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Starting then stopp...
Starting then stopping: a nationwide register-based study on the magnitude, predictors, and urban-rural patterns of under-vaccination variation across health centers in The Gambia
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- Sowe, Alieu (author)
- Umeå universitet,Institutionen för epidemiologi och global hälsa,Expanded Program on Immunization, Ministry of Health, Banjul, The Gambia
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- Namatovu, Fredinah, PhD, 1980- (author)
- Umeå universitet,Institutionen för epidemiologi och global hälsa
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- Cham, Bai (author)
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Bakau, The Gambia; School of Public Health, Georgia State University, Atlanta, GA, USA
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- Gustafsson, Per E (author)
- Umeå universitet,Institutionen för epidemiologi och global hälsa
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(creator_code:org_t)
- Taylor & Francis, 2024
- 2024
- English.
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 17:1
- Related links:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Objectives: Six million children were under-vaccinated in 2022. Our study aimed to 1) quantify the magnitude of under-vaccination variation between health facilities, 2) assess to which extent individual and health center level factors contributed to the variation, 3) identify individual and health facility factors associated with under-vaccination, and 4), explore rural vs. urban health facility variations.Methods: We used data from 61,839 children from The Gambia national routine vaccination register. We cross tabulated under-vaccination status across study variables and fitted two-level random intercept multilevel logistic regression models to measure variance, contribution to the variance, and factors associated with the variance and under-vaccination.Results: We found that 7% of the prevalence of under-vaccination was due to variation between health facilities. Thirty-seven percent of the variation was explained by individual and health center variables. The variables explained 36% of the variance in urban and 19% in rural areas. Children who were not vaccinated at 4 months or with delayed history, due for vaccination in the rainy season, and health facilities with very small or large population to health worker ratios had higher under-vaccination odds.Conclusion: Our study indicates that one of the pathways to improving vaccination coverage is addressing factors driving under-vaccination inequities between health facilities through urban-rural differentiated strategies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- Vaccination
- coverage
- under immunized
- inequality
- equity
- epidemiologi
- Epidemiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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