title: Coverage and predictors of vaccination among children of 1-4 years of age in a rural sub-district of Sindh.
abstract: OBJECTIVE
  To estimate the proportion of children 1-4 years of age vaccinated in the first year of their life and determine socio-demographic factors associated with vaccination in the rural sub-district Khairpur, Sindh, Pakistan.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The study was conducted in 9 Union Councils of sub-district Gambat, district Khairpur, Sindh, from August to October 2008.
  
  
  METHODS
  A questionnaire based representative multi-stage cluster survey was conducted. A total of 549 children aged 1-4 years were assessed for coverage and predictors of vaccination. Univariate and multivariate analysis was done using logistic regression to determine the unadjusted and adjusted relationship between socio-demographic predictor and outcome (vaccination status).
  
  
  RESULTS
  The coverage for complete vaccination was 71.9% (95%CI=68.1%-75.7%). Educational level of mother (p=0.042), father (p=0.001) and child birth at hospital (p=0.006) were significantly associated with the vaccination status. Mother's educational level of intermediate and above was the strongest predictor (OR=12.19, 95%CI=1.57-94.3) for vaccination.
  
  
  CONCLUSIONS
  Education of parents, particularly mother's education was important determinant of vaccination status of the children. In addition, distance from taluka health facility and misconception of parents were among the main reasons of not getting the children vaccinated. There is a need to educate the parents especially mothers about the importance of vaccination and organize EPI services at Basic Health Unit level to improve the vaccination coverage in rural areas of Pakistan.
authors.affiliation: Department of Community Health Sciences, The Aga Khan University, Karachi.
authors.forename: Shiraz
authors.initials: S
authors.lastname: Shaikh
authors.forename: Tahir M
authors.initials: TM
authors.lastname: Taj
authors.forename: Ambreen
authors.initials: A
authors.lastname: Kazi
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmed
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
mesh_terms: D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data*