Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries.

Thursday, 31st of May 2018

BMJ Glob Health. 2018 May 7;3(3):e000466. doi: 10.1136/bmjgh-2017-000466. eCollection 2018.

Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries.

Postolovska I¹ Helleringer S² Kruk ME¹ Verguet S¹.

Author information

1

Department of Global Health and Population Harvard T.H. Chan School of Public Health Boston Massachusetts USA.

2

Department of Population Family and Reproductive Health Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA.

Abstract

BACKGROUND:

Measles supplementary immunisation activities (SIAs) are an integral component of measles elimination in low-income and middle-income countries (LMICs). Despite their success in increasing vaccination coverage there are concerns about their negative consequences on routine services. Few studies have conducted quantitative assessments of SIA impact on utilisation of health services.

METHODS:

We analysed the impact of SIAs on utilisation of selected maternal and child health services using Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 28 LMICs where at least one SIA occurred over 2000-2014. Logistic regressions were conducted to investigate the association between SIAs and utilisation of the following services: facility delivery postnatal care and outpatient sick child care (for fever diarrhoea cough).

RESULTS:

SIAs do not appear to significantly impact utilisation of maternal and child services. We find a reduction in care-seeking for treatment of child cough (OR 0.67; 95% CI 0.48 to 0.95); and a few significant effects at the country level suggesting the need for further investigation of the idiosyncratic effects of SIAs in each country.

CONCLUSION:

The paper contributes to the debate on vertical versus horizontal programmes to ensure universal access to vaccination. Measles SIAs do not seem to affect care-seeking for critical conditions.

KEYWORDS:

child health; health systems; immunisation; measles

PMID: 29755760 PMCID: PMC5942424 DOI: 10.1136/bmjgh-2017-000466