An epidemiological assessment of immunization programme participation in the Philippines.

Because a large proportion of preschool children failed to present for free diphtheria-pertussis-tetanus (DPT) immunizations in a poor, rural area of the Philippines, we undertook an epidemiological analysis of their characteristics. The parents of 159 children were interviewed to determine the demographic, attitudinal, knowledge, and administrative correlates of immunization status. Logistic regression was used to model immunization status. Children were less likely to be immunized if they had a high score on an Adversity Index (composed of measures of the weather, the number of visits the team made, the distance, the appropriateness of the time of day, and miscellaneous problems), if they received health care from a native mother and child health specialist, if a parent was not on the town council, and if pain was an important deterrent. By contrast, many demographic and attitudinal measures that have traditionally been thought to predict health behaviour were not useful discriminators. Recommendations are made for immunization programme management. The general use of this method for programme planning is elaborated.