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Sangaré S, Sangho O, Doumbia L, Marker H, Sarro YDS, Dolo H, Telly N, Zakour IB, Ndiaye HM, Sanogo M, Sangho F, Diarra NH, Sangho A, Traoré FB, Diallo B, Coulibaly CA, Ongoiba S, Diakité L, Doumbia S. Concordance of vaccination status and associated factors with incomplete vaccination: a household survey in the health district of Segou, Mali, 2019. Pan Afr Med J 2021; 40:102. [PMID: 34887977 PMCID: PMC8627150 DOI: 10.11604/pamj.2021.40.102.29976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/18/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction the region of Segou recorded 36.8% of children were incompletely vaccinated in 2018. In 2019, the district of Segou was one of the districts with the lowest vaccination coverage in the region, with 85.1% coverage for the three doses of the pentavalent vaccine and 85.4% for the measles vaccine. This study was initiated to better understand this low vaccination coverage, in the absence of specific studies on vaccination coverage in the district of Segou. Methods a prospective cross-sectional study was conducted from May to August 2020 with 30 clusters. We performed Kappa coefficient, bivariate, and multiple logistic regression analysis. Results findings showed that 18.46% (101/547) [15.44-21.93] of children were incompletely vaccinated. Mothers correctly reported the vaccination status of their children in 67.30% of cases (Kappa coefficient). Uneducated (OR[IC95%]=2.13[1.30-3.50]), living in rural area (OR[IC95%]=2.07[1.23-3.47]), lack of knowledge of Expanded Program on Immunization (EPI) target diseases (OR[IC95%]=2.37[1.52-3.68]), lack of knowledge of vaccination schedule (OR[IC95%]=3.33[1.90-5.81]) and lack of knowledge of the importance of vaccination (OR[IC95%]=3.6[2.35-6.32]) were associated with incomplete vaccination. In multivariate analysis, uneducated (ORa[IC95%>]=1.68[1.004-2.810]) and lack of knowledge of the importance of vaccination were associated with incomplete vaccination (ORa[IC95%]=3.40[2.049-5.649]). Conclusion findings showed a good concordance of the vaccination status. Living in a rural area, no education, lack of the knowledge of EPI target diseases, lack of the knowledge of vaccination schedule and lack of knowledge of the importance of vaccination were associated with incomplete vaccination.
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Affiliation(s)
| | - Oumar Sangho
- Department of Education and Research of Biological and Medical Sciences, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.,Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Lancina Doumbia
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Hannah Marker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yeya Dit Sadio Sarro
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Housseini Dolo
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Nouhoum Telly
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | | | - Moussa Sanogo
- Regional Directorate of Health and Public Hygiene, Kidal, Mali
| | - Fanta Sangho
- Department of Education and Research of Biological and Medical Sciences, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.,Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Niélé Hawa Diarra
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Aboubacar Sangho
- Department of Education and Research of Pharmaceutical Sciences, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Baba Diallo
- University Hospital Center for Odonto-Stomatology (CHU-CNOS), Bamako, Mali
| | - Cheick Abou Coulibaly
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | | | - Seydou Doumbia
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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Hydarav R, Igweonu O, Anand S, Jemimah M, Merdekios A, Abrar L, Okeibunor J, Okiror S. Establishment and Use of Polio Communication Network in Response to Polio in Outbreak Countries of the Horn of Africa: 2013-2014. ACTA ACUST UNITED AC 2021; Spec Issue:1117. [PMID: 33954309 PMCID: PMC7610727 DOI: 10.29245/2578-3009/2021/s2.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Between 2013 and 2014, the Horn of Africa countries experienced a severe and prolonged outbreak of polio viruses. It started in one district in Somalia but quickly became a national and even international disaster, crossing international boundaries into Kenya and Ethiopia. This paper documents experiences in the establishment and contributions of the Polio Communication Network (PCN) to the polio outbreak response in the outbreak countries of Somalia, Kenya and Ethiopia from 2013 to 2015. Process The establishment of the PCN network of partnerships and technical assistance was designed to implement a strategic communication response. Various strategies were used to establish the PCN. Some of these strategies included partnerships with faith-based organizations; involvement of local leaders in microplanning; social mobilization committees and research, monitoring, evaluation and documentation structures. Major Outcomes PCN contributions through sustained high levels of community awareness of polio rounds were demonstrated. The contributions of the context-sensitive approaches included significant gains in reaching traditionally missed, hard-to-reach, pastoral communities with polio information, improved communication capacity, and successful closure of the outbreak within the expected timeline. This PCN experience provides important communication lessons relevant to polio eradication and other public health programmes. The focus on building capacity in areas such as monitoring, and data collection generated social data that led to the communication approaches making a significant impact. PCN contributed to a better understanding of the behavioral and environmental factors affecting the demand for, and uptake of, health services in the HoA which can be extended to most of the countries in the HoA with the same demographic and epidemiological realities. Conclusion The use of the PCN helped bring the 2013-2014 polio outbreak under control and illustrates how the PCN can help drive progress towards the realization of the agenda of the universal health coverage and vision 2030 agenda in the African Region and elsewhere.
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Affiliation(s)
| | | | | | | | | | | | | | - Sam Okiror
- WHO Horn of Africa Coordination Office (HOA), Nairobi KENYA
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Sato R, Fintan B. Women's understanding of immunization card and its correlation with vaccination behaviors. Hum Vaccin Immunother 2020; 16:2408-2414. [PMID: 32083511 DOI: 10.1080/21645515.2020.1726682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Despite the proven effectiveness of vaccinations, vaccination uptake is limited in Nigeria. According to the Multiple Indicator Cluster Survey (MICS), one of the main barriers is the lack of accurate knowledge of the vaccination schedule. This study evaluates caregivers' knowledge of the vaccination schedule and their ability to read the immunization card. Methods: The study evaluated the knowledge of caregivers in 11 settlements in the Jada local government area of Adamawa State in September 2019. The change in knowledge among caregivers before and after referring to the immunization card was evaluated using a simple statistical hypothesis testing (chi-square test). We also used logistic regression analysis to evaluate the determinants of vaccination knowledge, as well as the correlation between knowledge and actual vaccination behaviors. Results: More than half of the women had correct knowledge of the vaccination schedule for critical vaccines. However, the knowledge of the caregivers did not improve after referring to the immunization card which contained the information. Caregivers who brought their children to the clinic for vaccination recently were more likely to know the vaccination schedule correctly. Accurate knowledge was highly correlated with the actual vaccination behaviors. Conclusion: Reference to the immunization card did not improve the knowledge of vaccination schedule, especially among the less-educated population. To increase the demand for vaccinations, one potential policy is to target the uneducated population and help them increase their knowledge.
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Affiliation(s)
- Ryoko Sato
- Global Health and Population, Harvard T.H Chan School of Public Health , Boston, MA, USA
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Porth JM, Wagner AL, Teklie H, Abeje Y, Moges B, Boulton ML. Vaccine non-receipt and refusal in Ethiopia: The expanded program on immunization coverage survey, 2012. Vaccine 2019; 37:2106-2121. [PMID: 30826143 DOI: 10.1016/j.vaccine.2019.02.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/16/2019] [Accepted: 02/20/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Rates of full childhood immunization in Ethiopia are well below the WHO global goal of 90% coverage by 2020. This study explores associations between sociodemographic characteristics and healthcare services utilization with experiences of not receiving a vaccine in Ethiopia. METHODS This analysis uses data from Ethiopia's 2012 Expanded Program on Immunization Coverage Survey. The relationships between explanatory variables, including sociodemographic and healthcare utilization factors, and various reasons a child was not vaccinated were assessed with Rao-Scott chi-square tests. Multivariable logistic regression analyses examined significant predictors of these experiences. RESULTS The sample includes the caregivers of 2,722 children. Experiences of not receiving a vaccine were characterized overall and by type of experience: whether a caregiver ever refused vaccination for their child (2.9%), ever decided to not take their child to a health center for vaccination (3.6%), and ever went to a health facility for vaccination but child was not vaccinated (12.0%). Region of residence, possession of a vaccination card, and the setting of the child's last routine vaccination were predictors of not receiving a vaccine. Caregivers reported negative perceptions of vaccines were among their reasons for refusing a vaccine or declining to take their child to a health facility for vaccination. CONCLUSION Prior experiences with health facilities, such as where a child received their last routine vaccine, play a key role in future vaccination. Vaccine receipt at an outreach event is associated with not bringing a child to a health facility for vaccination, which may indicate an unwillingness to visit or difficulty accessing health centers. Further, negative perceptions of vaccines may result in vaccine refusal or delay. Findings of this study provide public health officials with a better understanding of factors related to vaccination experiences and can inform development of interventions that will improve childhood vaccination rates in Ethiopia.
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Affiliation(s)
- Julia M Porth
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Habtamu Teklie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yemesrach Abeje
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Beyene Moges
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Matthew L Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, Ann Arbor, MI, USA
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Duarte DC, Oliveira VCD, Guimarães EADA, Viegas SMDF. Vaccination access in Primary Care from the user's perspective: senses and feelings about healthcare services. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2018-0250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To understand the feelings, senses, perceptions and perspectives of Users regarding access to vaccination in Primary Health Care. Method: This is a Holistic-Qualitative Multiple Case Study, based on Comprehensive Sociology of Everyday Life with 74 participants representing four microregions of health in the Western Extended Region of Minas Gerais. Data collection occurred between June 2016 and April 2017. In order to analyse the data, we used the Thematic Content Analysis, obeying the technique of cross-synthesis of the cases. Results: The results reveal the senses perceived by Users in the experience of vaccination and the feelings regarding care, showing that interpersonal relations between population and health professionals are determinant in the access to vaccination. The constant expansion of the official immunization schedule increased access, however, geographical and social aspects, the lack of knowledge about vaccination and the recurrent lack of immunobiological were referred to as barriers to immunization access. Final considerations: We emphasized the need to reinforce more equitable policies and effective communication as a means to promote the credibility of the services with Users.
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Hu Y, Chen Y, Wang Y, Liang H. Measuring childhood vaccination acceptance of mother in Zhejiang province, East China. Hum Vaccin Immunother 2018; 15:287-294. [PMID: 30235056 DOI: 10.1080/21645515.2018.1526557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the vaccine hesitancy among mothers and examine risk factors associated with mother's intention to vaccination in Zhejiang province. METHODS A provincial sample of mothers of children aged 24-35 months was surveyed (N = 770) in August, 2017. Demographic information, perception on the past childhood vaccination, knowledge on vaccination, information searches and needs, trust in different institutions on vaccination were collected. Based on the theory of planned behaviour (TPB), attitudes toward vaccination, perceived social support, perceived behavioural control as well as mothers' intention to immunize their child were constructed. Descriptive statistics were generated for all variables. Univariate and multivariate analyses were performed to identify differences between mothers who had strong intentions to immunize their children in future and those with weaker intentions. RESULTS Of the participants, 79.6% had a positive attitudes towards vaccination, 77.5% had a high perceived social support, 63.2% had a high perceived behaviour control and 87.3% strongly intended to have their child vaccinated. Strong intention to vaccination was significantly associated with the positive behavioral attitudes [adjusted odds ratios (AOR) = 3.2, 95% CI: 2.3-5.7], the high perceived social support (AOR = 2.8, 95% CI: 1.8-3.6), the perceived ease of undergoing vaccination (AOR = 2.1, 95% CI: 1.6-3.3), respectively. CONCLUSIONS It was recommended that interventions focused on trust-building, promoting social norms, changing the negative attitude would be effective to enhance the maternal acceptance on vaccination.
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Affiliation(s)
- Yu Hu
- a Zhejiang Center for Disease Control and Prevention , Institute of Immunization and Prevention , Hangzhou , China
| | - Yaping Chen
- a Zhejiang Center for Disease Control and Prevention , Institute of Immunization and Prevention , Hangzhou , China
| | - Ying Wang
- a Zhejiang Center for Disease Control and Prevention , Institute of Immunization and Prevention , Hangzhou , China
| | - Hui Liang
- a Zhejiang Center for Disease Control and Prevention , Institute of Immunization and Prevention , Hangzhou , China
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Tadesse T, Getachew K, Assefa T, Ababu Y, Simireta T, Birhanu Z, Hailemichael Y. Factors and misperceptions of routine childhood immunization service uptake in Ethiopia: findings from a nationwide qualitative study. Pan Afr Med J 2017; 28:290. [PMID: 29675124 PMCID: PMC5903705 DOI: 10.11604/pamj.2017.28.290.14133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 11/20/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction While the routine childhood immunization program might be affected by several factors, its identification using qualitative evidence of caretakers is generally minimal. This article explores the various factors and misperceptions of routine childhood immunization service uptake in Ethiopia and provides possible recommendations to mitigate them. Methods In this study, we used a qualitative multiple case study design collecting primary data from 63 focus group discussions (FGDs) conducted with a purposefully selected sample of children's caretakers (n = 630). Results According to the results of this study, the use of routine childhood immunization is dependent on four major factors: caretakers' behavior, family characteristics, information and communication and immunization service system. In addition, the participants had some misperceptions about routine childhood immunization. For example, immunization should be taken when the child gets sick and a single dose vaccine is enough for a child. These factors and misperceptions are complex and sometimes context-specific and vary between categories of caretakers. Conclusion Our interpretations suggest that no single factor affects immunization service uptake alone in a unique way. Rather, it is the synergy among the factors that has a collective influence on the childhood immunization system. Therefore, intervention efforts should target these multiple factors simultaneously. Importantly, this study recommends improving the quality of existing childhood immunization services and building awareness among caretakers as crucial components.
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Affiliation(s)
| | | | | | - Yohannes Ababu
- Immunization Program, World Health Organization, Addis Ababa, Ethiopia
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