Abstract

RUIZ-RODRIGUEZ, Myriam; VERA-CALA, Lina M  and  LOPEZ-BARBOSA, Nahyr. Health insurance for infants and infant vaccination related to forced-displacement in Colombia . Rev. salud pública [online]. 2008, vol.10, n.1, pp.49-61. ISSN 0124-0064.

Objective Determining vaccination coverage amongst children (<5 years old) having multiple socio-economic risk factors and their relationship to insurance status. Methods This was a cross-sectional study of 514 families from urban settlements receiving people displaced by the armed conflict in 4 municipalities in the Santander department ( Colombia ). The households were selected by probabilistic sampling, using proportional modelling by municipality. Immunisation data was collected from vaccination cards; interviews provided socio-demographic data. The dependent variable consisted of having the complete vaccination scheme by age according to the official Ministry of Social Protection's programme. The probability of being vaccinated was modelled by a logistical regression, adjusted for sociodemographic variables. Results 369 children were studied, of whom 48,8 % belonged to families displaced by the armed conflict. 46,1 % of the people being interviewed presented their vaccination cards. Contrary to what had been expected, only 21,2 % of those having a vaccination card were insured and 22,9 % of them had a complete vaccination scheme for their age. The probability of having a complete vaccination scheme for those individuals who were covered by the subsidised health system was 2,4 times higher when compared to those who were not insured (p=0.042). Conclusions Low vaccination coverage indicated barriers for people living in conditions of poverty and displacement obtaining health services and low insurance coverage suggested faults in health insurance policies addressing similar populations.

Keywords : Health insurance; vulnerable population; vaccination; coverage; Colombia.

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