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首页> 外文期刊>Vaccine >Are hard-to-reach populations being reached with immunization services? Findings from the 2005 Papua New Guinea national immunization coverage survey
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Are hard-to-reach populations being reached with immunization services? Findings from the 2005 Papua New Guinea national immunization coverage survey

机译：免疫服务是否覆盖了难以触及的人群？ 2005年巴布亚新几内亚全国免疫接种覆盖率调查的结果

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Objective: To measure immunization coverage among children aged 12-23 months in Papua New Guinea (PNG) and to assess if and why there are differences between hard-to-reach and more accessible communities.Methods: WHO cluster sampling methodology was employed to measure immunization coverage in PNG's four regions. Survey data were re-analyzed according to a local assessment of geographical accessibility indicated by census unit type: urban, rural and hard-to-reach. Census units were designated as hard-to-reach if they were five or more kilometres from a health centre.Findings: Nationwide coverage for most antigens falls below the national target of 80% although there are regional differences with Islands performing the best. Late doses are a major concern: just 4% were fully immunized with valid ("on time") doses by 1 year of age. Coverage was lower in both rural and remote communities: at 6 months 48% of children from urban units had received three valid doses of DTP-3 but only 16% in rural areas and 13% in hard-to-reach communities. Reasons for failure to immunize varied: 21% of mothers said their child was not immunized because distance, travel conditions or cost of transportation prevented access to local health centres; 27% cited a lack of knowledge or misconceptions about immunization; while 29% believed it was because of an issue with the health system.Conclusions: Throughout PNG there is an urgent need to increase immunization coverage and to ensure that children are immunized on time according to the schedule. Both coverage and timeliness of doses are worse for children living in hard-to-reach and rural areas. Achieving national immunization targets requires improvements in health service delivery, including outreach, especially for remote and rural communities, as well as greater community education and social mobilisation in support of immunization services
机译：目的：测量巴布亚新几内亚（PNG）12至23个月大儿童的免疫接种覆盖率，并评估难以及近和较易接近社区之间是否存在差异以及为何存在差异。方法：采用WHO整群抽样方法进行测量巴布亚新几内亚四个地区的免疫接种覆盖率。根据对普查单位类型（城市，农村和难以到达的人口普查单位）指示的地理可及性的本地评估，对调查数据进行了重新分析。如果人口普查单位距离卫生中心五公里或更远，则被指定为难以到达的调查结果。发现：尽管有些地区的差异最大，但全国范围内大多数抗原的覆盖率均低于80％的国家目标。后期剂量是一个主要问题：到1岁时，只有4％的人接受有效（“按时”）剂量的完全免疫。农村和边远社区的覆盖率均较低：在6个月时，来自城市单位的儿童中有48％接受了三剂有效的DTP-3，但在农村地区只有16％，在难以到达的社区中只有13％。未能接种疫苗的原因多种多样：21％的母亲说，他们的孩子未进行免疫接种是因为距离，旅行条件或交通费用阻止了他们进入当地医疗中心; 27％的人表示缺乏有关免疫的知识或误解;结论：整个PNG迫切需要增加免疫覆盖率，并确保按时按时对儿童进行免疫，而29％的人则认为这是由于卫生系统存在问题所致。对于生活在难以到达的农村地区的儿童来说，剂量的覆盖范围和及时性都更差。要实现国家免疫目标，就需要改善卫生服务的提供，包括扩大服务范围，尤其是对偏远和农村社区的宣传，以及加强社区教育和社会动员以支持免疫服务

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