Child immunization Educational attainment of mother
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after the third dose of DPT, is higher than DPT, raises concern. As explained in the 2006 Afghanistan Health Survey Ministry of Public Health 2008, there are several possible reasons for this: 1 recent outreach campaigns provide
measles but not DPT vaccination to populations without regular access to facilities and DPT3 immunizations; 2 some children receive measles vaccination from the health system, but do not have a chance to make sufficient numbers of
visits thereafter to receive all catch-up DPT vaccines; and 3 error in mother’s recall of vaccinations. Any combination of the aforementioned reasons is possible.
Immunization against tuberculosis
The schedule recommended by the WHO on immunization against tuberculosis TB – to give BCG as the first vaccine given at birth – is adopted in Afghanistan. The NRVA 20078 found that almost three-quarters 74 percent of children
aged 12-23 months had received a BCG vaccination. This indicates that these children had at least initial contact with the health care system.
Full immunization
Afghanistan has low rates of full childhood immunization. According to NRVA 20078, full immunization, consisting of BCG, OPV3, DPT3, and measles vaccinations, among children aged 12-23 months, is estimated at only 37 percent.
Furthermore, 15 percent of children have never been immunized. Full immunization rates among urban children were nearly double those among rural children 63 versus 33 percent, and rural children in turn had more than twice the
immunization rate of Kuchi children 13 percent. The low rates of all vaccinations among Kuchi children, which yield the extremely low rate of full vaccination among this migrant population, are cause for concern.
The national full vaccination rate according to the 20078 NRVA was nearly triple that found in the 2005 NRVA 33 percent versus 12 percent. Education was significantly related to full immunization status, with full immunization rates
much higher among educated women 83 percent than non-educated women 35 percent.
Figure 8.2 Percentage of children aged 12-23 months who received full immunization, by province
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Tetanus toxoid coverage
Neonatal tetanus can be prevented by immunizing women of childbearing age with tetanus toxoid TT, typically during pregnancy. A lifetime protection is provided if a woman has received the complete recommended series of 5
immunizations. However, according to WHO, “pregnant women with an inadequate or unknown immunization history should always receive 2 doses of tetanus toxoid-containing vaccine: the first dose as early as possible during pregnancy
and the second dose at least 4 weeks later” WHO 2006.
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Overall, 33 percent of eligible women, according to card and recall combined, received two or more doses of TT immunization status and are considered to be protected against neonatal tetanus. While there were no differences
between urban and rural residents, there was a visible gap in coverage of Kuchi women see Table 8.5. Interestingly,
there does not appear to be a clear association between the TT coverage and level of education. However, this is likely to be a result of a low number of observations in each educational category because 92 percent of women do not have
any formal education. There is also no association between the age at delivery and TT coverage.
Table 8.5 Percentage of women who received TT vaccination, by a residence, b educational attainment, c age at delivery
Selected variables TT doses received
Less than 2 2 or more