title: Routine vaccination coverage in low- and middle-income countries: further arguments for accelerating support to child vaccination services.
abstract: OBJECTIVE
  The Expanded Programme on Immunization was introduced by the World Health Organization (WHO) in all countries during the 1970s. Currently, this effective public health intervention is still not accessible to all. This study evaluates the change in routine vaccination coverage over time based on survey data and compares it to estimations by the WHO and United Nations Children's Fund (UNICEF).
  
  
  METHODS
  Data of vaccination coverage of children less than 5 years of age was extracted from Demographic and Health Surveys (DHS) conducted in 71 low- and middle-income countries during 1986-2009. Overall trends for vaccination coverage of tuberculosis, diphtheria, tetanus, pertussis, polio and measles were analysed and compared to WHO and UNICEF estimates.
  
  
  RESULTS
  From 1986 to 2009, the annual average increase in vaccination coverage of the studied diseases ranged between 1.53 and 1.96% units according to DHS data. Vaccination coverage of diphtheria, tetanus, pertussis, polio and measles was all under 80% in 2009. Non-significant differences in coverage were found between DHS data and WHO and UNICEF estimates.
  
  
  CONCLUSIONS
  The coverage of routine vaccinations in low- and middle-income countries may be lower than that previously reported. Hence, it is important to maintain and increase current vaccination levels.
authors: Health Systems and Policy Research Group, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors: Wenjing
authors: W
authors: Tao
authors: Max
authors: M
authors: Petzold
authors: Birger C
authors: BC
authors: Forsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D014611:Vaccination / Q000706:statistics & numerical data*; D014944:World Health Organization; D055815:Young Adult
keywords: World Health Organization; child; data collection; developing countries; health care surveys; immunization programs; immunization schedule; infant; vaccination
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