Peer-reviewed article
Pentavalent vaccination in Kenya: coverage and geographical accessibility to health facilities using data from a community demographic and health surveillance system in Kilifi County
Morris Ondieki Ogero, James Orwa, Rachael Odhiambo, Felix Agoi, Adelaide M. Lusambili et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined pentavalent vaccine coverage and geographical access to health facilities in two rural sub-counties in Kenya. Overall vaccination coverage was 77.3%, but children living more than one hour's travel time from a health facility were significantly less likely to be vaccinated. The research shows that geographical barriers to healthcare are a major obstacle to immunisation in rural areas, and suggests that improving road networks, establishing new health centres, or providing mobile vaccination services could increase coverage.
Key points
- Pentavalent vaccine coverage was 77.3% in the study area
- The median travel time to a health facility was 41 minutes, with 28.5% of children living more than one hour away
- Children living more than one hour's travel time from a facility had 16% reduced odds of being vaccinated (AOR = 0.84)
- Geographical accessibility to health facilities significantly affected immunisation coverage
- The study recommends improving road networks, establishing new health centres, and scaling up outreach vaccination services in remote areas
Limitations
The study is limited to two sub-counties in one coastal county in Kenya, so findings may not generalise to other regions with different geography, infrastructure, or health system characteristics. The research design measures associations but cannot definitively determine causality.
Abstract
BACKGROUND: There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The third dose of pentavalent vaccine for children is an important indicator for assessing performance of the immunisation programme because it mirrors the completeness of a child's immunisation schedule. Spatial access to an immunizing health facility, especially in sub-Sahara African (SSA) countries, is a significant determinant of Pentavalent 3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of Pentavalent 3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya. METHODS: We used longitudinal survey data from the health demographic surveillance system implemented in Kaloleni and Rabai Sub-counties in Kenya. To compute the geographical accessibility, we used coordinates of health facilities offering immunisation services, information on land cover, digital elevation models, and road networks of the study area. We then fitted a hierarchical Bayesian multivariable model to explore the effect of travel time on pentavalent vaccine coverage adjusting for confounding factors identified a priori. RESULTS: Overall coverage of pentavalent vaccine was at 77.3%. The median travel time to a health facility was 41 min (IQR = 18-65) and a total of 1266 (28.5%) children lived more than one-hour of travel-time to a health facility. Geographical access to health facilities significantly affected pentavalent vaccination coverage, with travel times of more than one hour being significantly associated with reduced odds of vaccination (AOR = 0.84 (95% CI 0.74 - 0.94). CONCLUSION: Increased travel time significantly affects immunization in this rural community. Improving road networks, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county could improve immunisation coverage. These data may be useful in guiding the local department of health on appropriate location of planned immunization centres.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Geographical accessibility analysis to identify barriers and inform placement of immunisation services; recommendations for improving road networks, establishing new health centres, and scaling up outreach vaccination activities
- Population
- Children in Kaloleni and Rabai Sub-counties, Kilifi County, Kenya
Key finding
Overall pentavalent vaccine coverage was 77.3%