科研之友
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摘要
This study analysed reports of infant immunisation from 331 districts across 7 regions of Afghanistan between 2000 and 2003. Geographic information system (GIS) analysis was used to visualise the distribution of immunisation coverage in districts and to identify geographic inequalities in the process of improvement of infant immunisation coverage. The number of districts reporting immunisation coverage increased substantially during the four years of the study. Progress in Bacillus Calmette-Guerin (BCG) immunisation coverage was observed in all 7 regions, although satisfactory coverage of 80% remained unequally distributed. Progress in the third dose of Diphtheria-Pertussis-Tetanus (DPT3) immunisation differed among regions, in addition to the unequal distribution of immunisation coverage in 2000. The results of multivariate logistic regression analysis indicated a significant negative association between lack of security in the region and achievement of 80% coverage of immunisation regardless of available resources for immunisation, while resource availability showed no relation to immunisation coverage.Although progress was observed in all 7 regions, geographic inequalities in these improvements remain a cause for concern. The results of the present study indicated that security within a country is an important factor for affecting the delivery of immunisation services.More than 95% of the 14 million deaths of children under 5 years old around the world occur in developing countries. Moreover, at least 70% of these deaths are due to diseases that can be prevented by vaccination [1,2]. Of 165 countries where immunisation coverage data are available, 20% have failed to achieve 80% coverage of Diphtheria-Pertussis-Tetanus (DPT) immunisation for infants. Moreover, 10% of these countries have failed to achieve even 50% coverage [3]. Afghanistan is one such country, which has not achieved reasonable coverage of infant immunisation.Provision of immunisation services to a
