Title : Immunization current situation among children under 2 years and CBA women 15 – 49 years in Afghanistan 2022 – 2023
Abstract:
Background: Immunization remains one of the most important public health interventions to reduce child morbidity and mortality. The 2023 National Demographic and Health Community Coverage Survey indicated low full immunization coverage among children aged 12–23 months in Afghanistan. Factors contributing to the low coverage of immunization have been poorly understood. The aim of this study was to identify factors associated with full immunization coverage among children aged 12–23 months in Afghanistan.
Methods: This was a cross-sectional survey that determined the coverage of childhood immunization Afghanistan, 34 provinces with an estimated population of 47 million people. The sample size for this study has been estimated to be 4160 questionnaires and conducted 4132 interviews for identification of immunization coverage of BCG, Penta1, 2 & 3, Measles1,2 and Td1,2,3,4,5 is developed, data cleaned, entered, and analyzed in Excel and Epi Info V7.2.1.
Results: The Specific coverage for BCG was 36.5 %, three doses of DPT+Hib+Hepb, 1st dose 82.03%, 2nd dose 81.2%, 3rd dose 67.3%, measle1 61%, measles2 54.4%, Td1 34%, Td2 32%, Td3 29.5%, Td4 21% and Td5 19%. The multivariable analysis showed that sources of information from vaccination cards 76 % of children and CBA women 83% of women’s awareness of community conversation programs 74.7% and National target for full immunization coverage is 95% but in this survey the Penta3 was 63.03%, Mealse1 was 44.4%, and Measle2 was 20.1% and the zero dose vaccine in penta1 was 17.7% and the community awareness of immunization 54.3%
Conclusion: The overall full immunization coverage in Afghanistan was considerably low compared to the national target. Health service use and access to information on maternal and child health were found to predict full immunization coverage, the coverage of all antigens was very low compared to the NEPI expected rate, dropouts (%) Penta 3 and Measles 1 were higher than the normal range, Caregivers’ literacy was very low, and more families didn’t have knowledge of immunization, appropriate strategies should be devised to enhance health information and accessibility for full immunization coverage by addressing the variations among regions.