Ethnicity and Delay in Measles Vaccination in a Nairobi Slum

Tuesday, 26th of November 2013

[source]Tropical Medicine and Health[|source]

The vaccination coverage of measles in urban poor is low and continues to be a major public health concern in many countries. To solve this problem therefore requires a better understanding of the determinants of vaccination uptake in slums and other informal settlements where the urban poor reside.  Unfortunately, studies on the timeliness of vaccinations among urban poor are scarce, and the complexity of these informal settlements heightens the challenge of addressing missed or late vaccinations.

In this study, the authors examined the relationship between ethnicity and the timeliness of measles vaccination uptake in a Nairobi slum. The authors document that a) measles vaccine coverage was about 40% in the slum, b) more than 20% of children receive delayed measles vaccinations, c) delayed vaccinations varied with ethnic groupings in the slums and d) delays in receipt of vaccinations were sadly associated with service-related factors such as health worker perceptions and attitudes, vaccine stock-outs and policies regarding opened multi-dose vials. More details are available at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475315/

Abstract

The influence of ethnicity on vaccination uptake in urban slums in Kenya is largely unknown. We examined the disparities in timeliness and coverage of measles vaccination associated with ethnicity in the Korogocho slum of Nairobi. The study used data from the Maternal and Child Health component of the Urbanization, Poverty and Health Dynamics Research Programme undertaken in the Korogocho and Viwandani slums by the African Population and Health Research Center from 2006 to 2010. Vaccination information was collected from children recruited into the study during the first year after birth, and a sub-sample of 2,317 who had been followed throughout the period and had the required information on measles vaccination was included in the analysis. Cox regression analysis was used to determine the association of ethnicity with delayed measles in the slum. We found significant disparities in the coverage and timeliness of measles vaccination between the ethnic groups in Korogocho. The Luhya and minor ethnic groups in the slum were more likely than the Kikuyu to have delayed measles vaccination. Ethnic groups with a high proportion of children with delayed measles vaccination need to be targeted to address cultural barriers to vaccination as part of efforts to improve coverage in urban slums.