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Immunisation uptake, services required and government incentives for users of formal day care
1Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria. bond@cryptic.rch.unimelb.edu.au
Insights
Immunisation uptake in children attending day care was 84% before new incentives. Flexible services and government support could increase this rate, especially for families receiving childcare assistance.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Childhood immunisation is crucial for disease prevention.
- Formal day care settings present opportunities to monitor and improve immunisation coverage.
- Government policies, including incentives and legislation, are being explored to enhance immunisation rates.
Purpose of the Study:
- To assess immunisation uptake among children in formal day care before policy changes.
- To understand parental and carer attitudes towards state and federal immunisation incentive strategies.
- To identify factors associated with incomplete immunisation in this population.
Main Methods:
- A random sample of 60 child care centers and 300 family day carers in suburban Melbourne was surveyed in 1997.
- Data on immunisation status, service use, and views on incentives were collected from parents of children under three.
- Statistical analysis, including logistic regression, was used to identify factors associated with immunisation status.
Main Results:
- Complete immunisation was documented in 84% of 1,779 children.
- Factors associated with incomplete immunisation included low income, larger family size, and exclusive use of a doctor.
- Minor illnesses and work commitments were primary reasons for delayed immunisation; preferred service delivery included Maternal and Child Health visits, evening sessions, and day care.
Conclusions:
- Flexible, client-centered immunisation services are recommended.
- Government incentives and legislation may effectively increase immunisation levels in formal child care settings.
- Improved documentation and updating of immunisation status by child care providers are necessary.
Objectives:
To determine immunisation uptake in children attending formal day care prior to the introduction of certificates (state) and parent incentives (federal), and to document parent and child carers' attitudes to these strategies.
Method:
In 1997, 60 child care centres and 300 family day carers in suburban Melbourne were randomly sampled. Immunisation dates, service use and preference, and views on government incentives were obtained from parents of children under three years of age.
Results:
From 2,454 eligible children, information was obtained for 1,779, of whom 84% (95% CI 82-86) were completely immunised. Low income (OR 1.8, 95% CI 1.2-1.9, p < or = 0.001) and larger family size (OR 1.8, 95% CI 1.2-2.7, p = 0.002) and only ever using a doctor (OR 1.6, 95% CI 1.1-2.3) was associated with incomplete immunisation. Main reasons for delaying immunisation were occurrence of minor illness and work commitments. Families would prefer immunisation services at Maternal and Child Health visits (39%), evening sessions (22%) and at day care (22%). Immunisation uptake could increase to 94% if those receiving Childcare Assistance (67%) immunised their children on time but would increase to 87% if these incentive only motivated those for whom Childcare Assistance was essential (15%). While 98% of day care co-ordinators and 71% of family day care co-ordinators documented immunisation status at commencement of child care, only 51% and 33% respectively regularly updated this information.
Conclusion:
Providing client-focused, flexible immunisation services and government incentives and legislation may work together to boost immunisation levels for those in formal child care.