ABSTRACT
BACKGROUND: Since last 100 years, immunization rate is one of the best public health outcome and service indicators. However, the immunization system is still imperfect; there are many countries that still have unvaccinated children. Parental decisions regarding immunization are very important to improve immunization rate. The aim of this study is to evaluate the association between parental knowledge-practice (KP) regarding immunization with family and immunization providers' factors. METHODS: This is a prospective cross-sectional study design. Immunization knowledge and practices among 528 Iraqi parents were evaluated through validated questionnaire. Familial data and immunization provider's characteristics were collected from parents through interview. RESULTS: More than half of respondents/study population (66.1%) have adequate knowledge- practice scores. Significant associations were noted for knowledge-practice groups with father's education level, mother's education level, mother's age at delivery, number of preschool children, parents gender, family income, provider types, and birth place (p < 0.05). CONCLUSION: Immunization campaigns and awareness are required to improve parents' knowledge and practice regarding immunization. The study results reinforce recommendations for use of educational programmes to improve the immunization knowledge and practice.
Subject(s)
Attitude to Health , Health Knowledge, Attitudes, Practice , Immunization , Parents/psychology , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Iraq , Male , Prospective Studies , Surveys and Questionnaires , Young AdultABSTRACT
To identify the immunization providers' characteristics associated with immunization rate in children younger than 2 years. A cohort and a cluster sampling design were implemented; 528 children between 18 and 70 months of age were sampled in five public health clinics in Mosul-Iraq. Providers' characterizations were obtained. Immunization rate for the children was assessed. Risk factors for partial immunization were explored using both bivariate analyses and multi-level logistic regression models. Less than half of the children had one or more than one missed dose, considered as partial immunization cases. The study found significant association of immunization rate with provider's type. Two factors were found that strongly impacted on immunization rate in the presence of other factors: birthplace and immunization providers' type.
Subject(s)
Health Facilities , Immunization Programs/organization & administration , Immunization/statistics & numerical data , Vaccination/statistics & numerical data , Child , Child, Preschool , Female , Health Care Surveys , Health Knowledge, Attitudes, Practice , Health Personnel , Health Services Accessibility , Humans , Immunization Schedule , Infant , Infant, Newborn , Iraq , Logistic Models , Male , Patient Compliance , Pediatrics , Population Surveillance , Retrospective Studies , Risk Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
The immunization status of children is improved by interventions that increase community demand for compulsory and non-compulsory vaccines, one of the most important interventions related to immunization providers. The aim of this study is to evaluate the activities of immunization providers in terms of activities time and cost, to calculate the immunization doses cost, and to determine the immunization dose errors cost. Time-motion and cost analysis study design was used. Five public health clinics in Mosul-Iraq participated in the study. Fifty (50) vaccine doses were required to estimate activities time and cost. Micro-costing method was used; time and cost data were collected for each immunization-related activity performed by the clinic staff. A stopwatch was used to measure the duration of activity interactions between the parents and clinic staff. The immunization service cost was calculated by multiplying the average salary/min by activity time per minute. 528 immunization cards of Iraqi children were scanned to determine the number and the cost of immunization doses errors (extraimmunization doses and invalid doses). The average time for child registration was 6.7 min per each immunization dose, and the physician spent more than 10 min per dose. Nurses needed more than 5 min to complete child vaccination. The total cost of immunization activities was 1.67 US$ per each immunization dose. Measles vaccine (fifth dose) has a lower price (0.42 US$) than all other immunization doses. The cost of a total of 288 invalid doses was 744.55 US$ and the cost of a total of 195 extra immunization doses was 503.85 US$. The time spent on physicians' activities was longer than that spent on registrars' and nurses' activities. Physician total cost was higher than registrar cost and nurse cost. The total immunization cost will increase by about 13.3% owing to dose errors.
