Abstract
Objectives: Child mortality is still high in developing countries due to low vaccination coverage and outbreaks of vaccine-preventable diseases. Therefore, this study is conducted to determine the status of vaccination coverage and associated factors among children aged 12-23 months in urban and rural parts of Sindh, Pakistan. Methods: A cross-sectional study was conducted in the rural and urban settings of Sindh, Pakistan. Following the WHO guidelines, a 30 cluster household survey was conducted and 300 children were recruited for each study setting from Lyari, Karachi and Umerkot areas of Sindh province from Feb – Mar 2017. Information was obtained from consenting parents by trained interviewers through a pre-tested questionnaire. Multivariable logistic regression model was used to identify the factors associated with the vaccination. Findings: Overall 600 children from both settings were included in the analysis. A total of 62.8% children were vaccinated. About 80.3% children were fully vaccinated in Lyari in comparison to 45.3% in Umerkot. The logistic regression analysis factors associated with vaccination were: parent`s awareness of vaccination (AOR: 9.77; 95%CI: 1.76 – 54.28), knowledge about vaccination place (AOR: 2.51; 95% CI: 1.19 – 5.26) and mother\'s tetanus vaccination status (one dose AOR: 4.27; 95% CI: 1.84 – 9.93 and two doses AOR: 12.43; 95% CI: 7.71 –20.04). Conclusion: In the urban setting, vaccination coverage was better than compared to rural settings. Parent\'s knowledge about vaccination and vaccination centers were identified as the statistically significant determinants of vaccination among children aged 12-23 months. Keywords: Children; Vaccination Coverage; Urban; Rural; Pakistan
Highlights
Pakistan is among 10 countries in the world which shares the burden of 60% of 2.3 millions of unvaccinated children, every year [1]
Our study revealed that overall 377 (62.8%) children received full course of routine immunization (RI), 174 (29%) children were found partially vaccinated and 49(8.2%) children did not get any dose of RI
It was observed that there was better vaccination coverage in urban area as compared to rural area but still very low according to WHO standards
Summary
Pakistan is among 10 countries in the world which shares the burden of 60% of 2.3 millions of unvaccinated children, every year [1]. In [3,4] Pakistan, expanded program on immunization (EPI) was launched in 1976 on a pilot scale and was further expanded nationwide by 1978, aiming to reduce the morbidity and mortality associated with vaccine preventable diseases (VPDs) in children like childhood tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus and measles, and pregnant women and their newborns from tetanus. In Pakistan, around four out of ten children do not get full course of vaccination by their first year of life[5,6,7] This is one of the main reasons that Pakistan is still lagging behind in the eradication of polio and is one of the three endemic countries in the world, one of the sixth leading countries with the burden of tuberculosis, and having on and off outbreaks of measles and diphtheria [6,7]. To avoid outbreaks from vaccine preventable diseases; a high-level coverage estimated at 95% is essential [1]
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