Effects of three interventions and determinants of full vaccination among children aged 12-59 months in Nyanza province, Kenya.
OBJECTIVE
The purpose of this study is to describe the effects of the three main interventions and identify the individual and community determinants of full vaccination coverage among children aged 12-59 months in Nyanza province, Kenya.


METHODS
Cross-sectional study.


METHODS
We utilized three datasets. One is the Nyanza Province County-based Multiple Indicator Cluster Survey 2011. The other two datasets are the lists of community units and health facilities in Nyanza Province, Kenya. A three-level multilevel logistic regression analysis was performed.


RESULTS
In the final model, the highest wealth quintile (AOR: 2.49; 95% CI: 1.333-4.642; P = 0.004), the community with high coverage of media devices (AOR: 1.50; 95% CI: 1.029-2.198; P = 0.035), the participation of mass immunization campaigns (AOR: 1.63; 95% CI: 1.153-2.303; P = 0.006) were the significant determinants of complete child vaccination.


CONCLUSIONS
In conclusion, further implementation of mass immunization campaigns is the recommended intervention to increase the uptake of required vaccinations among children. In addition, further attention to the poor and the low coverage of media devices is necessary, since they are the most vulnerable population in terms of accessibility of vaccination services. Implementation community based activity, such as community health workers, would have a positive impact on vaccination coverage, if their performance is continuously high.
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. Electronic address: y.kawakatsu.0829@gmail.com.
Y
Y
Kawakatsu
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
J
J
Tanaka
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
K
K
Ogawa
Ministry of Health, Kenya.
K
K
Ogendo
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
S
S
Honda
D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007630:Kenya; D016015:Logistic Models; D032541:Mass Vaccination / Q000706:statistics & numerical data; D055361:Multilevel Analysis; D014611:Vaccination / Q000706:statistics & numerical data*
Community health worker; Determinant; Kenya; Mass immunization campaign; Multi-level analysis; Vaccination