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撒哈拉以南非洲零剂量儿童的多层次分析:三次延迟模型研究
Charles S Wiysonge1, Muhammed M B Uthman2, Duduzile Ndwandwe1
1Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parrow Valley, Cape Town 7501, South Africa.
撒哈拉以南非洲的零剂量儿童在弱势群体中最常见,母亲寻求健康的行为是关键预测因素. 政策应将产前护理与疫苗接种相结合,并消除财务障碍.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 儿科 儿科 儿科
背景情况:
- 零剂量儿童在撒哈拉以南非洲地区对普遍免疫接种构成重大障碍.
- 三次延迟模型为理解导致零剂量状态的因素提供了一个框架.
研究的目的:
- 检查与撒哈拉以南非洲零剂量儿童相关的多层次因素.
- 确定零剂量状态的个人,社区和国家层面的决定因素.
主要方法:
- 在28个撒哈拉以南非洲国家 (2015-2024) 分析了来自30500名儿童 (12-23个月) 的人口和健康调查数据.
- 零剂量状态的定义是没有喉,结节炎和百日咳疫苗的第一剂量.
- 应用多级逻辑回归来识别决定因素.
主要成果:
- 总体而言,零剂量患病率为12.19%,在不同国家之间存在显著差异.
- 较差的母亲寻求健康的行为 (OR 12.00) 是最强的预测因素.
- 父亲教育,母亲赋权 (决策,财务障碍,媒体访问),社区识字和国家卫生支出是重要因素.
结论:
- 零剂量儿童集中在弱势群体中,突出了母亲寻求健康行为的关键作用.
- 政策建议包括将产前护理与疫苗接种相结合,针对高平价母亲,增加国家卫生支出.
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