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|Title: ||One size does not fit all : local determinants of measles vaccination in four districts of Pakistan|
|Authors: ||Cockcroft, Anne|
Ansari, Noor M.
Chaudhry, Ubaid Ullah
|Issue Date: ||2009|
|Publisher: ||BioMed Central, London, GB|
|Citation: ||Cockcroft, A., Andersson, N., Omer, K., Ansari, N. M., Khan, A., Chaudhry, U. U., & Ansari, U. (2009). One size does not fit all: local determinants of measles vaccination in four districts of Pakistan. BMC International Health and Human Rights, 9(Suppl 1):S4. doi:10.1186/1472-698X-9-S1-S4|
|Abstract: ||Background: Rates of childhood vaccination in Pakistan remain low.There is continuing debate about
the role of consumer and service factors in determining levels of vaccination in developing countries.
Methods: In a stratified random cluster sample of census enumeration areas across four districts
in Pakistan, household interviews about vaccination of children and potentially related factors with
10,423 mothers of 14,542 children preceded discussion of findings in separate male and female focus
groups. Logistic regression analyses helped to clarify local determinants of measles vaccination.
Results: Across the four districts, from 17% to 61% of mothers had formal education and 50% to
86% of children aged 12-23 months had received measles vaccination. Children were more likely
to receive measles vaccination if the household was less vulnerable, if their mother had any formal
education, if she knew at least one vaccine preventable disease, and if she had not heard of any bad
effects of vaccination. Discussing vaccinations in the family was strongly associated with vaccination.
In rural areas, living within 5 km of a vaccination facility or in a community visited by a vaccination
team were associated with vaccination, as was the mother receiving information about vaccinations
from a visiting lady health worker. Focus groups confirmed personal and service delivery obstacles
to vaccination, in particular cost and poor access to vaccination services. Despite common factors,
the pattern of variables related to measles vaccination differed between and within districts.
Conclusions: Vaccination coverage varies from district to district in Pakistan and between urban
and rural areas in any district. Common factors are associated with vaccination, but their relative
importance varies between locations. Good local information about vaccination rates and
associated variables is important to allow effective and equitable planning of services.|
|Project Number: ||102172|
|Project Title: ||Operational Research: Canadian International Immunization Initiative - Phase II (CIII2)|
|Appears in Collections:||Health Systems Research / recherche sur les systèmes de santé|
Maternal, Newborn, and Child Health (MNCH) / la santé de la mère, du nouveau-né, et de l’enfant
Canadian International Immunization Initiative (CIII2) / l’initiative canadienne d’immunisation internationale
Research Results (GHRI) / Résultats de recherches (IRSM)
Research Results (GEHS) / Résultats de recherches (GESS)
2000-2009 / Années 2000-2009
IDRC Research Results / Résultats de recherches du CRDI
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