Contextual Effect of the Integrated Health Post and Social Capital on Completeness of Child Immunization in Pacitan, East Java

[摘要] Background: Around 2-3 million deaths each yearwere caused by diseases that could be pre­vented by immunization. Immunization is an effort to actively increase a person's immunity against a disease. Basic immuniza­tion can pro­tect infants from diseases that can be prevented by immunization. This study aimed to analyze the factors at the individual level and the inte­grated health post level that affected the complete basic immunization status of infants. Subjects and Method: This was an observa­tional analytic study with a cross-sectional design. The study was conducted at 25 Inte­grated Health Posts (posyandu) in Pacitan, East Java. A sample of 200 infants aged 12-23 months was selected randomly. The dependent variable was complete basic immunization. The independent variables were knowledge, self-efficacy, outcome expectations, vicarious learn­ing, health workers support, social capital, and posyandu strata. The data were analyzed using a multiple multilevel logistic regression. Results: Complete basic immunization status increased with good knowledge (OR= 10.16; 95% CI= 1.48 to 69.98; p= 0.019), high self-efficacy (OR= 10.32; 95% CI= 2.01 to 53.13; p= 0.005), positive outcome expectations (OR= 20.40; 95% CI= 3.39 to 123; p= 0.001), vica­rious learning (OR= 4.35; 95% CI= 0.90 to 21.10; p= 0.068), strong health workers sup­port  (OR= 14.54; 95% CI=2.63 to 80.65; p= 0.002), and strong social capital (OR= 6.54; 95% CI= 1.41 to 30.40; p= 0.017).  Integrated Health Post strata had a contextual effect on the complete basic immunization status with Intra-Class Correlation (ICC)=34.15%. Conclusion: Complete basic immunization status increases with good knowledge, high self-efficacy, positive outcome expectations, had done vicarious learning, and strong social capital.  Integrated Health Post strata have a contextual effect on the complete basic immunization status.

[学科分类] 食品科学和技术

[关键词] basic immunization;contextual effect;social cognitive theory;social capital