Cross-sectional Investigation And Analysis Of Childhood Immunization Program In Floating Children In Dongguan

Childhood immunization program is based on the epidemic situation monitoring and analysis of population immunity, in accordance with the provisions of immunization procedures, it plans to use the vaccine for vaccination to increase population immunity levels, to control and eventually eradicate infectious diseases for the purpose, it is most economical, the most effective, the most convenient means in our country at present. Since 1978, China joined in EPI established by WHO, we achieved noteworthy achievements. With socio-economic development, reform, the floating children has become a large group. Because of their own peculiarities constrained by many factors and the impact, planned immunization work of floating children often difficult to implement, resulting in vaccination rates and low immunization coverage, or even blank immune phenomenon. How to improve the mobile population immunization work to improve floating children immunization rate and immunization services quality, and lower immunization rates against infectious diseases, protecting the health of children, health departments at all levels have become issues of common concern.Dongguan is the most important floating population inflowing city of Guangdong province. According to Statistics Bureau of Dongguan City, in 2005 the total population of Dongguan City is 8.6536 million, in whom the population of local household registration is 1.5772 million, 6.0764 million is the floating population, the floating population is about four times as large as the resident population. Dongguan City from 2000 to local resident child immunization program implemented computer management, obtained the good effect, But most of the city's floating children have not yet implemented effective management for a variety of reasons, floating children's immunization status, such as routine immunization coverage rate of five EPI, vaccination rates and the influencing factors of them have not yet conducted a comprehensive investigation and study. Accordingly, this project investigated and analyzed the floating children immunization status and influence factors between Sep, 2006 to Oct, 2007, and proposed some management strategies and measures.Objective:Through this investigation, understood the current status of Childhood immunization program about floating children in Dongguan, to analyze the problems and difficulties of the Childhood immunization program about Floating Children, and to provide the strategy and control measures, promote the immunization program work in Dongguan full scale development.Methods:According to geographical feature and custom of Dongguan, The whole city division is 4 areas, there are 32 towns (streets) in Dongguan, Each area draws to 1 town (street) as the investigation scene, each investigation scene stochastically extracts 1 village takes the investigation sample. Investigates its all 0 - 6 years old of floating child's age, the sex, the birth hospital, the housing time and the floating reason, the basic vaccine immunity situation, card and vaccine immunity vaccination immunization program present situation and so on. Simultaneously develops the guardian planned immunization program vaccination correlation knowledge the questionnaire survey and investigating the service situation of prophylaxis inoculation outpatient service.Results:983 floating children were investigated, 412 children were local household registers, the 0 - 3 years old children accounts for 72.72%of floating children, the sex ratio male to female is 1.33: 1, approximately 46% children's housing time is less than 1year, about 75%of floating children follows their parents to do business or work. The rates of setting vaccination card, vaccination certificates were85.35 %, and 88.20 % separately during the invested floating children. Those children's routine immunization vaccination rates were as follow: vaccination rate of BCG was 80.44%,OPV was91.64%, DPT was 85.12%,MV was 84.01% and HepB was 89.79% , routine immunization coverage rate of five vaccines was 76.14%;Strengthening vaccination rates were as follow: strengthening rate of OPV was 86.19%,DPT was 81.64%,and MV was 80.32%。The rates of setting vaccination card, vaccination certificates and immunization vaccination were lower who was floating children.Through investigation we found, vaccination rates of children who was born in the county or above level hospital were higher than the children who was born in the township level hospital or born in the home, those children's vaccination rates were lower who came from village. Children who had longer housing time in the town, whose immunity coverage rate was higher and the higher of the knowledge level the higher of the vaccination rates. Routine immunization coverage rate of five vaccines of children who had vaccination certificates or appointment was 82.85%, it was higher than children who had no appointment remarkably(48.75%). Why don't they vaccinate the vaccine? We found that "did not know must vaccinate" and "does not know the vaccination time, the place" are the main reason. Only 38.23% guardians who known children should vaccinate BCG and HepB, only 22.68% guardians who known children should vaccinate"five vaccines".Conclusions:1. This article has investigated the current status of Childhood immunization program about floating children in Dongguan, the rates of setting vaccination card, vaccination certificates and outine immunization coverage rate of five vaccines of floating children are lower than the local house hold register child, the situation anxious.2. The reasons of lower vaccination rates in floating children is as follow, firstly, the life of floating children is unstable, the living conditions is generally worse, The housing time is shorter and guardians have insufficiency understanding to immunity vaccination; Secondly, Basic unit immunity organization understaffed, the quality of people is somewhat low, takes insufficiently, the funds insufficiency, the propaganda does not arrive and so on. Above the multitudinous factor mutually affected, mutually affects has created the floating children prophylactic inoculation work relative lag。3. Proposed the strengthened government responsibility, establish steady financial guarantee mechanism; broken restriction of household register system, implementation management network based on where the people live and work; strengthens childhood immunization program service network of the basic unit; improve the service model of the floating children prophylactic inoculation; develop health education of immunization program; found interdepartmental coordination mechanism; attach importance to management and suggestion of vaccines inoculation side reaction.