1
|
Zhou Y, Li D, Cao Y, Lai F, Wang Y, Long Q, Zhang Z, An C, Xu X. Immunization coverage, knowledge, satisfaction, and associated factors of non-National Immunization Program vaccines among migrant and left-behind families in China: evidence from Zhejiang and Henan provinces. Infect Dis Poverty 2023; 12:93. [PMID: 37833775 PMCID: PMC10571434 DOI: 10.1186/s40249-023-01145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Migrant and left-behind families are vulnerable in health services utilization, but little is known about their disparities in immunization of non-National Immunization Program (NIP) vaccines. This study aims to evaluate the immunization coverage, knowledge, satisfaction, and associated factors of non-NIP vaccines among local and migrant families in the urban areas and non-left-behind and left-behind families in the rural areas of China. METHODS A cross-sectional survey was conducted in urban areas of Zhejiang and rural areas of Henan in China. A total of 1648 caregivers of children aged 1-6 years were interviewed face-to-face by a pre-designed online questionnaire, and their families were grouped into four types: local urban, migrant, non-left-behind, and left-behind. Non-NIP vaccines included Hemophilus influenza b (Hib) vaccine, varicella vaccine, rotavirus vaccine, enterovirus 71 vaccine (EV71) and 13-valent pneumonia vaccine (PCV13). Log-binomial regression models were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the difference on immunization coverage of children, and knowledge and satisfaction of caregivers among families. The network models were conducted to explore the interplay of immunization coverage, knowledge, and satisfaction. Logistic regression models with odds ratios (ORs) and 95% CIs were used to estimate the associated factors of non-NIP vaccination. RESULTS The immunization coverage of all non-NIP vaccines and knowledge of all items of local urban families was the highest, followed by migrant, non-left-behind and left-behind families. Compared with local urban children, the PRs (95% CIs) for getting all vaccinated were 0.65 (0.52-0.81), 0.29 (0.22-0.37) and 0.14 (0.09-0.21) among migrant children, non-left-behind children and left-behind children, respectively. The coverage-knowledge-satisfaction network model showed the core node was the satisfaction of vaccination schedule. Non-NIP vaccination was associated with characteristics of both children and caregivers, including age of children (> 2 years-OR: 1.69, 95% CI: 1.07-2.68 for local urban children; 2.67, 1.39-5.13 for migrant children; 3.09, 1.23-7.76 for non-left-behind children); and below caregivers' characteristics: family role (parents: 0.37, 0.14-0.99 for non-left-behind children), age (≤ 35 years: 7.27, 1.39-37.94 for non-left-behind children), sex (female: 0.49, 0.30-0.81 for local urban children; 0.31, 0.15-0.62 for non-left-behind children), physical health (more than average: 1.58, 1.07-2.35 for local urban children) and non-NIP vaccines knowledge (good: 0.45, 0.30-0.68 for local urban children; 7.54, 2.64-21.50 for left-behind children). CONCLUSIONS There were immunization disparities in non-NIP vaccines among migrant and left-behind families compared with their local counterparts. Non-NIP vaccination promotion strategies, including education on caregivers, and optimization of the immunization information system, should be delivered particularly among left-behind and migrant families.
Collapse
Affiliation(s)
- Yaguan Zhou
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Duanhui Li
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yuan Cao
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
- Songxian Center for Disease Control and Prevention, Luoyang, Henan, China
| | - Fenhua Lai
- Department of Immunoprophylaxis, Xiaoshan Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yu Wang
- Global Health Research Center, Division of Social Sciences, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Zifan Zhang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Chuanbo An
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaolin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China.
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
| |
Collapse
|
2
|
A Systematic Scoping Review on Migrant Health Coverage in Thailand. Trop Med Infect Dis 2022; 7:tropicalmed7080166. [PMID: 36006258 PMCID: PMC9415742 DOI: 10.3390/tropicalmed7080166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Thailand is a major migrant receiving country and pioneer of migrant health policy in the ASEAN region. However, on the ground, coverage of migrants is faced with multiple barriers. (2) Objectives: We aim to scope and analyse the types of available evidence on migrant health coverage in Thailand and identify knowledge gaps. Specifically, we characterise the literature along year of publication, migrant subpopulation, health domain, scope of coverage, methods, study design, objectives and results. (3) Methods: We searched PubMed, Web of Science, Google Scholar, Cochrane Database, Worldwide Science and the Asian Citation Index for peer-reviewed and grey literature in October 2021 for studies analysing original data on health coverage of migrants in Thailand. To conceptualise health coverage, we used the three dimensions availability, accessibility and acceptability. (4) Results: 101 articles were included in the final analysis. Sixty-three were published after 2016, 39 focused on migrant workers and 18 on migrants in general. Forty-two concentrated on health in broader terms, followed by reproductive and maternal health (n = 31). Thirty-eight assessed coverage of specific services and 36 health coverage in general. Migrants themselves and key informants were the main data sources in 80 and 43 of the articles, respectively. Forty publications were qualitative, while 38 applied quantitative methods (22% descriptive; 7% analytical). Among the health coverage components, 79 articles included aspects of accessibility, followed by acceptability (n = 59) and availability (n = 30). (5) Conclusions: While there is a high number and broad range of studies on migrant health coverage in Thailand, we found that research on migrant subgroups, such as victims of trafficking and migrant children, as well as on the health domains, non-communicable diseases and occupational and mental health is neglected.
Collapse
|
3
|
Ke X, Zhang L, Li Z, Tang W. Inequality in health service utilization among migrant and local children: a cross-sectional survey of children aged 0-14 years in Shenzhen, China. BMC Public Health 2020; 20:1668. [PMID: 33160326 PMCID: PMC7648970 DOI: 10.1186/s12889-020-09781-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Shenzhen is characterized with the largest scale of migrant children among all the cities in China. Unequal access to health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in using community-based healthcare between local and migrant children and to identify the influencing factors in Futian District of Shenzhen. Methods Households in 12 communities in Futian District of Shenzhen were randomly sampled. Children aged 0–14 years were investigated using self-administered questionnaire - the 2018 Survey of Health Service Needs of Chinese Residents. Differences in healthcare including physical examination, feeding guidance, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance, and mental health guidance, were tested between local and migrant children. Binary logistic regressions were used in identifying potential influencing factors which affected the use in the above healthcare items. Results A total of 936 participants from1512 families were sampled and 508 of them were included. Compared with local children, migrant children had less use of development guidance (OR = 0.417, 95% CI: 0.279–0.624) and oral health care guidance (OR = 0.557, 95% CI: 0.381–0.813). Children whose father received higher education level enjoyed a better use of disease prevention guidance as compared to whose father stopped at junior high school education or below (senior high vs junior high and below, OR = 1.286, 95% CI: 0.791–2.090; bachelor and above vs junior high and below, OR = 2.257, 95% CI: 1.417–3.595). Children whose fathers were blue-collar workers had less use of injury prevention guidance (OR = 0.750, 95% CI: 0.334–1.684) and mental health guidance (OR = 0.784, 95% CI: 0.295–2.080) as compared to whose father were white collar workers. Conclusions Except feeding guidance, healthcare utilization were lower among migrant children than among local children. Generally, fathers have a stronger influence on children’s use of community-based healthcare than mothers do. The potential influence of fathers in promoting children’s healthcare use behaviors should be carefully considered, and fathers’ attention to children’s health should be increased.
Collapse
Affiliation(s)
- Xiatong Ke
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, 211198, PR China.,Center for Pharmacoeconomics and Outcomes Research of China Pharmaceutical University, Nanjing, Jiangsu, 211198, PR China
| | - Liang Zhang
- School of Medical and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, PR China.,Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, Hubei, 430030, PR China
| | - Zhong Li
- School of Medical and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, PR China.,Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, Hubei, 430030, PR China
| | - Wenxi Tang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, 211198, PR China. .,Center for Pharmacoeconomics and Outcomes Research of China Pharmaceutical University, Nanjing, Jiangsu, 211198, PR China.
| |
Collapse
|