Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004–2016
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Data
2.2. Sociodemographic and District Factors
2.3. Statistical Analysis
3. Results
4. Discussion
Study Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
Informed Consent
References
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2004 | 2010 | 2016 | All Years | |
---|---|---|---|---|
Island of residence Papua | Reference | Reference | Reference | Reference |
Java-Bali | 1.2 (0.61–2.36) | 4.38 (2.25–8.51) ** | 1.53 (0.94–2.48) | 4.46 (3.34–5.97) ** |
Sumatra | 0.79 (0.43–1.44) | 2.03 (1.1–3.73) * | 0.81 (0.52–1.25) | 2.14 (1.62–2.83) ** |
Kalimantan | 1.00 (0.54–1.87) | 2.52 (1.32–4.79) * | 1.47 (0.93–2.33) | 2.59 (1.89–3.55) ** |
Sulawesi | 1.85 (0.99–3.44) | 5.65 (2.99–10.7) ** | 1.53 (0.97–2.41) | 4.37 (3.24–5.9) ** |
Other islands (Nusa Tenggara, Maluku) | 1.17 (0.6–2.28) | 4.23 (2.2–8.13) ** | 1.25 (0.78–1.99) | 3.1 (2.26–4.27) ** |
Living area Rural | Reference | Reference | Reference | Reference |
Urban | 1.14 (1.05–1.23) * | 1.19 (1.1–1.28) ** | 1.24 (1.11–1.37) ** | 1.16 (1.13–1.18) ** |
Birth attended by health professional No | Reference | Reference | Reference | Reference |
Yes | 1.57 (1.46–1.7) ** | 1.61 (1.48–1.75) ** | 1.97 (1.71–2.26) ** | 1.53 (1.5–1.56) ** |
Mother’s age 20 years | Reference | Reference | Reference | Reference |
21–30 years | 1.15 (1.02–1.29) * | 1.19 (1.05–1.35) * | 1.3 (1.09–1.54) * | 1.15 (1.11–1.19) ** |
>30 years | 1.13 (0.99–1.29) | 1.32 (1.15–1.53) ** | 1.44 (1.2–1.73) ** | 1.27 (1.22–1.32) ** |
Mother’s educational level Primary | Reference | Reference | Reference | Reference |
Secondary | 1.21 (1.13–1.31) ** | 1.34 (1.24–1.46) ** | 1.3 (1.18–1.44) ** | 1.3 (1.27–1.33) ** |
Higher | 1.37 (1.19–1.58) ** | 1.43 (1.26–1.63) ** | 1.42 (1.24–1.63) ** | 1.39 (1.34–1.44) ** |
Mother’s working status No | Reference | Reference | Reference | Reference |
Yes | 1.07 (1.00–1.15) * | 1.12 (1.04–1.2) * | 0.99 (0.9–1.08) | 1.04 (1.02–1.06) ** |
Number of children Few | Reference | Reference | Reference | Reference |
Intermediate | 0.92 (0.85–0.99) * | 0.89 (0.82–0.97) * | 0.85 (0.77–0.95) * | 0.87 (0.86–0.89) ** |
Many | 0.72 (0.61–0.84) ** | 0.62 (0.52–0.73) ** | 0.56 (0.44–0.72) ** | 0.66 (0.64–0.7) ** |
Household income | 1.38 (1.29–1.48) ** | 1.36 (1.26–1.46) ** | 1.11 (1.03–1.21) * | 1.27 (1.24–1.29) ** |
Medical resources/1000 population | ||||
Hospitals | 1.19 (1.05–1.34) * | 1.2 (1.04–1.39) * | 1.19 (1.06–1.33) * | 0.95 (0.47–1.91) |
Health centers | 0.41 (0.16–1.09) | 0.88 (0.36–2.15) | 0.63 (0.34–1.16) | 0.94 (0.79–1.11) |
Village health posts | 2.36 (1.76–3.16) ** | 0.91 (0.59–1.41) | 1.37 (1.12–1.69) * | 1.19 (1.15–1.23) * |
Doctors | 1.58 (0.8–3.13) | 0.84 (0.44–1.62) | 0.66 (0.35–1.26) | 1.2 (1.07–1.35) * |
Other health workers | 0.65 (0.45–0.93) * | 1.03 (0.9–1.18) | 0.91 (0.84–0.99) * | 0.97 (0.95–0.98) * |
Between-district variance | 0.17 | 0.24 | 0.53 | 0.16 |
ICC | 0.67 | 1.06 | 0.13 | 0.61 |
Median odds ratio | 2.19 | 2.67 | 2. | 2.11 |
Island | Hospitals/1000 pop | Health Centers/1000 pop | Integrated Health Posts/1000 pop | Doctors/1000 pop | Other Health Worker/1000 pop |
---|---|---|---|---|---|
Papua | 2.52 (0.21–29.73) | 1.82 (1.26–1.52) * | 1.61 (1.37–1.9) ** | 0.64 (0.46–0.89) * | 0.86 (0.81–0.91) ** |
Java | 4.13 (0.91–18.82) | 3.02 (1.09–8.41) * | 1.06 (0.97–1.16) | 0.93 (0.71–1.2) | 1.19 (1.08–1.31) ** |
Sumatera | 1.65 (0.59–4.63) | 0.9 (0.64–1.25) | 1.39 (1.3–1.49) ** | 1.24 (1.03–1.51) * | 0.99 (0.96–1.03) |
Kalimantan | 0.07 (0.00–0.84) * | 0.52 (0.34–0.81) * | 1.01 (0.91–1.13) | 1.26 (0.82–1.94) | 1.09 (1.04–1.16) * |
Sulawesi | 5.75 (0.37–89.55) | 0.52 (0.36–0.76) * | 1.07 (0.97–1.18) | 1.22 (0.84–1.78) | 0.95 (0.91–0.99) * |
2004 n (%) | 2016 n (%) | |
---|---|---|
DTP | ||
Complete | 10,231 (37.83) | 14,329 (75.93) |
Non complete | 16,814 (62.17) | 4542 (24.07) |
Polio | ||
Complete | 10,338 (38.23) | 14,924 (79.24) |
Non complete | 16,703 (61.77) | 3911 (20.76) |
Hepatitis B | ||
Complete | 6948 (25.70) | 13,649 (75.37) |
Non complete | 20,085 (74.30) | 4461 (24.63) |
BCG | ||
Complete | 23,444 (86.70) | 17,472 (92.89) |
Non complete | 3596 (13.30) | 1337 (7.11) |
Measles | ||
Complete | 21,371 (79.05) | 16,003 (85.56) |
Non complete | 5664 (20.95) | 2701 (14.44) |
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Holipah, H.; Maharani, A.; Sujarwoto, S.; Hinoura, T.; Kuroda, Y. Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004–2016. Vaccines 2020, 8, 518. https://doi.org/10.3390/vaccines8030518
Holipah H, Maharani A, Sujarwoto S, Hinoura T, Kuroda Y. Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004–2016. Vaccines. 2020; 8(3):518. https://doi.org/10.3390/vaccines8030518
Chicago/Turabian StyleHolipah, Holipah, Asri Maharani, Sujarwoto Sujarwoto, Takuji Hinoura, and Yoshiki Kuroda. 2020. "Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004–2016" Vaccines 8, no. 3: 518. https://doi.org/10.3390/vaccines8030518
APA StyleHolipah, H., Maharani, A., Sujarwoto, S., Hinoura, T., & Kuroda, Y. (2020). Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004–2016. Vaccines, 8(3), 518. https://doi.org/10.3390/vaccines8030518