VoICE Immunization Evidence: Geographic inequity
Those living farther from health facilities are less likely to be immunized, or to be immunized on time, than children living closer to facilities.
Key Evidence: An study using GIS to quantify the percent of pregnant women in Mozambique without access to tetanus toxoid (TT) vaccine at varying distances from health facilities estimated that if women cannot travel more than 5 km to a TT immunization site there will be almost 18,000 neonatal tetanus cases each year that could be prevented, costing the country more than US$362 million in treatment costs and lost productivity. Covering 99% of women with TT will currently require people to travel up to 35 km to obtain an immunization.
From the VoICE Editors: GIS, a geospatial information system, is a computer system capable of capturing, storing, analyzing, and displaying geographically referenced information.
Haidari LA, Brown ST, Constenla D et al. 2016. The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique. Vaccine. 34.
Key Evidence: Children in Tanzania living 5 km or greater distance from the nearest healthcare facility were less likely to be immunized than children living less than 5 km from facilities. Compared to children living close a health facility, children far from a health facility had almost three times the risk of missing out on BCG, 84% higher risk of missing the third dose of DTP, and 48% higher risk of missing the first dose of measles-containing vaccine. Of children who did receive BCG, those living more than 5 km from facilities were 26% more likely to received BCG vaccine late than children close to the facility.
Le Polain de Waroux, O., Schellenberg, J.R., Manzi, F., et al. 2013. Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania.. International Health. 5(2).