Migration and child immunization in Nigeria: individual- and community-level contexts.
Migration and child immunization in Nigeria: individual- and community-level contexts.
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DOI：
10.1186/1471-2458-10-116
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发表时间：
2010-03-09
影响因子：
4.5
通讯作者：
Antai D
中科院分区：
文献类型：
--
作者：
Antai D
疫苗可预防的疾病是造成非洲严重发病率和死亡率的原因。尽管有适当的疫苗可供婴儿常规使用，但疫苗可预防的疾病在整个撒哈拉以南非洲高度流行。在尼日利亚的农村和城市地区、区域和社区之间和内部，免疫规划的覆盖面仍然存在着广泛的差距。这项研究评估了移民和非移民群体之间与儿童免疫接种差异相关的个人和社区层面的解释因素。估计了尼日利亚常规免疫计划中的八种疫苗中每种疫苗的儿童比例。多水平多变量回归分析使用了具有全国代表性的6029名儿童样本，这些儿童来自2735名15-49岁的母亲，嵌套在365个社区中。用95%可信区间的优势比来表示特征之间的关联度。方差分配系数和Wald统计量，即估计值与其标准误差的比率被用来表示变异度量。个人和社区背景与移徙群体获得全面免疫的可能性密切相关。与农村-城市移徙母亲的子女相比，农村非移徙母亲的子女获得全面免疫的可能性更高。调查结果支持了传统的移徙观点，并表明，个人一级的特征，如移徙干扰(移徙本身)、选择性(人口和社会经济特征)和适应(卫生保健利用)，以及社区一级的特征(居住地和住院分娩的母亲比例)，对于解释儿童在充分接种疫苗方面的差异很重要。移徙是儿童免疫接种的一个重要决定因素。这项研究强调，需要在社区一级努力增加女性教育，采取措施减轻城市和偏远农村地区居民的贫困，改善妇幼保健服务的公平分配。
Vaccine-preventable diseases are responsible for severe rates of morbidity and mortality in Africa. Despite the availability of appropriate vaccines for routine use on infants, vaccine-preventable diseases are highly endemic throughout sub-Saharan Africa. Widespread disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria. This study assessed the individual- and community-level explanatory factors associated with child immunization differentials between migrant and non-migrant groups. The proportion of children that received each of the eight vaccines in the routine immunization schedule in Nigeria was estimated. Multilevel multivariable regression analysis was performed using a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities. Odds ratios with 95% confidence intervals were used to express measures of association between the characteristics. Variance partition coefficients and Wald statistic i.e. the ratio of the estimate to its standard error were used to express measures of variation. Individual- and community contexts are strongly associated with the likelihood of receiving full immunization among migrant groups. The likelihood of full immunization was higher for children of rural non-migrant mothers compared to children of rural-urban migrant mothers. Findings provide support for the traditional migration perspectives, and show that individual-level characteristics, such as, migrant disruption (migration itself), selectivity (demographic and socio-economic characteristics), and adaptation (health care utilization), as well as community-level characteristics (region of residence, and proportion of mothers who had hospital delivery) are important in explaining the differentials in full immunization among the children. Migration is an important determinant of child immunization uptake. This study stresses the need for community-level efforts at increasing female education, measures aimed at alleviating poverty for residents in urban and remote rural areas, and improving the equitable distribution of maternal and child health services.
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影响因子：
4.8
作者：
Fotso, Jean-Christophe
通讯作者：
Fotso, Jean-Christophe
影响因子：
5.4
作者：
Ngowu, Rufus;Larson, James S.;Kim, Min Su
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Kim, Min Su
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168.9
作者：
Black, RE;Morris, SS;Bryce, J
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Pritchett, LH
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作者：
Fein, SB;Roe, B
通讯作者：
Roe, B