TY - JOUR
T1 - An epidemiological assessment of immunization programme participation in the Philippines
AU - Friede, Andrew M.
AU - Waternaux, Christine
AU - Guyer, Bernard
AU - De Jesus, Antonio
AU - Filipp, Laura C.
N1 - Funding Information:
CONCLUSION In 1974 the World Health Assembly created the Expanded Programme on Immunization to reduce the morbidity and mortality due to the six target diseases by providing immunization against them for all children of the world by 1990. The director, Dr Ralph H Henderson, recently said: Despite being one of the most powerful and cost-effective means of preventing disease, immunization remains tragically underutilized. In the developing world today (excluding China), less than 20% of children are immunized against diphtheria, pertussis, tetanus, tuberculosis, measles and poliomyelitis. As a consequence, these six diseases kill 10 children and disable 10 more with each passing minute . . . The difficulties which countries face in establishing effective immunization services are primarily those relating to programme management." Although there is some room for technical improvements in the vaccine, it is wider delivery that will have the greatest impact. Even in developed countries, when immunization rates drop, susceptibility to vaccine preventable diseases can return rapidly.20'21 In the middle 1970's, acceptance of pertussis vaccination in the UK declined, due to lay fears of vaccine-associated neurological sequelae. The result was epidemic pertussis in young, non-immunized children.22 The current near eradication of endogenous measles in the US is not the result of a new vaccine: it is the result of applied management. Rigorous local research could give Third World immunization managers the information they need to achieve the same success.8-23 ACKNOWLEDGEMENTS We wish to thank Drs Lorna Labayen, Dennis Labayen, and Lawrence Cross of the International Institute of Rural Reconstruction for help in carrying out the study. Drs William A Reinke and Robert L Parker of the Johns Hopkins University School of Hygiene and Public Health made valuable comments on an earlier manuscript. Dr Carl E Taylor of Johns Hopkins gave invaluable advice and inspiration throughout. We thank Ms Francine Saunders and Mr Jeffrey Lisle for preparation of the manuscript. The field work was funded by the National Fund for Medical Education, and the generous support of the International Institute of Rural Reconstruction.
Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 1985/3
Y1 - 1985/3
N2 - Friede A M (Massachusetts Department of Public Health, Division of Family Health Services, 150 Tremont Street, Boston, MA 02111, USA), Waternaux C, Guyer B, de Jesus A and Filipp L C. An epidemiological assessment of immunization programme participation in the Philippines. International Journal of Epidemiology 1985, 14: 135-142.Because a large proportion of preschool children failed to present for free diphtheria-pertussis-tetanus (DPT) immunizations in a poor, rural area of the Philippines, we undertook an epidemiological analysis of their characteristics. The parents of 159 children were interviewed to determine the demographic, attitudinal, knowledge, and administrative correlates of immunization status.Logistic regression was used to model immunization status. Children were less likely to be immunized if they had a high score on an Adversity Index (composed of measures of the weather, the number of visits the team made, the distance, the appropriateness of the time of day, and miscellaneous problems), if they received health care from a native mother and child health specialist, if a parent was not on the town council, and if pain was an important deterrent. By contrast, many demographic and attitudinal measures that have traditionally been thought to predict health behaviour were not useful discriminators. Recommendations are made for immunization programme management. The general use of this method for programme planning is elaborated.
AB - Friede A M (Massachusetts Department of Public Health, Division of Family Health Services, 150 Tremont Street, Boston, MA 02111, USA), Waternaux C, Guyer B, de Jesus A and Filipp L C. An epidemiological assessment of immunization programme participation in the Philippines. International Journal of Epidemiology 1985, 14: 135-142.Because a large proportion of preschool children failed to present for free diphtheria-pertussis-tetanus (DPT) immunizations in a poor, rural area of the Philippines, we undertook an epidemiological analysis of their characteristics. The parents of 159 children were interviewed to determine the demographic, attitudinal, knowledge, and administrative correlates of immunization status.Logistic regression was used to model immunization status. Children were less likely to be immunized if they had a high score on an Adversity Index (composed of measures of the weather, the number of visits the team made, the distance, the appropriateness of the time of day, and miscellaneous problems), if they received health care from a native mother and child health specialist, if a parent was not on the town council, and if pain was an important deterrent. By contrast, many demographic and attitudinal measures that have traditionally been thought to predict health behaviour were not useful discriminators. Recommendations are made for immunization programme management. The general use of this method for programme planning is elaborated.
UR - http://www.scopus.com/inward/record.url?scp=0021921819&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0021921819&partnerID=8YFLogxK
U2 - 10.1093/ije/14.1.135
DO - 10.1093/ije/14.1.135
M3 - Article
C2 - 3872849
AN - SCOPUS:0021921819
SN - 0300-5771
VL - 14
SP - 135
EP - 142
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 1
ER -