Spatial and socio-demographic predictors of time-to-immunization in a rural area in Kenya: Is equity attainable?

We conducted a vaccine coverage survey in Kilifi District, Kenya in order to identify predictors of childhood immunization. We calculated travel time to vaccine clinics and examined its relationship to immunization coverage and timeliness among the 2169 enrolled children (median age: 12.5 months). 86% had vaccine cards available, >95% had received three doses of DTP-HepB-Hib and polio vaccines and 88% of measles. Travel time did not affect vaccination coverage or timeliness. The Kenyan EPI reaches nearly all children in Kilifi and delays in vaccination are few, suggesting that vaccines will have maximal impact on child morbidity and mortality.

[1]  S. Kalaça,et al.  Assessment of sociodemographic factors and socio-economic status affecting the coverage of compulsory and private immunization services in Istanbul, Turkey. , 2005, Public health.

[2]  S I Hay,et al.  Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya , 2003, Tropical medicine & international health : TM & IH.

[3]  N. McGrath,et al.  Ascertainment of childhood vaccination histories in northern Malawi , 2008, Tropical medicine & international health : TM & IH.

[4]  N. Andersson,et al.  One size does not fit all: local determinants of measles vaccination in four districts of Pakistan , 2009, BMC international health and human rights.

[5]  O. Müller,et al.  Risk factors of infant and child mortality in rural Burkina Faso. , 2004, Bulletin of the World Health Organization.

[6]  R. Stock Distance and the utilization of health facilities in rural Nigeria. , 1983, Social science & medicine.

[7]  G. Mwabu,et al.  Quality of Medical Care and Choice of Medical Treatment in Kenya An Empirical Analysis , 1993 .

[8]  J. van den Broeck,et al.  Maternal determinants of child survival in a rural African community. , 1996, International journal of epidemiology.

[9]  C. Fasano,et al.  Immunization Histories Given by Adult Caregivers Accompanying Children 3-36 Months to the Emergency Department: Are Their Histories Valid for the Haemophilus influenzae B and Pneumococcal Vaccines? , 2007, Pediatric emergency care.

[10]  S. Sahinoz,et al.  Vaccination coverage in the South-East Anatolian Project (SEAP) region and factors influencing low coverage. , 2006, Public health.

[11]  B. Loevinsohn,et al.  The accuracy of mother's reports about their children's vaccination status. , 1989, Bulletin of the World Health Organization.

[12]  K. Maleta,et al.  Childhood immunization in rural Malawi: time of administration and predictors of non-compliance , 2000, Annals of tropical paediatrics.

[13]  A. Noor,et al.  Geographic access to care is not a determinant of child mortality in a rural Kenyan setting with high health facility density , 2010, BMC public health.

[14]  T. Smith,et al.  The effect of distance from home on attendance at a small rural health centre in Papua New Guinea. , 1998, International journal of epidemiology.

[15]  M. Tanner,et al.  Health and survival of young children in southern Tanzania , 2008, BMC Public Health.

[16]  R. Hoekelman,et al.  The Reliability of Maternal Recall , 1976, Clinical pediatrics.

[17]  Gwatkin Dr,et al.  Inequalities in knowledge of HIV / AIDS prevention. An overview of socio-economic and gender differentials in developing countries. Initial discussion draft. , 2001 .

[18]  R. Daum,et al.  Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department. , 1993, JAMA.

[19]  J. Scott,et al.  Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens , 2006, BMC public health.

[20]  F. Alexander,et al.  Mothers' reports of childhood vaccinations and infections and their concordance with general practitioner records. , 1991, Journal of public health medicine.

[21]  S. Awasthi,et al.  Gender inequity and age-appropriate immunization coverage in India from 1992 to 2006 , 2009, BMC International Health and Human Rights.

[22]  Séraphin Simboro,et al.  Assessment of factors associated with complete immunization coverage in children aged 12-23 months: a cross-sectional study in Nouna district, Burkina Faso , 2009, BMC international health and human rights.

[23]  R. Langsten,et al.  The accuracy of mothers' reports of child vaccination: evidence from rural Egypt. , 1998, Social science & medicine.

[24]  P. Gething,et al.  A spatial national health facility database for public health sector planning in Kenya in 2008 , 2009, International journal of health geographics.

[25]  Alberto Minujin,et al.  Monitoring equity in immunization coverage. , 2005, Bulletin of the World Health Organization.

[26]  C. Sanderson,et al.  Timing of children's vaccinations in 45 low-income and middle-income countries: an analysis of survey data , 2009, The Lancet.

[27]  D. Gwatkin,et al.  IMMUNIZATION COVERAGE INEQUALITIES An Overview of Socio-Economic and Gender Differentials in Developing Countries , 2002 .

[28]  M. Sokal,et al.  Accuracy of Parental Reporting of Immunization , 2004, Clinical pediatrics.

[29]  P. Mohan Inequities in coverage of preventive child health interventions: the rural drinking water supply program and the universal immunization program in Rajasthan, India. , 2005, American journal of public health.

[30]  A. Koumaré,et al.  Evaluation of immunization coverage within the Expanded Program on Immunization in Kita Circle, Mali: a cross-sectional survey , 2009, BMC international health and human rights.