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A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme.
Adamu, Abdu A; Uthman, Olalekan A; Gadanya, Muktar A; Adetokunboh, Olatunji O; Wiysonge, Charles S.
Afiliación
  • Adamu AA; Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa.
  • Uthman OA; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Gadanya MA; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Adetokunboh OO; Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, University of Warwick Medical School, Coventry, United Kingdom.
  • Wiysonge CS; Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano State, Nigeria.
PLoS One ; 14(7): e0218572, 2019.
Article en En | MEDLINE | ID: mdl-31291267
BACKGROUND: We aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0-23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria. METHODS: This cross-sectional study was conducted in the pre-implementation phase of a quality improvement programme. One-stage cluster sampling technique was employed. Data were collected from caregivers of children aged 0-23 months in ten randomly selected PHC facilities in Nassarawa Local Government Area of Kano State. Semi-structured, interviewer administered questionnaires were used. Frequencies and percentages were used to summarize the data. Multilevel logistic regression model with fixed effect and random effect component was fitted to obtain measures of association and variation respectively. RESULTS: Caregivers of 675 children responded. Among these children, the prevalence of MOV (for at least one antigen) was 36.15%. MOV (for individual antigens) was highest for inactivated polio vaccine followed by measles vaccine. The random effect model yielded an intraclass correlation coefficient of 9.60% for the empty model. The fixed effect model revealed that MOV was more likely among children that were accompanying a caregiver to the health facility (OR = 2.86, 95%CrI: 1.28 to 5.80) compared to those that were visiting the health facility for medical consultation. Failure to receive vaccination on the day of health facility visit (OR = 2.32, 95%CrI: 1.12 to 4.12) and visiting a clinic with three or more vaccinators (OR = 12.91, 95%CrI: 4.82 to 27.14) increased the likelihood of MOV. CONCLUSION: The study identified important local factors that are responsible for MOV which can be addressed in the QI programme.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vacunación Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies / Sysrev_observational_studies Aspecto: Equity_inequality / Implementation_research Límite: Adolescent / Adult / Humans / Infant / Male / Newborn País/Región como asunto: Africa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vacunación Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies / Sysrev_observational_studies Aspecto: Equity_inequality / Implementation_research Límite: Adolescent / Adult / Humans / Infant / Male / Newborn País/Región como asunto: Africa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Estados Unidos