Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...

Boys (54 percent) are somewhat more likely to be fully vaccinated than girls (51 percent).
Surprisingly, children in rural areas (54 percent) are more likely to be fully vaccinated than children in
urban areas (48 percent). Vaccination coverage varies significantly by district, with Manufahi and Dili
having the lowest coverage of fully immunized children at 43 percent each. Aileu and Lautem have
the highest coverage of fully immunized children at 79 and 75 percent, respectively. Many of the
districts with lower coverage of fully vaccinated children have the highest dropout rates, especially for
polio. Dili has a very high dropout rate between polio 1 and polio 3 at 46 percent, compared with less
than 5 percent for Aileu. The single biggest reason that full vaccination coverage in rural areas is
higher than in urban areas is the very low polio 3 coverage in urban areas (49 percent). In fact all
other vaccines have higher coverage in urban than rural areas. Even though oral polio vaccine has
minimum side effects and can be given to persons with diarrhea, it can lead to gastrointestinal upset
like diarrhea and vomiting, prompting physicians (who operate predominantly in urban areas) to
withhold the vaccine from children with diarrhea. Additionally, mothers may not return for follow-up
visits upon the physician’s advice to bring their children back once the diarrhea has ceased. The
considerably lower coverage in urban areas and particularly in Dili could also be attributed to the
2006 civil unrest in the country, which disrupted all basic health services, severely damaged
infrastructure, and displaced thousands of residents from their homes.
Vaccination coverage is highest for first-born children (58 percent), with little difference in
coverage for children of birth order two and above (about 51 percent). Children whose mothers attend
only primary or secondary school are more likely to be fully vaccinated than children whose mothers
have no education. The proportion of children fully vaccinated generally increases with wealth
quintile, from 43 percent in the lowest wealth quintile to 66 percent in the fourth quintile, and
decreases for children in the highest wealth quintile (45 percent).
11.3 TRENDS IN VACCINATION COVERAGE
Table 11.4 shows by age cohorts the percentage of children age 12-59 months (at the time of
the survey) who received specific vaccines by 12 months of age and the percentage with a vaccination
card. Thirty-six percent of children received all their vaccinations by 12 months of age. Children in
the oldest cohort (48-59 months) were less likely to have received all their vaccinations (28 percent)
than children age 12-23 months (47 percent). This pattern is seen with each vaccine but is most
marked when all the vaccines are considered together. Vaccination cards were shown to interviewers
for 50 percent of children age 12-23 months, compared with 16 percent of children age 48-59 months.
The difference may partly be a result of the cards for older children being lost or misplaced over the
longer period of time and may partly be due to a better card uptake in more recent years.
Table 11.4 Vaccinations in first year of life
Percentage of children age 12-59 months at the time of the survey who received specific vaccines by 12 months of age, and percentage with a vaccination card, by current
age of child, Timor-Leste 2009-10
Age in months BCG
DPT Polio 1
Hep B
1 2 3 0 1 2 3 1 2 3
Measles
All basic
vaccinations
2
No
vaccinations
Percentage
with a
vaccination
card
seen
Number
of
children
12-23 76.6 74.2 69.9 64.2 65.2 74.0 68.1 54.4 73.7 69.0 62.9 60.0 47.2 23.1 49.6 1,752
24-35 73.0 70.5 66.6 60.2 58.1 70.3 63.0 45.8 69.6 65.8 58.9 56.5 38.2 26.9 34.7 1,959
36-47 70.7 67.0 64.0 54.7 53.6 67.2 60.2 38.7 66.4 63.4 53.5 51.1 31.4 30.0 26.3 1,947
48-59 64.3 61.7 56.8 49.9 46.7 60.9 52.9 31.8 61.2 56.0 49.2 52.8 27.9 36.3 16.2 1,745
Total 71.6 69.0 64.9 57.6 56.2 68.7 61.5 42.9 68.3 64.1 56.4 55.6 36.3 28.3 31.7 7,403
Note: Information was obtained from the vaccination card or if there was no written record, from the mother. For children whose information was based on the mother’s
report, the proportion of vaccinations given during the first year of life was assumed to be the same as for children with a written record of vaccinations.
1 Polio 0 is the polio vaccination given at birth.
2 BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth)
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