期刊
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
卷 106, 期 -, 页码 105-114出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ijid.2021.03.067
关键词
Migration; Childhood vaccination; Kenya; Sub-Saharan Africa; Inverse probability of treatment weighting; Multiple imputation
资金
- Michigan Global Institute for Vaccination Equity as part of JMP's doctoral studies
This study in Kenya found that maternal migration status and mobility within the country did not significantly affect childhood vaccination behavior, suggesting that characteristics enabling migration may play a bigger role in vaccination behavior than the migration process itself.
Objectives: Kenya has substantially improved child mortality between 1990 and 2019, with under-5 mortality decreasing from 104 to 43 deaths per 1000 live births. However, only two-thirds of Kenyan children receive all recommended vaccines by 1 year, making it essential to identify undervaccinated subpopulations. Internal migrants are a potentially vulnerable group at risk of decreased access to healthcare. This analysis explored how maternal migration within Kenya influences childhood vaccination.& nbsp; Methods: Data were from the 2014 Kenya Demographic and Health Survey, a nationally representative cross-sectional survey. Logistic regressions assessed relationships between maternal migration and full and up-to-date child vaccination using inverse probability of treatment weighting. Two exposure variables were examined: migration status and stream (e.g. rural-urban). Multiple imputation was used to impute up-to-date status for children without vaccination cards to reduce selection bias.& nbsp; Results: After accounting for selection and confounding biases, all relationships between migration status and migration stream and full and up-to-date vaccination became statistically insignificant.& nbsp; Conclusions: Null findings indicate that, in Kenya, characteristics enabling migration, rather than the process of migration itself, drive differential vaccination behavior between migrants and non-migrants. This finding is an important deviation from previous literature, which did not rigorously address important biases.& nbsp; (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).
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