Socio-economic and demographic factors influencing immunisation access in children of self-settled Mozambican refugees and South African children in the Agincourt sub-district, Mpumalanga, South Africa.
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Date
2011
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Abstract
Immunisations are one of the most important interventions to decrease mortality and provide
a foundation for a successful health system. Eliminating disparities in immunisation access is
needed to meet immunisation coverage goals. Although migrants have been identified as
influencing recent measles outbreaks in South Africa, research on access to immunisations is
lacking for migrants in the country. Numerous barriers to accessing health care have been
reported for international migrants in South Africa despite official policies of equal access.
Children of Mozambican refugees may be a vulnerable group and not being immunised
because of their migration status or other socio-economic and demographic factors.
This study aims to determine immunisation rates in rural South Africa and identify socioeconomic
and demographic factors influencing immunisation access including being a child
of a refugee. All children under 5 years during 2003 and 2006 censuses in the Agincourt subdistrict,
Mpumalanga, South Africa (N=17,532) are included in this retrospective, nested
cross-sectional multivariate analysis of immunisation access community level data.
Immunisation rates are approximately 85% for the first immunisation but rates for subsequent
dosing decreased and only 5% of children of appropriate age obtained all immunisations on
the South African immunisation schedule. Children of former Mozambican refugees were
significantly more likely to be immunised than South African children (OR=1.59, p=0.018)
controlling for other socio-economic and demographic characteristics. Children who lived in a
village with a clinic (OR=1.43, p=0.015), children with older mothers (OR=1.02, p=0.028),
and children in households with higher wealth (OR=1.13, p=0.033) were also more likely to
be immunised. Strategies for increasing immunisation access should focus on delivery of
services to villages without health care facilities, providing support and outreach to poorer
and younger mothers, and ensuring continuing engagement with the immunisation
programme.
This study adds to the sparse existing research on predictors of immunisation access in South
Africa as well as health care access for refugees in South Africa. This research shows that
health care access can be higher for international migrants than the host population.
Policymakers can use this research to target vulnerable groups to decrease disparities.
Description
Thesis (M.Dev.Studies)-University of KwaZulu-Natal, Durban, 2011.
Keywords
Immunisation of children--Mpumalanga--Agincourt., Refugees--Medical care--Mpumalanga--Agincourt., Immigrants--Medical care--Mpumalanga--Agincourt., Mozambicans--Mpumalanga--Agincourt., Theses--Development studies.