Performance and determinants of routine immunization coverage within the context of intensive polio eradication activities in Uttar Pradesh, India: Social Mobilization Network (SM Net) and Core Group Polio Project (CGPP)
Performance and determinants of routine immunization coverage within the context of intensive polio eradication activities in Uttar Pradesh, India: Social Mobilization Network (SM Net) and Core Group Polio Project (CGPP)
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DOI：
10.1186/1472-698x-13-25
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发表时间：
2013-05-16
影响因子：
3
通讯作者：
Solomon, Roma
中科院分区：
文献类型：
--
作者：
Weiss, William M.;Choudhary, Manojkumar;Solomon, Roma
背景资料：研究了印度根除脊髓灰质炎工作对常规免疫计划的影响，得出了不同的结果。在印度北方邦，由美国国际开发署（美援署）资助、CORE集团小儿麻痹症项目执行的一个消除小儿麻痹症项目包括加强例行免疫系统，作为其消除小儿麻痹症战略的核心部分。本文探讨了CGPP干预地区常规免疫服务与强化根除脊髓灰质炎活动同时进行的绩效。本文还探讨了常规免疫性能的决定因素，如看护人的特点和CGPP活动，以加强常规免疫service.Methods：我们进行二次数据分析，在2011年的最新项目的家庭免疫调查，并将这些结果与过去的调查报告在CGPP计划领域，并在北方邦国家一级（衡量儿童的百白破疫苗接种）。这样做是为了判断是否有任何证据表明常规免疫服务受到干扰。我们还对调查对象的特征和受访者接触CGPP的情况、沟通活动与其子女接受关键疫苗接种的情况进行了建模，以确定常规免疫接种覆盖率的决定因素。从第一次调查到第二次调查，（2005年为州一级的估计，2008年为CGPP计划）和最新的（2011年为州一级和CGPP地区），以儿童接种百白破疫苗为衡量标准。这一增加是在大力开展根除小儿麻痹症工作的同时发生的，其力度足以阻断传播。此外，母亲接触到特定的通信材料，她的宗教和教育与她的孩子是否接受一个或多个剂量的DPT.Conclusions：分析的局限性是没有一个控制比较。如果没有根除脊髓灰质炎的努力，常规免疫覆盖率可能会增加更多。但与此同时，没有证据表明常规免疫接种服务因根除小儿麻痹症的努力而中断。有针对性的卫生宣传有助于提高常规免疫接种的效果。还需要制定战略，解决常规免疫的其他决定因素，如宗教和教育，以最大限度地扩大覆盖面。
Background: Studies that have looked at the effect of polio eradication efforts in India on routine immunization programs have provided mixed findings. One polio eradication project, funded by US Agency for International Development (USAID) and carried out by the CORE Group Polio Project (CGPP) in the state of Uttar Pradesh of India, has included the strengthening of routine immunization systems as a core part of its polio eradication strategy. This paper explores the performance of routine immunization services in the CGPP intervention areas concurrent with intensive polio eradication activities. The paper also explores determinants of routine immunization performance such as caretaker characteristics and CGPP activities to strengthen routine immunization services.Methods: We conduct secondary data analysis of the latest project household immunization survey in 2011 and compare these findings to reports of past surveys in the CGPP program area and at the Uttar Pradesh state level (as measured by children's receipt of DPT vaccinations). This is done to judge if there is any evidence that routine immunization services are being disrupted. We also model characteristics of survey respondents and respondents' exposure to CGPP, communication activities against their children's receipt of key vaccinations in order to identify determinants of routine immunization coverage.Results: Routine immunization coverage has increased between the first survey (2005 for state level estimates, 2008 for the CGPP program) and the latest (2011 for both state level and CGPP areas), as measured by children's receipt of DPT vaccination. This increase occurred concurrent with polio eradication efforts intensive enough to result in interruption of transmission. In addition, a mothers' exposure to specific communication materials, her religion and education were associated with whether or not her children receive one or more doses of DPT.Conclusions: A limitation of the analysis is the absence of a controlled comparison. It is possible routine immunization coverage would have increased even more in the absence of polio eradication efforts. At the same time, however, there is no evidence that routine immunization services were disrupted by polio eradication efforts. Targeted health communications are helpful in improving routine immunization performance. Strategies to address other determinants of routine immunization, such as religion and education, are also needed to maximize coverage.