Doctor Educationis / The weak routine immunization activities in Nigeria have led to an upsurge of vaccine preventable diseases such as poliomyelitis in the northern parts of the country. This made the federal government to intensify efforts to improve routine immunization activities with various intervention programmes over the years. This commitment of the federal government towards improving routine immunization as a way to promote infant and child survival led to the partnership between the UK Department for International Development (DFID) to support the launching of Partnership for Reviving Routine Immunization in Northern Nigeria (PRRINN) programme in 2006. The programme, implemented in the northern states of Jigawa, Katsina, Yobe, and Zamfara was intended to augment other federal government immunization intervention efforts in improving routine immunizations services. After five years of programme implementation, assessment of the effectiveness of PRRINN had not be undertaken using a survey based immunization coverage to establish how well the primary objectives of the programme are being met in terms of improving routine immunization. This study was designed to evaluate the performance of the PRRINN programme in improving routine immunization coverage in Jigawa State using coverage data from the National Immunization Coverage Survey (NICS) of 2010.

<p>The aim of the study was to describe immunization coverage for DPT, Polio and Measles among children of ages between 12 to 18 months in Kawempe Division and to investigate factors associated with immunization coverage. A cross-sectional survey was conducted in 239 households with children aged between 12-18 months in five villages that were selected through multi-stage cluster sampling. Information on demographic and socio-economic factors and immunization status was obtained from mothers and caretakers. Immunization coverage and analysis of associations between immunization coverage and demographic and socio-economic factors were done.</p>

<p>The aim of the study was to describe immunization coverage for DPT, Polio and Measles among children of ages between 12 to 18 months in Kawempe Division and to investigate factors associated with immunization coverage. A cross-sectional survey was conducted in 239 households with children aged between 12-18 months in five villages that were selected through multi-stage cluster sampling. Information on demographic and socio-economic factors and immunization status was obtained from mothers and caretakers. Immunization coverage and analysis of associations between immunization coverage and demographic and socio-economic factors were done.</p>

Magister Public Health - MPH / The aim of the study was to describe immunization coverage for DPT, Polio and Measles among children of ages between 12 to 18 months in Kawempe Division and to investigate factors associated with immunization coverage. A cross-sectional survey was conducted in 239 households with children aged between 12-18 months in five villages that were selected through multi-stage cluster sampling. Information on demographic and socio-economic factors and immunization status was obtained from mothers and caretakers. Immunization coverage and analysis of associations between immunization coverage and demographic and socio-economic factors were done. / South Africa

研究の目的 : 多変量解析とGISを用いて、乳幼児を対象とする日本の予防接種率の地域差の実態を把握し、その要因を検討する。研究の背景 : 公衆衛生上の課題である予防接種率の地域差の特定と改善を目的として、多様な地域スケールからその要因を分析する研究が行われている。しかしながら、日本における既往研究では個人を対象とした研究が多く、接種率の地域差の検討や関連要因を用いた生態学的研究もほとんど行われてこなかった。研究手法 : 日本の1737の市区町村における7種類19回の予防接種を対象として、重回帰分析と市区町村―都道府県間の階層を用いたマルチレベル分析を行った。被説明変数には推計した2013年から2018年までの予防接種率を、説明変数には9つの個人要因と4つの環境要因を用いた。これらの変数の作成には国勢調査などの政府統計を用いた。予防接種率の分布図と予測モデルの残差プロットを用いて、地理的な関連要因を探索した。結果 : 一人当たり課税所得と乳幼児健診受診率は市区町村レベルで、世帯の児童数は都道府県レベルで全般的に有意な関連を示した。その他の変数は予防接種の種類や接種時期(回数)によって関連の有無が異なった。接種率は西日本で低く、大都市圏で高い傾向がみられた。残差は内陸部と接種率の偏差が大きい地域に多く見られた。考察 : 市区町村の所得格差と都道府県の世帯あたり児童数の差が、地域の接種率の格差に関連すると示唆された。また、人口減少と高齢化が進む小規模地域には接種率に関連する固有の因子が存在する可能性がある。結論 : 接種率の向上には、その地域の社会経済的状況や人口構造、地域の文脈、予防接種の種類、それらの要因の影響するスケールを踏まえた施策が求められる。 / Objective: Examining geographical variation and the factors of infant immunization coverage in Japan. Background: Incomplete vaccination coverage is one of the largest public health threats. Many interdisciplinary studies have investigated factors that might increase immunization rates or cause Vaccine Hesitancy. However, most studies in Japan have focused on individuals and few studies have considered regional disparities of vaccination coverage. Methods: We conducted a multiple regression analysis and a multilevel analysis (municipality-prefecture hierarchy) for 19 vaccinations in 1737 municipalities in Japan, during 2013-2018. The dependent variable was the estimated vaccination rate, and nine individual factors and four environmental factors were used as explanatory variables. Data were collected from publicly available sources. We used distribution maps of vaccination rates and residuals of the predictive models to explore geographical factors. Results: In general, per capita taxable income and infant health checkup rate showed generally significant positive associations at the municipal level, and the number of children in the household negative association at the prefectural level. Other factors showed various associations depending on the type and the timing of vaccines. Vaccination rates were likely to be lower in western Japan and higher in metropolitan areas. Residuals were found mostly in inland areas and areas with large deviations in vaccination rates. Discussion: These results suggested that vaccination rates were associated with regional differences in municipal income inequality and in the number of children per household in prefectures. Smaller villages with declining and aging populations might have unique factors. Conclusions: To increase vaccination coverage among infants, it requires to consider the effect size at various spatial scales, in addition to compositional and contextual effects as the socioeconomic status, demographic structure, the local contexts, and the type of vaccination. / 京都大学 / 修士 / 修士(文学) / Kyoto University / TFtmp