Sasaki, Satoshi and Igarashi, Kumiko and Fujino, Yasuyuki and Comber, Alexis and Brunsdon, Chris and Muleya, Clala Mbwili and Suzuki, Hiroshi
(2010)
The impact of community-based outreach
immunisation services on immunisation coverage
with GIS network accessibility analysis in peri-urban
areas, Zambia.
Journal of Epidemiology and Community Health, 65 (12).
pp. 1171-1178.
ISSN 1470-2738
Abstract
determinant for health outcome.
Objectives To examine the association between
immunisation coverage and distance to an immunisation
service as well as socio-demographic and economic
factors before and after the introduction of outreach
immunisation services, and to identify optimal locations
for outreach immunisation service points in a peri-urban
area in Zambia.
Methods Repeated cross-sectional surveys were
conducted for two groups of children born between 1999
and 2001, and between 2003 and 2005.The association
between immunisation coverage for DPT3 and measles,
and access distance, child sex, female headed
households, and monthly household income were
assessed using logistic regression analysis. Optimal
locations for outreach service points were identified
using GIS network analysis and genetic algorithms.
Results Before the introduction of outreach services,
longer distances to the service points were associated
with lower DPT3 and measles immunisation coverage
(OR¼0.24, 95% CI 0.10 to 0.56, p<0.01 for DPT3; and
OR¼0.38, 95% CI 0.17 to 0.83, p<0.05 for measles).
However, access distances were not an impediment to
immunisation coverage once the outreach services were
introduced. The average distance to immunisation
services could be decreased from 232.3 to 168.4 metres
if the current 12 outreach service points were
repositioned at optimal locations.
Conclusion Access distance to immunisation services
was a critical determinant of immunisation coverage in
a peri-urban area. Intervention via outreach services
played an important role in averting the risk of missing
out on immunisation. Optimal location analysis has the
potential to contribute to efficient decision making
regarding the delivery of immunisation services.
| Item Type: |
Article
|
| Keywords: |
community-based outreach; immunisation services; immunisation coverage; GIS network accessibility analysis in peri-urban;
areas; Zambia; |
| Academic Unit: |
Faculty of Science and Engineering > Research Institutes > National Centre for Geocomputation, NCG |
| Item ID: |
5864 |
| Identification Number: |
https://doi.org/10.1136/jech.2009.104190 |
| Depositing User: |
Prof. Chris Brunsdon
|
| Date Deposited: |
19 Feb 2015 09:57 |
| Journal or Publication Title: |
Journal of Epidemiology and Community Health |
| Publisher: |
BMJ Publishing Group |
| Refereed: |
Yes |
| URI: |
|
| Use Licence: |
This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available
here |
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