Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016

Li, Anyie J.; Tabu, Collins; Shendale, Stephanie; Sergon, Kibet; Okoth, Peter; Mugoya, Isaac; Machekanyanga, Zorodzai; Onuekwusi, Iheoma; Sanderson, Colin; Ogbuanu, Ikechukwu U.

doi:10.1371/journal.pone.0237913

Cited by 26 publications

(21 citation statements)

References 23 publications

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“…To support this notion, we found a median of 6.6 [5.4 – 9.1] weeks delay in the uptake the BCG vaccine, which could be suggestive of catch-up vaccination campaigns conducted for those who were missed during the global shortage. Additionally, the minimum recommended time of 24 h for the receipt of the birth dose is a contributing factor to timely uptake of vaccines in that caregiver-child pairs visit health care facilities often post-partum and as a result, missed opportunities for birth doses are a rare occurrence [32] , [33] , [34] . In contrast, the low immunisation coverage for the 9- and 18-months vaccines could be a result of caregivers’ inability to adhere to the schedule due to busy work schedules and caregivers’ limited awareness about risk of VPDs at the 9- and 18-months immunisation age timepoints [35] , [36] .…”

Section: Discussionmentioning

confidence: 99%

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

et al. 2022

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Highlights Immunisation coverage has an inverse relationship with age, while delay in vaccine uptake has a direct relationship with age. High vaccine coverage rates do not translate to timely receipt of routine childhood vaccines. Time-at-risk for vaccine preventable diseases is positively associated with increasing immunisation age timepoints. Preschool attendance and having adult caregivers are protective against delaying vaccine uptake. Low and upper-middle socio-economic quartiles are associated with delayed uptake of routine childhood vaccines.

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Section: Discussionmentioning

confidence: 99%

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

et al. 2022

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“…Nonetheless, even without formal statistical tests or high-precision confidence intervals, broad-stroke results based on survey respondents with documented dates may suffice to inspire collaboration to address MOVs. If the MOSV analysis of a coverage survey indicates that MOSVs are prevalent, then a follow-up clinic-based study can be indicated to identify all types of MOVs and determine their reasons [ 64 , 65 , 66 , 67 ]. The choice of health facilities to include in such a study can be informed by stratum-specific results from the household survey (if it is large enough).…”

Section: Discussionmentioning

confidence: 99%

Using Household Surveys to Assess Missed Opportunities for Simultaneous Vaccination: Longitudinal Examples from Colombia and Nigeria

Rhoda¹,

Prier²,

Clary³

et al. 2021

Vaccines

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One important strategy to increase vaccination coverage is to minimize missed opportunities for vaccination. Missed opportunities for simultaneous vaccination (MOSV) occur when a child receives one or more vaccines but not all those for which they are eligible at a given visit. Household surveys that record children’s vaccination dates can be used to quantify occurrence of MOSVs and their impact on achievable vaccination coverage. We recently automated some MOSV analyses in the World Health Organization’s freely available software: Vaccination Coverage Quality Indicators (VCQI) making it straightforward to study MOSVs for any Demographic & Health Survey (DHS), Multi-Indicator Cluster Survey (MICS), or Expanded Programme on Immunization (EPI) survey. This paper uses VCQI to analyze MOSVs for basic vaccine doses among children aged 12–23 months in four rounds of DHS in Colombia (1995, 2000, 2005, and 2010) and five rounds of DHS in Nigeria (1999, 2003, 2008, 2013, and 2018). Outcomes include percent of vaccination visits MOSVs occurred, percent of children who experienced MOSVs, percent of MOSVs that remained uncorrected (that is, the missed vaccine had still not been received at the time of the survey), and the distribution of time-to-correction for children who received the MOSV dose at a later visit.

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“…Missed opportunities for vaccination occur when children have contact with health services either directly, or indirectly through attending with family, but do not receive vaccine doses for which they are eligible [46]. They are attributed in part due to knowledge gaps in the routine immunisation schedule and issues in vaccine supply and vaccine-related equipment such as syringes and vaccination record books [47].…”

Section: Discussionmentioning

confidence: 99%

Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya

Allan

Adetifa

Abbas

2021

Preprint

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Background: Immunisation of children is a highly cost-effective public health intervention and fosters health equity for the overall population. The WHO Immunisation Agenda 2030 highlights coverage and equity as one of the strategic priority goals to reach high equitable immunisation coverage at national levels and in all districts. We analysed full immunisation coverage among children aged 12-23 months in Kenya and estimated the inequities in full immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics using data from the 2014 Kenya Demographic and Health Survey. Methods: We analysed full immunisation coverage (1-dose BCG, 3-dose DTP-HepB-Hib, 3-dose polio, 1-dose measles, and 3-dose pneumococcal vaccines) of 3,943 children aged 12-23 months. We disaggregated mean coverage by socioeconomic (household wealth, religion, ethnicity), geographic (place of residence, province), maternal (maternal age at birth, maternal education, maternal marital status, maternal household head status), child (sex of child, birth order), and place of birth characteristics. We conducted bivariate and multivariate logistic regression to assess associations between full immunisation coverage and socioeconomic, geographic, maternal, child, and place of birth characteristics. Results: Immunisation coverage ranged from 82% [81-84] for the third dose of polio to 97.4% [96.7-98.2] for the first dose of DTP-HepB-Hib, while full immunisation coverage was 68% [66-71] in 2014. After controlling for other background characteristics, children of mothers with primary school education or higher have at least 54% higher odds of being fully immunised compared to children of mothers with no education. Children born in clinical settings have 41% higher odds of being fully immunised compared to children born in home settings. Children in the Coast, Western, Central, and Eastern regions had at least 74% higher odds of being fully immunised compared to children in the North Eastern region, while children in urban areas had 26% lower odds of full immunisation compared to children in rural areas. Children in the middle and richer wealth quintile households were 43-57% more likely to have full immunisation coverage compared to children in the poorest wealth quintile households. Children who were sixth born or higher had 37% lower odds of full immunisation compared to first-born children. Conclusions: The inequities in full immunisation adversely affect children of mothers with no education, born in home settings, in regions with limited health infrastructure, living in poorer households, and of higher birth order. Further, the COVID-19 pandemic has disrupted routine and campaign immunisation services in 2020 and enhances the risk of vaccine-preventable disease outbreaks, but it also presents an opportunity to tackle the identified inequities in vaccine uptake as immunisation services are restored to capacity.

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Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016

Cited by 26 publications

References 23 publications

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

Using Household Surveys to Assess Missed Opportunities for Simultaneous Vaccination: Longitudinal Examples from Colombia and Nigeria

Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya

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