MICS4 Survey Design Workshop Multiple Indicator Cluster Surveys Survey Design Workshop Questionnaire for Children Under Five: Immunization

MICS4 Survey Design Workshop

Multiple Indicator Cluster SurveysSurvey Design Workshop

Questionnaire for Children Under Five:

Immunization


International goals and targetsMillennium Development Goals

MDG 4: Reduce Child Mortality by two thirdsamong children under five

Indicator 4.3 - Proportion of 1 year old childrenimmunized against measles


International goals and targets World Fit for Children

By 2005, reduction in infant and under-five mortality rate by at least 1/3, in pursuit of the goal of reducing it by 2/3 by 2015

Ensure full immunization of children under one year of age at 90% nationally, with at least 80% coverage in every district or equivalent administrative unit

- Extend the benefits of new and improved vaccines and other preventive health interventions to children in all countries (Hepatitis B, Hib, Yellow Fever, etc)

International goals and targets World Fit for Children

Achieve sustainable elimination of vitamin A deficiency by 2010

IndicatorProportion (%) under fives who received at least one

high dose vitamin A supplement within the last 6 months.



Global proportion of one year old children vaccinated against measles; 1980-2007

0%

20%

40%

60%

80%

100%

Source: WHO/UNICEF National Coverage Estimates


MICS Indicators

In MICS4, immunization indicators are defined as:

- The percentage of children aged 12-23 months who received each specific vaccine: BCG, Polio, DPT, Measles, Hepatitis B and Yellow Fever before their first birthday (# 3.1 through 3.6)

- The module also collects information on Vitamin A supplementation for children under age 5


Content

Data on immunization are collected from:

• Vaccination cards

• Mother’s report (when card is not available)


Preparation (1) Obtain country

specific child immunization card(s)


Preparation (2) Obtain the most

current national immunization schedule for children

Age Group VaccineUsual location of

delivery

At birth or by 2 months BCG and OPV (“zero” dose)

Left shoulderBy mouth

2 months or 8 weeks 1st dose of Oral polio Vaccine (OPV)1st dose of pentavalent (Hepatitis B, DPT + Hib)

By mouthBegan Pentavalent in 1999Upper thigh

4 months or 16 weeks 2nd dose of OPV2nd dose of pentavalent

By mouthUpper thigh

6 months or 24 weeks 3rd dose of OPV3rd dose of Pentavalent

By mouthUpper thigh

12 months or 1 year Measles Mumps Rubella (MMR)Yellow Fever (YF)

Upper right arm

18 months or 1 year 6 months

Booster OPV and DPT vaccine

By mouthUpper thigh

45 months or 3 years 9 months

Booster OPV,DPT, MMR

By mouthUpper ThighUpper right arm

15 years plus DT vaccines for pregnant women

Upper right arm


Preparation

(3) Find out about the most recent immunization campaigns

• Polio National Immunization Days• Measles campaigns• Other vaccine campaigns (e.g., Yellow Fever)• Others (to distinguish between antigens and probe

for answers)

Preparation

(4) Obtain samples of Vitamin A capsules to show respondent

WHO/UNICEF recommendation: All children between the ages of 6 to 59 months living in affected areas

should receive one high-dose vitamin A supplement every four to six months

Ages 6-11 mos – 100,000 IU Ages 12-59 mos – 200,000 IU



Customization of the questionnaire



Change order for dates according to common practices


EXAMPLE: Month/Day/Year


DayMonth


Remove any that do not appear on vaccination cards and are not in usein your country




Eligibility for VAS Program

Countries with an under five mortality rate higher than 70 per 1000, or

Where vitamin A deficiency is a public health problem


Correct combinations if necessary

In countries where only MMR is used instead of measles vaccine alone, leave only MMR in the list


MMR MMR

DPTHepHib1

DPTHepHib2

DPTHepHib3

DPTH1

DPTH2

DPTH3


If both vaccines are in use, retain both items (insert new row in order to separate them)


MMR MMR

MEASLES Measles

YELLOW FEVER YF

VITAMIN A (MOST RECENT) VitA


Changes need to be reflected in questions IM7 through IM17 administered only to mothers/primary caretakers of children for whom vaccination cards were not shown




List most recent immunization campaigns


Methodological issues• Ensure a vaccine is given nationwide before including it on

the questionnaire

• Ensure a vaccine is given during last couple of years. Don’t include vaccines that started to be administered just recently

• In some countries, vaccination cards are kept at health centres and are not given to mothers

– In these countries, if necessary, health centres should be visited to record information from the child’s health card

– However, the module should be used in its entirety during the

interview

Documents

MICS4 Survey Design Workshop Multiple Indicator Cluster Surveys Survey Design Workshop Questionnaire for Children Under Five: Immunization