From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

Eastern Mediterranean Health Journal – EMHJ
Vol. 24 No. 4 – 2018
Research article
Provincial differences in levels, trends, and determinants of child-hood immunization in Pakistan
Adrienne Kols,1 Zulfikar Gorar,2 Muhammad Sharjeel,3 Farid Midhet,4 Rashid Nazir,4 Dileep Kumar 5 and Aslam Fareed 4
1Jhpiego, Baltimore, Maryland, United States of America (Correspondence to: Adrienne Kols: 2USAID/Pakistan, Karachi, Pakistan. 3Marie Stopes Society, Karachi, Pakistan; Pathfinder International, Karachi, Pakistan (current). 4Jhpiego/Pakistan, Karachi, Pakistan. 5JSI Research & Training Institute, Inc., Karachi, Pakistan; USAID/Pakistan, Karachi, Pakistan (current).
Background: Efforts to improve immunization rates are urgently needed in Pakistan but national statistics mask impor­tant local differences in immunization levels and determinants.
Aim: In this study we aimed to determine how similar or different are recent trends and levels of immunization coverage in Pakistan’s 4 main provinces [Punjab, Sindh, Khyber Pakhtunkhwa (KPK) and Balochistan], and what factors are associ­ated with complete childhood immunization in each province.
Method: We analysed data from the 2006–07 and 2012–13 Pakistan Demographic and Health Surveys. Trends in immuni­zation coverage among children aged 12–23 months were calculated for each province. Bivariate and multivariate analyses were conducted to identify factors associated with complete immunization.
Results: The proportion of children completely immunized had risen significantly in Punjab but had fallen significantly in Balochistan. Complete coverage ranged from 16.4% in Balochistan to 65.8% in Punjab (2012–13). Tetanus toxoid injection during pregnancy was a significant predictor of complete immunization everywhere. Other predictors in specific prov­inces were: urban residence in Balochistan, wealth in Sindh and KPK, mother’s education in Punjab and KPK, and distance to the facility in Punjab.
Conclusions: Although some strategies to increase immunization coverage are relevant nationwide, programme manag­ers need to seek solutions specific to provincial trends and predictors. This analysis demonstrates that viewing childhood immunization in Pakistan through a provincial lens can help achieve a deeper understanding of the challenges and po­tential strategies to boost coverage.