ACHIEVING COMPREHENSIVE CHILDHOOD IMMUNIZATION: AN ANALYSIS OF OBSTACLES AND OPPORTUNITIES IN THE GAMBIA

Monday, 28th of April 2014

[source]Health Policy and Planning[|source]

Immunization coverage, particularly in the developing world, has been shown to be associated with several socio-economic and demographic factors, such as parental education, economic status, region of residence, age of the mother, ethnicity and gender of the child. And these disparities are not necessarily remedied by increasing the overall percentage of immunization coverage.

 In this report, the authors use Demographic Surveillance data to assess the immunization coverage, in particular full immunization and to determine if variation exists in immunization coverage. The report highlights that, despite high levels of coverage of many individual vaccines, full immunization remains a challenge, even in a country with a committed childhood immunization programme. The study identified groups of the population who are potentially more at risk of defaulting on immunizations befor recommending targeted campaigns for these groups. More details are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944881/#!po=3.84615

 

 ABSTRACT

INTRODUCTION: Immunization is a vital component in the drive to decrease global childhood mortality, yet challenges remain in ensuring wide coverage of immunization and full immunization, particularly in low- and middle-income countries. This study assessed immunization coverage and the determinants of immunization in a semi-rural area in The Gambia.

METHODS: Data were drawn from the Farafenni Health and Demographic Surveillance System. Children born within the surveillance area between January 2000 and December 2010 were included. Main outcomes assessed included measles, BCG and DTP vaccination status and full immunization by 12 months of age as reported on child healthcards. Predictor variables were evaluated based on a literature review and included gender, ethnicity, area of residence, household wealth and mother’s age.

RESULTS: Of the 7363 children included in the study, immunization coverage was 73% (CI 72–74) for measles, 86% (CI 86–87) for BCG, 79% (CI 78–80) for three doses of DTP and 52% (CI 51–53) for full immunization. Coverage was significantly associated with area of residence and ethnicity, with children in urban areas and of Mandinka ethnicity being least likely to be fully immunized.

CONCLUSIONS: Despite high levels of coverage of many individual vaccines, delivery of vaccinations later in the schedule and achieving high coverage of full immunization remain challenges, even in a country with a committed childhood immunization programme, such as The Gambia. Our data indicate areas for targeted interventions by the national Expanded Programme of Immunization.