Abstract
BackgroundImmunization is one of the most cost-effective public health interventions to prevent children from contracting vaccine-preventable diseases. Indonesia launched the Expanded Program for Immunization (EPI) in 1977. However, immunization coverage remains far below the United Nations International Children’s Emergency Fund (UNICEF) and World Health Organization (WHO) target of 80%. This study aims to investigate the determinants of complete immunization status among children aged 12–23 months in Indonesia.MethodsWe used three waves of the Indonesian National Socioeconomic Survey (2008, 2011, and 2013) and national village censuses from the same years. Multilevel logistic regression was used to conduct the analysis.ResultsThe number of immunized children increased from 47.48% in 2008 to 61.83% in 2013. The presence of health professionals, having an older mother, and having more educated mothers were associated with a higher probability of a child’s receiving full immunization. Increasing the numbers of hospitals, village health posts, and health workers was positively associated with children receiving full immunization. The MOR (median odds ratio) showed that children’s likelihood of receiving complete immunization varied significantly among districts.ConclusionsBoth household- and district-level determinants were found to be associated with childhood immunization status. Policy makers may take these determinants into account to increase immunization coverage in Indonesia.
Highlights
Immunization is one of the most cost-effective public health interventions to prevent children from contracting vaccine-preventable diseases
Both household- and district-level determinants were found to be associated with childhood immunization status
Policy makers may take these determinants into account to increase immunization coverage in Indonesia
Summary
Immunization is one of the most cost-effective public health interventions to prevent children from contracting vaccine-preventable diseases. Indonesia launched the Expanded Program for Immunization (EPI) in 1977. Immunization and vaccination have been recognized as preventive strategies for vaccinepreventable diseases [1]. Data from World Health Organization (WHO) showed that immunization prevents 2,5 million deaths every year in the world [2]. WHO initiated the Expanded Program for Immunization (EPI) in 1974 to protect the population from six diseases: tuberculosis, diphtheria, tetanus, pertussis, measles, and poliomyelitis. This goal was considered an essential element of the WHO strategy to achieve health for all by 2000 [3].
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