Author(s): Brugha R, Kevany J
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Abstract A study of the immunization determinants of children aged 12 to 18 months was conducted in 1991 in the Eastern Region of Ghana, using structured interviews of mothers and fathers. The completion of immunization schedules by one year, among the 294 children, was positively associated (P < 0.005) with the town of residence of the child and mother, the ability of the mother to speak English, the target child having been treated for illness at the local hospital, the child's mother having given birth to less than 5 children, the possession of a sewing machine by the mother, and the birth of the child in the current town of residence. Significantly higher immunization coverage levels were achieved where the Under Fives' Clinic was an affordable and acceptable service, integrating preventive and curative care, and where measures were implemented by the community to increase attendance levels at the Clinic. This was achieved among a target group who were otherwise at a relatively high risk of failing to complete immunization schedules on-time. PIP: The study of immunization determinants was conducted in July and August 1991 in 3 towns in the eastern region of Ghana using structure interviews of mothers and fathers. Town 1 had weekly Under Fives' Clinics; Town 2 had a monthly Under Fives' Clinic; and Town 3 had monthly outreach clinic provided by a team from the mission hospital. The target group was 12-18 month old children who numbered 296 including 2 sets of twins. The responses of 294 female caretakers were analyzed. The completion of immunization schedules by 1 year was positively associated (p 0.005) with the town of residence of the child and mother (adjusted odds ratio [OR] = 7.7) in Town 1 and 3; the ability of the mother to speak English (OR = 2.8); the child having been treated at the local hospital (OR = 4.1); the mother's parity of less than 5 births (OR = 6.6); the possession of a sewing machine by the mother (OR = 2.0); and the birth of the child right in the respective town (OR = 4.6). In bivariate analyses the best fit logistic repression equations included: mother from local ethnic group (OR = 3.7); mother earns money (OR = 2.4); assisted birth (OR = 2.3); and mother's economic level exclusive of owning a sewing machine (OR = 1.9). In addition, significantly higher coverage of immunization was achieved where the Under Fives' Clinic was affordable, integrating preventive and curative care, and where measures by the community increased attendance levels among the target group who were otherwise at relatively high risk of failing to complete immunization on time. These results support the hypothesis that higher female literacy, or perhaps more effective education of parental and Under Fives' Clinic attenders, improved economic status, and lower parity may contribute to the better use of primary health care services by mothers.
This article was published in Health Policy Plan
and referenced in Journal of Addiction Research & Therapy