Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment

Abstract Background Vaccination is one of the effective ways to develop immunity against potential life-threatening diseases in children in early age. This study is focused on analysing the age-appropriate vaccination coverage at national and subnational levels and identify the factors associated wi...

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Autores principales:	Santosh Kumar Rauniyar, Yoko Iwaki, Daisuke Yoneoka, Masahiro Hashizume, Shuhei Nomura
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Delay Timeliness Vaccine coverage Vaccination Immunization Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/0c870def2cbd43c29a6cd1602e7e1dd0
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spelling	oai:doaj.org-article:0c870def2cbd43c29a6cd1602e7e1dd02021-11-14T12:14:09ZAge-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment10.1186/s12889-021-11841-21471-2458https://doaj.org/article/0c870def2cbd43c29a6cd1602e7e1dd02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-11841-2https://doaj.org/toc/1471-2458Abstract Background Vaccination is one of the effective ways to develop immunity against potential life-threatening diseases in children in early age. This study is focused on analysing the age-appropriate vaccination coverage at national and subnational levels and identify the factors associated with age-appropriate coverage in Nepal. Methods 460 children aged 12–36 months were included in the study. The data was obtained from Nepal Demographic and Health Survey (NDHS) 2016–17. Age-appropriate coverage of Bacillus Calmette-Guerin vaccine (BCG), oral polio vaccine (OPV) doses 1–3, pentavalent vaccine (PE) doses 1–3, and first dose of measles, mumps, and rubella vaccine (MMR) were estimated using Kaplan Meier method. Multilevel logistic regression with random intercept was used to identify the factors associated with age-appropriate vaccination. Results The crude coverage of the vaccines included in the study ranged from 91.5% (95% CI, 88.5–93.7) for PE3 to 97.8% (95.8–98.7) for BCG. Although the crude coverage of all the vaccines was above 90%, the age-appropriate coverage was significantly low, ranging from 41.5% (36.5–46.6) for PE3 to 73.9% (69.2–78.1) for PE1. Furthermore, high disparity in timely vaccination coverage was observed at regional level. Compared to the age-appropriate vaccination coverage in other provinces, Province 2 had the lowest coverage of all, followed by that in Province 6. The timeliness of vaccination was significantly associated with subnational regions i.e., provinces and the season of childbirth. Conclusion Although the immunization program in Nepal has achieved the target of 90% crude coverage of all the childhood vaccines, the age-appropriate coverage is significantly low which undermines the effectiveness of the vaccines administered. Thus, along with crude coverage, timeliness of the vaccines administered should be taken into consideration and thoroughly monitored at national and subnational levels. Provincial government should formulate tailored strategies to ensure the timely administration of the childhood vaccines.Santosh Kumar RauniyarYoko IwakiDaisuke YoneokaMasahiro HashizumeShuhei NomuraBMCarticleDelayTimelinessVaccine coverageVaccinationImmunizationPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Delay Timeliness Vaccine coverage Vaccination Immunization Public aspects of medicine RA1-1270
spellingShingle	Delay Timeliness Vaccine coverage Vaccination Immunization Public aspects of medicine RA1-1270 Santosh Kumar Rauniyar Yoko Iwaki Daisuke Yoneoka Masahiro Hashizume Shuhei Nomura Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment
description	Abstract Background Vaccination is one of the effective ways to develop immunity against potential life-threatening diseases in children in early age. This study is focused on analysing the age-appropriate vaccination coverage at national and subnational levels and identify the factors associated with age-appropriate coverage in Nepal. Methods 460 children aged 12–36 months were included in the study. The data was obtained from Nepal Demographic and Health Survey (NDHS) 2016–17. Age-appropriate coverage of Bacillus Calmette-Guerin vaccine (BCG), oral polio vaccine (OPV) doses 1–3, pentavalent vaccine (PE) doses 1–3, and first dose of measles, mumps, and rubella vaccine (MMR) were estimated using Kaplan Meier method. Multilevel logistic regression with random intercept was used to identify the factors associated with age-appropriate vaccination. Results The crude coverage of the vaccines included in the study ranged from 91.5% (95% CI, 88.5–93.7) for PE3 to 97.8% (95.8–98.7) for BCG. Although the crude coverage of all the vaccines was above 90%, the age-appropriate coverage was significantly low, ranging from 41.5% (36.5–46.6) for PE3 to 73.9% (69.2–78.1) for PE1. Furthermore, high disparity in timely vaccination coverage was observed at regional level. Compared to the age-appropriate vaccination coverage in other provinces, Province 2 had the lowest coverage of all, followed by that in Province 6. The timeliness of vaccination was significantly associated with subnational regions i.e., provinces and the season of childbirth. Conclusion Although the immunization program in Nepal has achieved the target of 90% crude coverage of all the childhood vaccines, the age-appropriate coverage is significantly low which undermines the effectiveness of the vaccines administered. Thus, along with crude coverage, timeliness of the vaccines administered should be taken into consideration and thoroughly monitored at national and subnational levels. Provincial government should formulate tailored strategies to ensure the timely administration of the childhood vaccines.
format	article
author	Santosh Kumar Rauniyar Yoko Iwaki Daisuke Yoneoka Masahiro Hashizume Shuhei Nomura
author_facet	Santosh Kumar Rauniyar Yoko Iwaki Daisuke Yoneoka Masahiro Hashizume Shuhei Nomura
author_sort	Santosh Kumar Rauniyar
title	Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment
title_short	Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment
title_full	Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment
title_fullStr	Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment
title_full_unstemmed	Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment
title_sort	age-appropriate vaccination coverage and its determinants in children aged 12–36 months in nepal: a national and subnational assessment
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0c870def2cbd43c29a6cd1602e7e1dd0
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Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment

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