/S0140-6736(05)67599-X 10.1186/1478-7954-9-6 10.1186/1471-2288-3-21 10.1177/004947550203200305 10.1016/S0140-6736(14)61698-6 10.1093/ije/22.6.1146 |
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| Copyright | 2016 María Clara Restrepo-Méndez et al. 2016 2016 María Clara Restrepo-Méndez et al. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Snippet | An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized... BackgroundAn estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully... BACKGROUNDAn estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully... Background: An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully... |
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| SubjectTerms | Africa Asia child health Children Childrens health Dietary supplements Diphtheria Dosage Female Haiti Health promotion Health services Health Surveys Humans Immunization Immunization Programs - statistics & numerical data Immunization Schedule Infant Infants Insecticides Intervention Low income groups Male Maternal and infant welfare Measles Mothers Original Poliomyelitis Polls & surveys Postpartum period Poverty Prenatal care Prenatal Care - statistics & numerical data Tetanus vaccination Vaccination - utilization Vaccines Vitamin A Vitamins Whooping cough |
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| Title | Missed opportunities in full immunization coverage: findings from low- and lower-middle-income countries |
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| Volume | 9 |
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