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

作　　者：Xian-Yan Tang Man Cheng Alan Geater Qiu-Yun Deng Ge Zhong Yue-Dong Lin Ning Chen Tao Lan Long-Yan Jiang Man-Tong Zhu Qiao Li 

机构地区：[1]Department of Epidemiology and Biostatistics,School of Public Health,Guangxi Medical University,China.No.22nd,Shuangyong Road,Nanning,Guangxi Zhuang Autonomous Region,530021,People’s Republic of China [2]不详

出　　处：《Infectious Diseases of Poverty》2021年第4期100-101,共2页贫困所致传染病（英文）

摘　　要：Background Measles 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.Methods A 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.Results A 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

关 键 词：MEASLES VACCINATION TIMELINESS Health system barriers Mixed methods 

分 类 号：R186[医药卫生—流行病学]