Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of individual and contextual determinants.
Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of individual and contextual determinants.
复制标题
DOI：
10.1186/1471-2334-9-181
复制
发表时间：
2009-11-20
影响因子：
3.7
通讯作者：
Antai D
中科院分区：
文献类型：
--
作者：
Antai D
尼日利亚许多地区的免疫覆盖率远未达到最佳水平，也远未达到公平水平。尼日利亚占非洲麻疹死亡人数的一半，是世界上流行野生脊髓灰质炎病毒最多的国家，该国是世界上疫苗覆盖率低于50%的十个国家之一。因此，侧重于社区一级决定因素的研究具有严重的政策影响，对2003年尼日利亚人口与健康调查中具有全国代表性的15-49岁妇女样本进行了多层次多变量回归分析。对嵌套在母亲（水平2）中的儿童（水平1）进行了多水平回归分析，母亲又嵌套在社区（水平3）中。结果表明，家庭和社区内的全面免疫集群模式以及社会经济特征是解释研究中儿童全面免疫差异的重要因素。在个人层面上，种族、母亲的职业和母亲的家庭财富是与儿童全面免疫有关的母亲的特征。在社区一级，住院分娩的母亲比例是全面免疫状况的决定因素。在控制了儿童和母亲层面的特征之后，社区层面的显著差异仍然存在，这表明需要进一步研究社区层面的因素，从而能够广泛地调整社区层面的干预措施，以改善全面免疫和其他儿童健康结果。
Immunization coverage in many parts of Nigeria is far from optimal, and far from equitable. Nigeria accounts for half of the deaths from Measles in Africa, the highest prevalence of circulating wild poliovirus in the world, and the country is among the ten countries in the world with vaccine coverage below 50 percent. Studies focusing on community-level determinants therefore have serious policy implications Multilevel multivariable regression analysis was used on a nationally-representative sample of women aged 15-49 years from the 2003 Nigeria Demographic and Health Survey. Multilevel regression analysis was performed with children (level 1) nested within mothers (level 2), who were in turn nested within communities (level 3). Results show that the pattern of full immunization clusters within families and communities, and that socio-economic characteristics are important in explaining the differentials in full immunization among the children in the study. At the individual level, ethnicity, mothers' occupation, and mothers' household wealth were characteristics of the mothers associated with full immunization of the children. At the community level, the proportion of mothers that had hospital delivery was a determinant of full immunization status. Significant community-level variation remaining after having controlled for child- and mother-level characteristics is indicative of a need for further research on community-levels factors, which would enable extensive tailoring of community-level interventions aimed at improving full immunization and other child health outcomes.
登录
查看更多内容
影响因子：
168.9
作者：
Black, RE;Morris, SS;Bryce, J
通讯作者：
Bryce, J
DOI：
10.1111/j.1467-8268.2009.00204.x
发表时间：
2009-04-01
影响因子：
2.9
作者：
Alaba, Olufunke A.;Alaba, Olumuyiwa B.
通讯作者：
Alaba, Olumuyiwa B.
影响因子：
158.5
作者：
Omer, Saad B.;Salmon, Daniel A.;Halsey, Neal
通讯作者：
Halsey, Neal
影响因子：
10.7
作者：
Currie, J;Stabile, M
通讯作者：
Stabile, M
影响因子：
1.5
作者：
Antai, Diddy
通讯作者：
Antai, Diddy