Vaccination coverage in the South-East Anatolian Project (SEAP) region and factors influencing low coverage.

OBJECTIVES: To determine the vaccination coverage of children living in the South-east Anatolian Project (SEAP) region; whether the vaccination coverage was similar to formal reports, other studies and other countries; and which factors influence vaccination, in order to indicate how vaccination coverage can be improved. STUDY DESIGN: A descriptive cross-sectional study conducted in nine provinces of the SEAP region in order to determine public health problems and their causes. METHODS: A population-based sample of 1150 houses was selected from rural and urban areas of the SEAP region and visited by the researchers. Questionnaires were applied in 2001 and 2002. RESULTS: In the SEAP region, only 30% of children had received a complete set of vaccines. The vaccination coverage was 76.7% for Bacille Calmette-Guérin; 62.0% for the third doses of diphtheria, tetanus toxoid, pertussis and polio vaccine; 62.7% for measles; 44% for the third dose of hepatitis B vaccine in children aged 12-23 months; and 13.3% for the second dose of tetanus toxoid in women who gave birth in the last 5 years. In logistic regression analysis, residence type, number of siblings, birth interval, follow-up visits of midwives, and maternal level of education were found to influence whether children were completely vaccinated. CONCLUSIONS: The findings of this study indicate that vaccination coverage is not acceptable in the SEAP region. Efforts must focus on family planning services, education of women, follow-up visits and strengthening health facilities, especially in rural regions, to improve vaccination.

Family planning in the Southeast Anatolian Project Region.

OBJECTIVES: The aim of this study was to evaluate contraceptive use by women of reproductive age in the Southeast Anatolian Project Region and the promotion of the use of family planning services. METHODS: An optimum sample size to represent the rural and urban area of the region was determined and the sample was chosen by sampling method proportional to the size. A total of 1126 houses were visited and questions about reproductive health were asked of 1019 ever-married (currently married, widows and divorced) women. RESULTS: The study showed that 48.2% of the ever-married women of reproductive age had never used any method of family planning; 37.4% were currently using a family planning method, and 14.4% had used a family planning method in the past. Of the women who were currently using a family planning method, 73.1% were using an effective method. The result of the logistic regression analysis showed that educational level, knowledge of Turkish, type of residence, and total number of living children were the main variables that affected the use of family planning methods. CONCLUSIONS: Use of family planning methods in the region was not at the expected level. In order to decrease the barriers to family planning in developing countries, we must provide obtainable, acceptable, integrated health services.

A special risk group for hepatitis E infection: Turkish agricultural workers who use untreated waste water for irrigation.

Untreated waste water usage in agriculture is an important health-threatening issue which could affect both workers' and the public's health. In this study we researched hepatitis E infection in 46 of 57 farmers who used untreated waste water in agriculture. We compared them with 45 persons of the same socio-economic status and age. Anti-HEV seropositivity was 34.8% in the workers and 4.4% in the control group. We suggest that this type of irrigation is an important potential risk for hepatitis E infection.

Family planning in grand multiparous women in Diyarbakir, Turkey, 1998: the factors affecting contraceptive use and choice of method.

Family planning is an important service for preventing maternal deaths. A 3-year project on children and maternal health was conducted in suburban areas of the Diyarbakir province of Turkey. In this project, volunteer women told women resident in the area about family planning as well as other maternal and child health-related subjects. Within 3 years, all women were visited at least five times and changes in contraceptive use were recorded. A cross-sectional study was planned to understand the factors affecting contraceptive use in grand multiparous women. A total of 200 grand multiparous women were selected from visit cards and various characteristics of these women were evaluated. Odds ratios and 95% confidence intervals were calculated using logistic regression analyses. The use of contraceptives had increased from 33.5% to 59.5% by the end of the 3 years in the 200 women. The main factors affecting contraceptive use were misconceptions and concerns about health-related risks, having a child younger than 14 years working outside the home to contribute to the household income, religious opposition, a gap between the desired and actual number of sons, number of previous deaths of children and discussion with the husband about family planning.