Measles Immunization Coverage Research Articles

A Behavioural-Theory-Based Qualitative Study of the Beliefs and Perceptions of Marginalised Populations towards Community Volunteering to Increase Measles Immunisation Coverage in Sabah, Malaysia.

The development of the measles-containing vaccine (MCV) has rendered measles a largely preventable disease. In the state of Sabah in Malaysia, a complete course of measles immunisation for infants involves vaccinations at the ages of six, nine, and twelve months. However, it is difficult for marginalised populations to receive a complete course of measles immunisation. This present study used behavioural theory (BT) to examine the beliefs and perceptions of a marginalised population towards community volunteering as a method of increasing the immunisation coverage of measles. Marginalised populations living in Kota Kinabalu, Sabah, more specifically, Malaysian citizens living in urban slums and squatter areas, as well as legal and illegal migrants, were extensively interviewed in person for this qualitative study. The 40 respondents were either the parents or primary caregivers of at least one child under the age of five. The components of the Health Belief Model were then used to examine the collected data. The respondents had poor awareness of the measles disease and perceived the disease as not severe, with some even refusing immunisation. The perceived barriers to receiving vaccinations included a nomadic lifestyle; issues with finances, citizenship status, language, and weather; failing to remember immunisation schedules; a fear of health care personnel; having too many children; and a lack of female autonomy in vaccine decision-making. However, the respondents were receptive towards community-based programmes and many welcomed a recall or reminder system, especially when the volunteers were family members or neighbours who spoke the same language and knew their village well. A few, however, found it awkward to have volunteers assisting them. Evidence-based decision making may increase measles immunisation coverage in marginalised populations. The components of the Health Belief Model validated that the respondents lacked awareness of the measles disease and viewed it and its effects as not severe. Therefore, future volunteer programmes should prioritise increasing the receptivity and self-control of marginalised populations to overcome barriers that hinder community involvement. A community-based volunteer programme is highly recommended to increase measles immunisation coverage.

Gaps in measles immunisation coverage for pre-school children in Aotearoa New Zealand: a cross-sectional study

Gaps in measles immunisation coverage for pre-school children in Aotearoa New Zealand: a cross-sectional study

Exploring data trends and providers' insights on measles immunization uptake in south-west Nigeria.

measles outbreak remains a recurring episode and continues to be responsible for millions of deaths globally every year. This study examines measles immunization coverage and uncovers barriers and enablers to effective provision and uptake of measles immunization services from the supply end and provider´s perspective in a developing nation´s context. the study employed a mixed-method approach to explore trends and patterns of measles immunization uptake in Ekiti State-a state in the southwestern region of Nigeria-utilizing DHIS 2014 - 2019 data of 789,518 under 1-year children and complemented the quantitative study with key informant interviews from appointed Immunization Officers in the state. Using deductive methods, we thematically analyzed the interview data using NVivo version 12 while STATA 16 was used to analyze the quantitative data. the annualized measles immunization coverage ranged between 49% and 86% from 2014 to 2019, which is below the WHO set threshold for measles infection prevention. Caregiver, geographical, human, and infrastructural factors were elicited as barriers, while potential enablers include increased public engagement and enhanced media involvement. while programmatic efforts are being improved nationally to drive up the uptake, this study provides baseline information for benchmarking the subsequent level of efforts and recommends improved collaboration across contextually similar states to promote program efficiency. The results can inform policy and program development, execution and direct future research on measles immunization to address uptake challenges at both local and central administration levels, especially in the aspect of surveillance and monitoring.

Trends, barriers and enablers to measles immunisation coverage in Saskatchewan, Canada: A mixed methods study.

Many social, cultural, and systemic challenges affect the uptake of measles immunisation services. Prior studies have looked at the caregivers' perspectives, but little is known about the perspectives of the health care providers on the barriers of measles immunisation services in Canada. This study examined measles immunisation coverage trends across the regional health authorities in Saskatchewan and explored the barriers and enablers to measles immunisation coverage from providers' perspectives. The study adopted an explanatory sequential mixed method. We utilized the entire population of 16,582 children under two years of age available in the Saskatchewan Immunisation Management System (SIMS) registry for 2002 and 2013 in aggregate format and interviewed 18 key informants in pre-determined two-stages in 2016 and 2017. The quantitative analysis was done with Joinpoint regression modelling, while the qualitative interview data was analyzed using hybrid inductive and deductive thematic approaches. There was a 16.89%-point increase in measles immunisation coverage in the province from 56.32% to 73.21% between 2002 and 2013. There was also a persistently higher coverage among the affluent (66.95% - 82.37%) than the most deprived individuals (45.79% - 62.60%) in the study period. The annual rate of coverage change was marginally higher among the most deprived (16.81%; and average annual percentage change (AAPC) 2.0, 95% CI 1.7-2.2) than among the affluent group (15.42% and AAPC 3.0; 95% CI 2.0-4.0). While access-related issues, caregivers' fears, hesitancy, anti-vaccination challenges, and resource limitations were barriers to immunisation, improving community engagement, service delivery flexibility, targeted social responses and increasing media role were found useful to address the uptake of measles and other vaccine-preventable diseases immunisation. There is low coverage and inequity in measles immunisation uptake in Saskatchewan from social and institutional barriers. Even though there is evidence of disparity reduction among the different groups, the barriers to increasing measles immunisation coverage have implications for the health of the socio-economically deprived groups, the healthcare system and other vaccination programs. There is a need to improve policy framework for community engagement, targeted programs, and public health discourse.

Hubungan Usia, Pengetahuan Ibu dan Dukungan Suami dengan Pemberian Imunisasi Campak Pada Bayi Usia 9 Bulan di Wilayah Kerja Puskesmas 23 Ilir Palembang Tahun 2021

Measles immunization is an immunization given to generate active immunity against measles. (Maryunani, 2010). Immunization is a health effort that has been proven to be the most effective. When immunization coverage reaches 90%, it can contribute to reducing morbidity and mortality by 80% - 90%. Although measles immunization coverage has been high (90%) but there are still children affected by measles. Because the remaining 10 percent of children who have not received immunizations plus 10 percent of children who are immunized but are not immune cause people's immunity to only reach 81%. (Center for public communication of the Indonesian Ministry of Health, 2015). The purpose of this study was to determine the relationship between age, mother's knowledge and husband's support simultaneously with the provision of Measles Immunization to infants aged 6-9 months in the Work Area of 23 Ilir Palembang Health Center in 2021. This design is quantitative in nature using an analytical survey method where the research This study uses a cross sectional approach. This research was conducted in the working area of 23 Ilir Health Center, Palembang with 83 respondents. And the results of the Chi-Square test on the knowledge variable obtained a p value of 0.038, age variable p.value 0.003 and variable p.value 0.001 < = 0.05 there is a relationship between the variables of knowledge, age and husband's support with measles immunization. statistically. Suggestions for health workers Conduct socialization to the community to take advantage of government programs by giving their children measles immunization according to the specified schedule, and if they know their child has measles, it is necessary to isolate the case to prevent transmission of measles.

Vaccination, life expectancy, and trust: patterns of COVID-19 and measles vaccination rates around the world

ObjectivesWe estimate patterns of covariation between COVID-19 and measles vaccination rates and a set of widely used indicators of human, social, and economic capital across 146 countries. Study designWe conduct exploratory analyses of social patterns that uphold vaccination success for COVID-19 and measles. MethodsWe use publicly available data on COVID vaccination rates and other country-level indicators from Our World in Data, Human Development Report, Corruption Perception Index, and the World Bank to devise bivariate correlations and multiple regression models. ResultsAbout 70% of the variability in COVID-19 vaccination rates in February 2022 can be explained by differences in the Human Development Index (HDI) and, specifically, in life expectancy at birth. Trust in doctors and nurses adds predictive value beyond HDI, clarifying controversial discrepancies between vaccination rates in countries with similar levels of HDI and vaccine availability. Cardiovascular disease deaths, an indicator of general health system effectiveness, and infant measles immunization coverage, an indicator of country-level immunization effectiveness, are also significant, though weaker, predictors of COVID-19 vaccination success. Measles vaccination in 2019 is similarly predicted by HDI and trust in doctors and nurses. ConclusionsThe remaining variability in COVID-19 vaccination success that cannot be pinned down through these sets of metrics points to a considerable scope for collective and individual agency in a time of crisis. The mobilization and coordination in the vaccination campaigns of citizens, medical professionals, scientists, journalists, and politicians, among others, account for at least some of this variability in overcoming vaccine hesitancy and inequity.

Sustainable Development Goals and childhood measles vaccination in Ekiti State, Nigeria: Results from spatial and interrupted time series analyses

Measles remains an important cause of childhood mortality in many resource-limited countries. With Sustainable Development Goals (SDG), there has been increasing emphasis on measles vaccination as a key strategy to remarkably improve child survival. While progress has been made towards measles vaccination coverage due to SDG in some settings, there has been no prior study evaluating its impact in Nigeria. To assess the effectiveness of SDG policy implementation on measles vaccination coverage, we examined the changes in first dose of measles vaccination coverage rates among children aged 9–15 months following the implementation of SDG, and changes in spatial patterns of measles vaccination from 2014 to 2019 in Ekiti State, Southwest Nigeria. Using state and local government area-level District Health Information data from January 2014 to December 2019, we conducted interrupted time series (ITS) and spatiotemporal analyses. The ITS evaluated the immediate and continuous effects of SDG policy implementation on the monthly childhood measles vaccination coverage by comparing longitudinal changes in rates between pre-intervention period (January 2014-December 2015) and during-intervention period (January 2016-December 2019). The low and high coverage clusters across the years were detected with spatial cluster analysis. The average state-level measles vaccination coverage rates from 2014 to 2019 was 70.67%. In 2019, coverage rate was 49%—a 35.53% decline from 76% in 2014 and a state-level gap of 46%. The geographical distribution of measles vaccination varied considerably across the local government areas from 2014 to 2019. There was an initial acceleration of vaccination rates (β^ = 24.07, p-value = 0.012), but a significant decrease in coverage rates after implementation of SDG policy in Ekiti State (β^ = −1.08, p-value < 0.001). No local government area had accelerated monthly coverage rates following SDG-implementation. Evidence suggests immediate acceleration in coverage rates which could not be sustained during SDG-era and calls for a rethink measles immunization coverage strategy in the state and other resource-limited jurisdictions to ensure vaccination scale-up.

Measles susceptibility in maternal-infant dyads—Bamako, Mali

Measles is endemic in Africa; measles mortality is highest among infants. Infant measles antibody titer at birth is related to maternal immune status. Older mothers are likelier to have had measles infection, which provides higher antibody titers than vaccine-induced immunity. We investigated the relationship between maternal age and measles susceptibility in mother-infant pairs in Mali through six months of infancy.We measured serum measles antibodies in 340 mother-infant pairs by plaque reduction neutralization test (PRNT) and calculated the proportion of mothers with protective titers (>120 mIU/mL) at delivery and the proportion of infants with protective titers at birth, and at three and six months of age. We explored associations between maternal age and measles antibodies in mothers and infants at the timepoints noted.Ten percent of Malian newborns were susceptible to measles; by six months nearly all were. Maternal and infant antibody titers were highly correlated. At delivery, 11% of mothers and 10% of newborns were susceptible to measles. By three and six months, infant susceptibility increased to 72% and 98%, respectively. Infants born to younger mothers were most susceptible at birth and three months. Time to susceptibility was 6.6 weeks in infants born to mothers with measles titer >120–<430 mIU/mL versus 15.4 weeks when mothers had titers ≥430 mIU/mL.Maternal and newborn seroprotective status were positively correlated. Improved strategies are needed to protect susceptible infants from measles infection and death. Increasing measles immunization coverage in vaccine eligible populations, including nonimmune reproductive-aged women and older children should be considered.

Data Exploration of Social Determinants of Health, Health Access and Quality in a Global Health Setting.

Diseases have no borders, and global health operates from both within and beyond. Global health informatics can adopt an assets-oriented approach to mitigate concerns by maximizing global health data, principles, and resources combined with geographic information systems' use case mapping. This exploratory study utilizes an assets-oriented approach to analyze four global social determinants of health indicators, including Skilled Birth Attendance, Measles Immunization Coverage, Education (Female), and the Healthcare Access and Quality Index in relation to countries' income and geographical region. Data were extracted and analyzed from two publicly available datasets. Positive trends and variations were detected among all variables aggregated by countries' income category and geographical region. These findings pinpoint potential health assets that the discipline of nursing can leverage to build healthier global health communities.

Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels.

SummaryBackgroundTo assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 2000−2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators.MethodsWe used national population-based datasets of 44,624 households in Vietnam from 2000 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Using the relative index, slope index, and concentration index of inequality, we examined the patterns and trends in RMNCH coverage inequality.FindingsWe projected that 9 out of 17 health service indicators (53%) would likely achieve the 2030 targets at the national level, including at least one and four ANC visits, BCG immunization, access to improved water and adequate sanitation, institutional delivery, skilled birth attendance, care-seeking for pneumonia, and ARI treatment. We observed very low coverages and zero chance of achieving the 2030 targets at national and sub-national levels in early initiation and exclusive breastfeeding, family planning needs satisfied, and oral rehydration therapy. The most deprived households living in rural areas and the Northwest, Northeast, North Central, Central Highlands, and Mekong River Delta regions would not reach the 80% immunization coverage of DPT3, Polio3, Measles and full immunization. We found socioeconomic, regional, and urban-rural inequalities in all RMNCH indicators in 2014 and no change in inequalities over 15 years in the lowest-coverage indicators.InterpretationVietnam has made substantial progress toward UHC. By improving the government's health system reform efforts, re-allocating resources focusing on people in the most impoverished rural regions, and restructuring and enhancing current health programs, Vietnam can achieve the UHC targets and other health-related SDGs.FundingThe authors did not receive any funds for conducting this study.

Multi-level determinants of failure to receive timely and complete measles vaccinations in Southwest China: a mixed methods study

BackgroundMeasles outbreaks re-emerged in 2013–2014 in Guangxi Zhuang Autonomous Region of China, where measles immunisation coverage is high. The discrepancy between the vaccination coverage and outbreaks indicates that timeliness is crucial, yet there is limited knowledge on the health system barriers to timely vaccination. Using integrated evidence at the household, village clinic, and township hospital levels, this study aimed to identify the determinants of failure in receiving timely measles vaccinations among children in rural Guangxi.MethodsA multi-stage stratified cluster sampling survey with a nested qualitative study was conducted among children aged 18–54 months in Longan, Zhaoping, Wuxuan, and Longlin counties of Guangxi from June to August 2015. The status of timely vaccinations for the first dose of measles-containing vaccine (MCV1) and the second dose of measles-containing vaccine (MCV2) was verified via vaccination certificates. Data on household-level factors were collected using structured questionnaires, whereas data on village and township-level factors were obtained through in-depth interviews and focus group discussions. Determinants of untimely measles vaccinations were identified using multilevel logistic regression models.ResultsA total of 1216 target children at the household level, 120 villages, and 20 township hospitals were sampled. Children were more likely to have untimely vaccination when their primary guardian had poor vaccination knowledge [MCV1, odds ratio (OR) = 1.72; MCV2, OR = 1.51], had weak confidence in vaccines (MCV1, OR = 1.28–4.58; MCV2, OR = 1.42–3.12), had few practices towards vaccination (MCV1, OR = 12.5; MCV2, OR = 3.70), or had low satisfaction with vaccination service (MCV1, OR = 2.04; MCV2, OR = 2.08). This trend was also observed in children whose village doctor was not involved in routine vaccination service (MCV1, OR = 1.85; MCV2, OR = 2.11) or whose township hospital did not provide vaccination notices (MCV1, OR = 1.64; MCV2, OR = 2.05), vaccination appointment services (MCV1, OR = 2.96; MCV2, OR = 2.74), sufficient and uniformly distributed sessions for routine vaccination (MCV1, OR = 1.28; MCV2, OR = 1.17; MCV1, OR = 2.08), or vaccination service on local market days (MCV1, OR = 2.48).ConclusionsGuardians with poor knowledge, weak beliefs, and little practice towards vaccination; non-involvement of village doctors in routine vaccinations; and inconvenient vaccination services in township hospitals may affect timely measles vaccinations among children in rural China.Graphical abstract

Correlation between measles immunization coverage and overall morbidity and mortality for COVID-19: an epidemiological study.

We conducted the current analysis to determine the potential role of measles vaccination in the context of the spread of COVID-19. Data were extracted from the World Health Organization’s (WHO) Global Health Observatory data repository about the measles immunization coverage estimates and correlated to overall morbidity and mortality for COVID-19 among different countries. Data were statistically analyzed to calculate the Spearman rank correlation coefficient (rho). There was a significant positive correlation between the vaccine coverage (%) and new cases per one million populations (rho = 0.24; p-value = 0.025); however, this correlation was absent in deaths per one million populations (rho = 0.17; p-value = 0.124). On further analysis of the effect of first reported year of vaccination policy, there was no significant correlation with both of total cases per one million populations (rho = 0.11; p-value = 0.327) and deaths per one million populations (rho = −0.02; p-value = 0.829). Claims regarding the possible protective effect of measles vaccination seem to be doubtful.

Measles outbreak in Western Uganda: a case-control study

BackgroundMeasles outbreaks are prevalent throughout sub-Saharan Africa despite the preventive measures like vaccination that target under five-year-old children and health systems strengthening efforts like prioritizing the supply chain for supplies. Measles immunization coverage for Kasese district and Bugoye HC III in 2018 was 72 and 69%, respectively. This coverage has been very low and always marked red in the Red categorization (below the national target/poor performing) on the national league table indicators. The aim of this study was to assess the scope of the 2018–2019 measles outbreak and the associated risk factors among children aged 0–60 months in Bugoye sub-county, Kasese district, western Uganda.MethodsWe conducted a retrospective unmatched case-control study among children aged 0–60 months with measles (cases) who had either a clinical presentation or a laboratory confirmation (IgM positivity) presenting at Bugoye Health Centre III (BHC) or in the surrounding communities between December 2018 and October 2019.. Caregivers of the controls (whose children did not have measles) were selected at the time of data collection in July 2020. A modified CDC case investigation form was used in data collection. Quantitative data was collected and analyzed using Microsoft excel and STATA version 13. The children’s immunization cards and health registers at BHC were reviewed to ascertain the immunization status of the children before the outbreak.ResultsAn extended measles outbreak occurred in Bugoye, Uganda occured between December 2018 and October 2019. All 34 facility-based measles cases were documented to have had maculopapular rash, conjunctivitis, and cough. Also, the majority had fever (97%), coryza (94.1%), lymphadenopathy (76.5%), arthralgias (73.5%) and Koplik Spots (91.2%) as documented in the clinical registers. Similar symptoms were reported among 36 community-based cases. Getting infected even after immunized, low measles vaccination coverage were identified as the principal risk factors for this outbreak.ConclusionMeasles is still a significant problem. This study showed that this outbreak was associated with under-vaccination. Implementing a second routine dose of measles-rubella vaccine would not only increase the number of children with at least one dose but also boost the immunity of those who had the first dose.

Trends in measles incidence and measles vaccination coverage in Nigeria, 2008–2018

IntroductionAll WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on improving vaccination coverage with the first routine dose of (monovalent) measles (MCV1) at 9 months, providing measles vaccine through supplemental immunization activities (children 9–59 months), and intensified measles case-based surveillance system. MethodsWe reviewed measles immunization coverage from population-based surveys conducted in 2010, 2013 and 2017–18. Additionally, we analyzed measles case-based surveillance reports from 2008–2018 to determine annual, regional and age-specific incidence rates. FindingsSurvey results indicated low MCV1 coverage (54.0% in 2018); with lower coverage in the North (mean 45.5%). Of the 153,097 confirmed cases reported over the studied period, 85.5% (130,871) were from the North. Moreover, 70.8% (108,310) of the confirmed cases were unvaccinated. Annual measles incidence varied from a high of 320.39 per 1,000,000 population in 2013 to a low of 9.80 per 1,000,000 in 2009. The incidence rate is higher among the 9–11 months (524.0 per million) and 12–59 months (376.0 per million). Between 2008 and 2018, the incidence rate had showed geographical variation, with higher incidence in the North (70.6 per million) compare to the South (17.8 per million). ConclusionThe aim of this study was to provide a descriptive analysis of measles vaccine coverage and incidence in Nigeria from 2008 to 2018 to assess country progress towards measles elimination. Although the total numbers of confirmed measles cases had decreased over the time period, measles routine coverage remains sub-optimal, and the incidence rates are critically high. The high burden of measles in the North highlight the need for region-specific interventions. The measles program relies heavily on polio resources. As the polio program winds down, strong commitments will be required to achieve elimination goals.

Correlation between Measles Immunization Coverage and Overall Morbidity and Mortality for COVID-19: An Epidemiological Study

Aim: We conducted the current analysis to determine the potential role of measles vaccination in the context of the spread of COVID-19.Methods: Data were extracted from the world health organization’s (WHO) Global Health Observatory data repository about the measles immunization coverage estimates and correlated to overall morbidity and mortality for COVID-19 among different countries. Data were statistically analyzed to calculate the Spearman rank correlation coefficient (rho).Result: There was no significant correlation between the measles vaccine coverage (%) and both of new cases per one million populations (rho= 0.21; p-value= 0.052) and deaths per one million populations (rho= 0.21; p-valueConclusion: Claims regarding the possible protective effect of measles vaccination seem to be doubtful.

PEMODELAN CAKUPAN IMUNISASI CAMPAK PADA ANAK USIA 12-59 BULAN DI PROVINSI ACEH TAHUN 2017

Campak merupakan penyakit yang mudah menular dan dapat menyebabkan komplikasi serius. Penyakit ini dapat dicegah secara efektif dengan imunisasi campak. Namun, hingga saat ini, Indonesia masih belum mencapai target 95% cakupan imunisasi campak secara nasional dan merata di seluruh wilayah. Provinsi dengan cakupan imunisasi campak terendah di Indonesia pada tahun 2017 adalah Provinsi Aceh dengan angka 70,8% untuk dosis pertama dan 20,4% untuk dosis kedua. Ini berarti masih banyak individu yang tidak memiliki kekebalan terhadap campak yang berpotensi menyebabkan penyebaran wabah di masa depan. Maka dari itu, penelitian ini bertujuan untuk mengidentifikasi variabel-variabel yang memengaruhi cakupan imunisasi campak pada anak usia 12-59 bulan di Provinsi Aceh. Analisis dilakukan dengan regresi logistik biner dua level. Hasil analisis menunjukkan cakupan imunisasi campak pada anak usia 12-59 bulan di Provinsi Aceh hanya sebesar 63,4%. Cakupan imunisasi campak pada anak usia 12-59 bulan dipengaruhi oleh status bekerja ibu, jaminan kesehatan (BPJS Kesehatan), kartu imunisasi, kepadatan penduduk tinggi dan tenaga kesehatan per 1000 penduduk. Dari hasil penelitian ini, pemerintah dapat meningkatkan cakupan imunisasi campak di Provinsi Aceh dengan melakukan sosialisasi di tingkat desa (gampong) serta peningkatan kuantitas dan kualitas fasilitas dan tenaga kesehatan, terutama di daerah dengan kepadatan penduduk tinggi.

Measles Distribution Map By Measles Immunization In Banyuwangi 2014 – 2016 Using Health Mapper Application

Measles disease is one of the infectious diseases caused by the Paramyxovirus Virus. Indonesia is one of the countries that has the largest number of measles cases in the world according to WHO (World Health Organization). Banyuwangi Regency is already able to give measles immunization more than 95% in accordance with the standards stipulated by the Ministry of Health of the Republic of Indonesia. However, the occurrence of measles cases is also still not reduced annually. This scientific article can help to see the tendency of measles occurrences seen from the scope of Immunisation in the local area. This type of research is a study by using secondary data health Profiles Banyuwangi District Health Office in 2014.205, and 2016. With the kind of observational research and design construct the research used is cross sectional. Descriptive data analysis using the Health Mapper version 4.3.0.0 with version 4.03. Results of the analysis obtained that the coverage of measles immunization in Banyuwangi district fluctuated in the year 2014 there is a coverage of the Banyuwangi Regency immunization of 102.4% d, in 2015 as much as 101.8% and in the year 2016 IE as much as 106.3. This is inversely proportional to the incidence of measles in Banyuwangi regency which increased in 2015 as many as 2 cases in the year 2014 the number of cases is still 0 and has a fixed value in the year 2016 IE as many as 2 cases are still the same as the year 2015.

Inequalities in measles immunization coverage in Ethiopia: a cross-sectional analysis of demographic and health surveys 2000\u20132016

BackgroundEthiopia has low measles immunization coverage and little is known about the disparities surrounding what coverage is provided. This study assessed disparities in measles immunization and its change over time using the four Ethiopia Demographic and Health Surveys conducted between 2000 and 2016.MethodsThis is a cross-sectional analysis of data using Ethiopia Demographic and Health Surveys (EDHS) conducted between 2000 and 2016. We used the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) to present the inequalities. Four measures of inequality were calculated: Difference (D), Ratio (R), Population Attributable Fraction (PAF) and Population Attributable Risk (PAR). The results were disaggregated by wealth, education, residence, sex and sub-national regions and 95% Uncertainty Intervals (UIs) were computed for each point estimate to boost confidence of the findings.ResultsMeasles immunization coverage was higher among the richest and secondary and above schools’ subgroup by nearly 30 to 31 percentage points based on point estimates (D = 31%; 95% CI; 19.48, 42.66) and 29.8 percentage points (D = 29.8%; 95% CI; 16.57, 43.06) as compared to the poorest and no education subgroup respectively in the 2016 survey. Still, in the 2016 survey, substantial economic status (PAF = 36.73; 95%CI: 29.78, 43.68), (R = 1.71; 95%CI: 1.35, 2.08), education status (PAF = 45.07; 95% CI: 41.95, 48.18), (R = 1.60; 95% CI: 1.30, 1.90), place of residence (PAF = 39.84, 95% CI: 38.40, 41.27), (R = 1.47, 95% CI: 1.20, 1. 74) and regional (PAF = 71.35, 95% CI: 31.76, 110.95), (R = 3.09, 95%CI: 2.01, 4.17) inequality were observed with both simple and complex measures. There was no statistically significant difference in the prevalence of measles immunization between male and female children in all the studied years, as indicated, for instance, by measures of PAF in 2000 (PAF = 0; 95%CI: − 6.79, 6.79), 2005 (PAF = 0; 95%CI: − 6.04, 6.04), 2011(PAF = 0; 95%CI: − 3.79, 3.79) and 2016 (PAF = 2.66; − 1.67; 6.99). Overall, the inequality of measles immunization narrowed significantly by at least some of the measures between the first and the last survey periods across all the studied subgroups.ConclusionsNational, regional and district levels of government should make a pledge to reduce inequalities in coverage of measles immunization. Equity-sensitive strategies, sufficient human and financial resources as well as continued research and monitoring of immunization coverage inequalities are necessary to achieve related sustainable development goals.

Analysis of Priority of Health Problems in Sleman District Yogyakarta

Health development is carried out through the implementation of improvements through: Health efforts, health financing, human resources, pharmaceuticals, medical devices, foods, health information management, and community empowerment. Priority analysis of health problems is the basic activity used to plan health programs. This study was intended to describe the priority of health problems in Sleman District, Indonesia. This study used descriptive design. Data collected through assessment from documentation and interviews. Interviews were conducted with health workers at the Sleman District Health Office. Health problems measured their rank using the Hanlon method. In this valuation method is based on four components, namely the magnitude of the problem, the seriousness of the problem, the estimated effectiveness of the solution, and PEARL (propriety, economy, acceptability, availability of resources, legality). The results of this study were found in five main health problems in Sleman, namely; (1) Measles, there was an outbreak even though measles immunization coverage 90% nationally and at least 80% at the district level (Score 37.5). (2) Maternal Mortality Rate (83.30 per 100,000 live births in 2014, 63.27 per 100,000 live births in 2013 (score 36). (3) DHF-related deaths were 4 people with IR of 50.6 per 100,000 population (score 24) (4) Morbidity of diarrhea in 2014 was 214 per 1000 inhabitants (score 22). (5) In 2014 new cases of smear + TB were 442 people, with a total number of cases (prevalence) 546 (score 20). The five main health problems in Sleman District were measles, maternal mortality, DHF, diarrhea, and tuberculosis. Measurements with the Hanlon Method are easy to do, and the costs incurred are relatively low, so they can be routinely carried out in Sleman District. Keywords: analysis, health, problem priority, Sleman

Faktor-faktor yang Berhubungan dengan Pemberian Imunisasi Campak pada Balita

Measles immunization is complete basic immunization that must be given to children from 9 to 59 months. Measles immunization coverage in the Limau-Limau Posyandu at the Asam Kumbang Health Center has decreased from 69.2% to 41.9%. The purpose of this study was to determine the relationship between knowledge, attitudes, and roles of cadres and measles immunization in infants. This study uses a cross sectional approach. The population in this study were all mothers with children (9-59 months). The sample is all toddlers, while the respondents are all mothers who have toddlers with a total sampling technique. Analysis was performed using Chi Square test. The univariate results in this study indicate that more respondents did not bring their children for measles immunization (59.5%) more than half of respondents had low knowledge (64.9%), more than half of respondents were negative (62.2%), and more of half of respondents said the cadre's role was not good (62.2%) for measles immunization in infants. Bivariate results showed that there was a significant relationship between knowledge, attitudes and roles of cadres and measles immunization for infants (p = 0,000). For this reason, it is necessary to increase the frequency of counseling and training of cadres in order to change the role of cadres from less good to better, in addition respondents respondents must increase active participation in extension activities in order to increase knowledge.