Abstract
ObjectivesChildhood vaccination coverage in Nagaland has lagged almost all states in India for more than two decades. This study aims to find drivers and barriers of childhood vaccination in Nagaland from the perspective of demand, supply and local health governance.DesignA cross-sectional study was designed using a survey conducted by the Directorate of Health and Family in 2015.SettingHouseholds, community-based health centres and health committees were surveyed.Participants285 children aged under 2 years with vaccination cards and data on households, health centres and health committees were included.OutcomesVariables indicating whether a child received each of bacillus
calmette–guérin (BCG), diphtheria-tetanus-pertussis (DTP3), oral polio (OPV3) and measles vaccination and all of them were outcome variables. Associated factors were identified using multilevel logistic regressions.ResultsAntenatal care at least three times was significantly associated with BCG, DTP3, OPV3 and full vaccination with adjusted ORs ranging from 2.4 (95% CI 1.1 to 5.1) to 3.3 (1.1 to 9.9). The availability of bus to health centre was slightly significant for BCG and OPV3 with the adjusted ORs of 2.0 (0.9 to 4.5) and 2.1 (0.9 to 4.8), respectively. Health committees’ budget provision to health centres was significant for OPV3 and full vaccination with the respective adjusted ORs of 15.7 (1.0 to 234.1) and 15.9 (1.2 to 214.7), the wide 95% CIs of which were driven by a small sample size. Health committees’ review of expenditure of health centres was significant for measles and full vaccination with the adjusted ORs of 4.0 (1.4 to 11.4) and 5.2 (1.4 to 19.4), respectively.ConclusionThis study suggests that enhancing the utilisation of antenatal care and providing reliable transportation between villages and health centres are required to improve childhood vaccination coverage. Also, the significant association of budget administration of health committees suggests that supporting local health committees for effective financial management is important.
Reference37 articles.
1. WHO . “Global and regional immunization profile,”, 2019. Available: https://www.who.int/immunization/monitoring_surveillance/data/gs_gloprofile.pdf?ua=1 [Accessed 3 Mar 2021].
2. International Institute for Population Sciences, “National Family Health Survey, India, 2020. Available: http://rchiips.org/nfhs/ [Accessed 3 Mar 2021].
3. Longvah T et al . “Mother and child nutrition among the Chakhesang tribe in the state of Nagaland, North-East India,”. Matern. Child Nutr 2017.
4. Rural recruitment and retention of health workers across cadres and types of contract in north-east India: a qualitative study;Rajbangshi;WHO South-East Asia J Public Health,2017
5. District level inequality in reproductive, maternal, neonatal and child health coverage in India;Panda;BMC Public Health,2020
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献