title: Use of rapid needs assessment as a tool to identify vaccination delays in Guatemala and Peru.
abstract: OBJECTIVE
  To explore the use of rapid needs assessment (RNA) surveys to determine the prevalence and factors contributing to delays in vaccination of children in two low middle-income countries (LMIC).
  
  
  METHODS
  Data from two RNA surveys performed as part of program improvement evaluations in Guatemala and Peru were used for this analysis. The primary endpoint was the timeliness of immunization with delay defined as administration of vaccines beyond 28 days from recommended age for DTwP-HepB-Hib (Penta) and measles-mumps-rubella (MMR) vaccines, as well as past age-restrictions for rotavirus vaccine. Independent risk factors analyzed included child's gender, birth year, number of children in household, maternal age, maternal education, and food insecurity.
  
  
  RESULTS
  Vaccine information was available from 811 children from 838 households surveyed. High rate of immunization delays was observed, with 75.6% of children in Guatemala and 57.8% of children in Peru being delayed for the third dose of Penta primary series. Factors associated with delayed vaccination in Guatemala included advanced maternal age and increased number of children in household. In Peru, significant associations were birth year before 2009, lower maternal education level, and increased number of children in household.
  
  
  CONCLUSIONS
  RNA is a fast and effective method to identify timely vaccine coverage and derive a hypothesis of factors possibly associated with vaccination delay.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Katie K
authors.initials: KK
authors.lastname: D'Ardenne
authors.affiliation: Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
authors.forename: Juliana
authors.initials: J
authors.lastname: Darrow
authors.affiliation: Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Aurora, CO, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Furniss
authors.affiliation: Center for Global Health, Colorado School of Public Health, Aurora, CO, USA; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Aurora, CO, USA.
authors.forename: Catia
authors.initials: C
authors.lastname: Chavez
authors.affiliation: School of Medicine and Public Health, University Cayetano Heredia, Lima, Peru.
authors.forename: Herminio
authors.initials: H
authors.lastname: Hernandez
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Berman
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Center for Global Health, Colorado School of Public Health, Aurora, CO, USA. Electronic address: edwin.asturias@ucdenver.edu.
authors.forename: Edwin J
authors.initials: EJ
authors.lastname: Asturias
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D005260:Female; D006166:Guatemala; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D006293:Health Promotion; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D009035:Mothers; D020380:Needs Assessment; D010568:Peru; D015397:Program Evaluation; D022243:Rotavirus Vaccines / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; C524361:DtwP-HepB-Hib vaccine; D018073:Haemophilus Vaccines; D017325:Hepatitis B Vaccines; D022542:Measles-Mumps-Rubella Vaccine; D022243:Rotavirus Vaccines
keywords: Guatemala; Immunization delays; Measles; Pentavalent; Peru; Rapid needs assessment; Rotavirus; Vaccines