The Effect of Cost on The Completeness of Basic Infant Immunization in Winong Subdistrict, Pati District
Loekito Siswojo, 2003. The Effect of Cost on The Completeness of Basic Infant Immunization in Winong Subdistrict, Pati District. A Thesis of the Masters Program in Family Medicine, Postgraduate Program, Sebelas Maret University, Surakarta 2003.
The background for conducting this study was a high infant mortality rate (IMR) and a high mortality rate of children under fives, both of which were associated with infectious diseases. Various infectious diseases are actually preventable by immunization. There was a gap in immunization coverage between Posyandu (free of charge, DPT1=63.7%) and Puskesmas (charge, 41.4%), in Winong subdistrict, Pati district. The question was whether this gap was associated with different costs of basic infant immunization. This study aimed to determine the effect of cost and several other variables on the completeness of basic infant immunization in Winong subdistrict, Pati district.
This study was analytic observational, using the cross sectional approach. The study was conducted in April to June 2003. The study population was mothers who had children aged between 17 and 29 months by May 2003, and lived within the jurisdiction area of Puskesmas Winong, Winong subdistrict, Pati district. A study sample of 614 people was selected from the entire population. The data analysis used SPSS Version 9.0 to perform Logistic Regression Analysis.
Results showed, cost was an important determinant for the completeness of infant immunization. Immunization cost that exceeds Rp. 3000 decreases the probability of complete immunization 0.48 higher than the cost less than or equal Rp. 3000,00 (OR = 0,48; 95% CI = 0,26 – 0,86). Factors that also increase the probability of complete infant immunization include mother’s education attainment, age of mother, mother’s employment status, family income – both father’s and mother’s incomes. Factors that decrease the probability of complete infant immunization include number of children, and distance to the immunization facility. Unearned income handed over to mother from father is not an important determinant for the completeness of infant immunization.
This study concludes that cost is an important determinant for the completeness of infant immunization, after controlling for several confounding factors. It is suggested that vaccination be provided free of charge through the government subsidy to increase the immunization coverage, because vaccination is an economic good that carries positive externality.
Key words: immunization, cost, completeness of basic infant immunization.