Objective:To assess the complete vaccination coverage and timeliness of childhood vaccinations among Indigenous children in Peninsular Malaysia.Methods:The study utilized data from the 2022 Orang Asli Health Survey,a ...Objective:To assess the complete vaccination coverage and timeliness of childhood vaccinations among Indigenous children in Peninsular Malaysia.Methods:The study utilized data from the 2022 Orang Asli Health Survey,a cross-sectional survey conducted among a representative sample of Orang Asli in Peninsular Malaysia.A total of 68 villages were randomly selected from a pool of 853 villages,encompassing diverse geographic and sociodemographic contexts with a total of 15950 respondents Orang Asli successfully interviewed.However,this study only utilized data from surveyed children aged 12 to 59 months with a total of 1551 children included.Validated structured questionnaires were used to collect sociodemographic data and health status,with nurses verifying vaccination records.Children who received all nine primary vaccinations were defined as having complete vaccination while those who received vaccine within the recommended time were defined as having timely vaccination.Data analysis was conducted using IBM SPSS version 25.0,focusing on descriptive analyses of children's vaccination status.Results:The prevalence of overall complete vaccination among Indigenous children was 87.7%,while timely vaccination was only 40.3%.The prevalence of complete vaccination for Bacillus Calmette-Guérin(BCG),the first dose of hepatitis B,three doses of DTaP-IPV-Hib,and measles,mumps,and rubella(MMR)was above 95.0%,except for the second and third doses of hepatitis B.The prevalence of timely vaccination ranged from above 95.0%for vaccines given at birth,gradually decreasing with increasing age to 57.5%for the first dose of MMR.Moreover,the completion rates for three doses of DtaP-IPV-Hib and the initial dose of MMR surpassed 90%among Indigenous children aged 12-23 months,yet the timeliness remained at a moderate level.Conclusions:While the overall complete vaccination coverage among Indigenous children in Malaysia is relatively high,there are concerning disparities in the timeliness of vaccination,particularly as children age.展开更多
Sirmaur district in the state of Himachal Pradesh in India is a hard-to-reach area situated in the western Himalayas having an extreme landscape with snow-laden mountains and extensive river systems that makes the del...Sirmaur district in the state of Himachal Pradesh in India is a hard-to-reach area situated in the western Himalayas having an extreme landscape with snow-laden mountains and extensive river systems that makes the delivery of immunization services extremely challenging. Vaccinators needed a long walk through the hilly terrain to reach outreach sites. Community mobilizers were unable to go house to house to inform the caregivers to bring children to the site for vaccination. Caregivers were unaware when the vaccinators arrive at the site. As a result, many children missed vaccination or were not vaccinated timely. Age-appropriate vaccination coverage (according to national immunization schedule) in the Sirmaur district was the lowest in the state. Thinking out-of-box to address the communication barriers with the caregivers, the traditional drum beating was used, for the first time in India, in two blocks of the Sirmaur district (Rajpura and Shillai). The initiative was planned and implemented by the district health system with the support of the local community leaders. An exit interview was conducted to know the reach of the drum beating to caregivers, and a baseline and end line household survey was conducted to know the outcome of the initiative on age-appropriate vaccination coverage. Analysis of exit interviews data indicated a very high reach of a drum beating to the caregivers;more than 97% of caregivers in Rajpura and 100% in Shillai heard drum beating, and almost 95% of caregivers in Rajpura and 98% in Shillai knew the purpose of drum beating. Analysis of immunization data from baseline and end line surveys showed improvement in age-appropriate vaccination coverage for all vaccines in Rajpura (by 2.2% for BCG, 15.3% for Pentavalent 1, 14.9% for Pentavalent 2, 14.1% for Pentavalent 3, and 6.5% for Measles/MR). In Shillai, age-appropriate vaccination coverage improved for Pentavalent 1 (by 3.4%), Pentavalent 2 (by 5%) and Measles/MR (by 1.7%). In addition, dropout rates were reduced in both the blocks, particularly in Rajpura Pentavalent 1 to Measles dropout rate was reduced by 13.5%. Both health workers and community leaders had positive perceptions of the drum beating initiative. However, another important lesson learned from the initiative was that both the access and demand-side barriers need to be addressed for the desired improvement of age-appropriate immunization coverage. In Shillai, there was lower coverage improvement and a reduction in dropout rates attributed to vacant positions of vaccinators that caused an issue with access to immunization services to people.展开更多
文摘Objective:To assess the complete vaccination coverage and timeliness of childhood vaccinations among Indigenous children in Peninsular Malaysia.Methods:The study utilized data from the 2022 Orang Asli Health Survey,a cross-sectional survey conducted among a representative sample of Orang Asli in Peninsular Malaysia.A total of 68 villages were randomly selected from a pool of 853 villages,encompassing diverse geographic and sociodemographic contexts with a total of 15950 respondents Orang Asli successfully interviewed.However,this study only utilized data from surveyed children aged 12 to 59 months with a total of 1551 children included.Validated structured questionnaires were used to collect sociodemographic data and health status,with nurses verifying vaccination records.Children who received all nine primary vaccinations were defined as having complete vaccination while those who received vaccine within the recommended time were defined as having timely vaccination.Data analysis was conducted using IBM SPSS version 25.0,focusing on descriptive analyses of children's vaccination status.Results:The prevalence of overall complete vaccination among Indigenous children was 87.7%,while timely vaccination was only 40.3%.The prevalence of complete vaccination for Bacillus Calmette-Guérin(BCG),the first dose of hepatitis B,three doses of DTaP-IPV-Hib,and measles,mumps,and rubella(MMR)was above 95.0%,except for the second and third doses of hepatitis B.The prevalence of timely vaccination ranged from above 95.0%for vaccines given at birth,gradually decreasing with increasing age to 57.5%for the first dose of MMR.Moreover,the completion rates for three doses of DtaP-IPV-Hib and the initial dose of MMR surpassed 90%among Indigenous children aged 12-23 months,yet the timeliness remained at a moderate level.Conclusions:While the overall complete vaccination coverage among Indigenous children in Malaysia is relatively high,there are concerning disparities in the timeliness of vaccination,particularly as children age.
文摘Sirmaur district in the state of Himachal Pradesh in India is a hard-to-reach area situated in the western Himalayas having an extreme landscape with snow-laden mountains and extensive river systems that makes the delivery of immunization services extremely challenging. Vaccinators needed a long walk through the hilly terrain to reach outreach sites. Community mobilizers were unable to go house to house to inform the caregivers to bring children to the site for vaccination. Caregivers were unaware when the vaccinators arrive at the site. As a result, many children missed vaccination or were not vaccinated timely. Age-appropriate vaccination coverage (according to national immunization schedule) in the Sirmaur district was the lowest in the state. Thinking out-of-box to address the communication barriers with the caregivers, the traditional drum beating was used, for the first time in India, in two blocks of the Sirmaur district (Rajpura and Shillai). The initiative was planned and implemented by the district health system with the support of the local community leaders. An exit interview was conducted to know the reach of the drum beating to caregivers, and a baseline and end line household survey was conducted to know the outcome of the initiative on age-appropriate vaccination coverage. Analysis of exit interviews data indicated a very high reach of a drum beating to the caregivers;more than 97% of caregivers in Rajpura and 100% in Shillai heard drum beating, and almost 95% of caregivers in Rajpura and 98% in Shillai knew the purpose of drum beating. Analysis of immunization data from baseline and end line surveys showed improvement in age-appropriate vaccination coverage for all vaccines in Rajpura (by 2.2% for BCG, 15.3% for Pentavalent 1, 14.9% for Pentavalent 2, 14.1% for Pentavalent 3, and 6.5% for Measles/MR). In Shillai, age-appropriate vaccination coverage improved for Pentavalent 1 (by 3.4%), Pentavalent 2 (by 5%) and Measles/MR (by 1.7%). In addition, dropout rates were reduced in both the blocks, particularly in Rajpura Pentavalent 1 to Measles dropout rate was reduced by 13.5%. Both health workers and community leaders had positive perceptions of the drum beating initiative. However, another important lesson learned from the initiative was that both the access and demand-side barriers need to be addressed for the desired improvement of age-appropriate immunization coverage. In Shillai, there was lower coverage improvement and a reduction in dropout rates attributed to vacant positions of vaccinators that caused an issue with access to immunization services to people.
