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Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004-2016

Holipah Holipah1,2, Asri Maharani3, Sujarwoto Sujarwoto4

  • 1Faculty of Medicine, Universitas Brawijaya, Malang, Jawa Timur 65145, Indonesia.

Vaccines
|September 15, 2020
PubMed

Insights

Indonesia

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Despite high initial vaccination rates, Indonesia faces challenges in DTP3 immunization completion.
  • Coverage remains below recommended standards by UNICEF and WHO.
  • Understanding determinants of DTP3 immunization is crucial for public health interventions.

Purpose of the Study:

  • To analyze trends and spatial disparities in DTP3 immunization coverage in Indonesia.
  • To identify individual and district-level social determinants of DTP3 immunization.
  • To inform strategies for improving DTP3 immunization rates.

Main Methods:

  • Multilevel analysis of nationally representative data (Susenas and Podes) from 2004-2016.
  • Inclusion of 305,090 children aged 12-23 months across ~500 districts.
  • Examination of demand and supply-side factors influencing DTP3 immunization status.

Main Results:

  • DTP3 immunization coverage increased from 37.8% in 2004 to 75.9% in 2016.
  • Individual factors like income, parity, education, and professional birth attendants significantly influenced coverage.
  • District-level factors showed variation, with island disparities, health service density, and socioeconomic status being key.

Conclusions:

  • Significant progress in DTP3 immunization coverage has been made, but disparities persist.
  • Addressing socioeconomic factors and improving health service access are vital for equitable immunization.
  • Targeted interventions are needed to overcome geographical and socioeconomic barriers to DTP3 completion.

Keywords:
DTP3 immunizationmultilevel analysissocial determinantsspatial disparities

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