title: The impact of an immunization programme administered through the Growth Monitoring Programme Plus as an alternative way of implementing Integrated Management of Childhood Illnesses in urban-slum areas of Lusaka, Zambia.
abstract: A time-lag study design was used to examine the effects of an immunization programme implemented through an integrated community-based child health approach called the Growth Monitoring Programme Plus (GMP+) in peri-urban areas of Lusaka, Zambia. The immunization coverage and sociodemographic data of eligible children and households were obtained from three repeated surveys in two intervention areas. Logistic regression analysis was performed to explore the factors affecting immunization coverage. For assessing the timeliness of immunization, a Computerised Immunization Coverage Calculation System (CICCS) was used. Full immunization coverage significantly increased in both the primary intervention (P<0.001) and lagged intervention (P = 0.011) areas after the initiation of the GMP+. Frequent attendance to GMP+ sessions played a significant role in the improvement of immunization coverage (P<0.001 for the final survey in the primary intervention area), whereas other sociodemographic characteristics of the child and caretaker were not associated with immunization coverage. Analysis of the timeliness of three doses of diphtheria, pertussis and tetanus DPT3 immunization by CICCS showed that coverage in the primary intervention area had significantly improved compared to the lagged intervention area. Our study indicated that immunization coverage was improved effectively with the intervention of the GMP+ as a model of an integrated immunization programme for child health in line with the Integrated Management of Childhood Illnesses (IMCI) and the Global Immunization Vision and Strategy (GIVS).
authors.affiliation: Department of Infectious Disease Control and International Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi dori Chuo Ward, Niigata, 951-8510, Japan. cp30zp@yahoo.co.jp
authors.forename: Kumiko
authors.initials: K
authors.lastname: Igarashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fujino
authors.forename: Naohito
authors.initials: N
authors.lastname: Tanabe
authors.forename: Clara Mbwili
authors.initials: CM
authors.lastname: Muleya
authors.forename: Bushimbwa
authors.initials: B
authors.lastname: Tambatamba
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D002675:Child, Preschool; D003153:Community Health Services / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000592:standards* / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D011204:Poverty Areas; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000592:standards* / Q000706:statistics & numerical data; D015024:Zambia / Q000453:epidemiology