母亲母乳喂养知识和信念对婴儿喂养方式影响的研究

目的:了解母亲母乳喂养知识和信念对婴儿喂养方式的影响.方法:用自行设计的母乳喂养调查表,对131名在门诊就诊的月龄在1～4月的婴儿母亲进行调查.结果:在出生后1周时和现场调查时纯母乳喂养比例,婴儿母亲知晓母乳喂养好处组均明显高于不知晓组,知晓放弃母乳喂养危害组明显高于不知晓组,母亲在孩子出生前就树立母乳喂养信心组均明显...     

攀枝花市东区纯母乳喂养现状调查及分析

目的 了解攀枝花市东区纯母乳喂养现状及相关影响因素,为临床提供参考依据。方法 对攀枝花市东区315名2岁以内婴幼儿母亲进行面对面问卷调查,将293份合格问卷运用SPSS 22.0软件对数据进行描述统计和Logistic回归分析。结果 母乳喂养坚持到18个月以上仅占1.4%,纯母乳喂养到4~6个月只有34.5%。结论 开奶时间越早、纯母乳喂养的方式、自觉母乳量可以满足婴儿使母亲更倾向于纯母乳喂养。     

The Pregnancy Risk Assessment Monitoring System: design, questionnaire, data collection and response rates

The birth certificate, the primary tool for population-based surveillance of the condition of infants at birth and maternal status during pregnancy, provides little data about maternal behaviour during pregnancy. To collect data on maternal behaviours that influence pregnancy outcome, we implemented the Pregnancy Risk Assessment Monitoring System in seven states. For this population-based surveillance, new mothers were sampled from birth certificates 2 to 6 months after delivery and contacted by mail; follow-up of nonrespondents was by telephone. Participants completed a 10-page questionnaire. Stratification permitted over-sampling of women with adverse pregnancy outcomes. Among 10,563 women sampled during 1988 and 1989, stratum-specific response rates ranged from 30% to 89%. In 11 of the 28 strata, response rates were greater than 70%. Response rates varied considerably between states. Rates were lower for Black mothers, mothers of low birthweight infants, unmarried mothers and mothers with less than 12 years of education. Active refusal to participate and undelivered mail occurred infrequently. Mail and telephone surveillance of new mothers can yield adequate response rates in selected population groups. Trials of alternative approaches to enhancing response among Black and disadvantaged mothers, such as additional mailings or post-partum in-hospital recruitment, are needed.     

Carotenoid composition and content of legumes, tubers and roots by HPLC

A survey was carried out in the district of Kemaman, Terengganu, Malaysia to study infant feeding practices in rural and semi-urban communities. A total of 593 mothers were interviewed and their socio-demographic information recorded. Data on infant feeding practices were collected from mothers who had children up to 15 months of age. Among breast-feeding mothers (n =157), 42.0 % fed their babies for less than 3 months and 58.0% bottle fed for more than 6 months. Sixteen children were found to be fed on sweetened condensed milk with 62.5% of them for the first 3 months. Among those who breast fed their babies, 40.1% were found to have bottle fed at one time or another. The majority of breast feeding mothers belonged to the groups having incomplete primary schooling or completed primary education only and household income below RM600 per month. A substantial number of breast fed babies were given weaning foods in the form of porridge mixture (rice + egg, rice + vegetables, rice + meat, rice+ fish and cereals) between the age of 0 - 3 months. The findings of this study concluded that although breast-feeding is widely practiced, however, their duration has dwindled, and early introduction of solid foods is widespread.     

Breastfeeding Duration, Social and Occupational Characteristics of Mothers in the French ‘EDEN Mother–Child’ Cohort

Socio-demographic characteristics of mothers have been associated with exclusive breastfeeding duration, but little is known about the association with maternal full- and part-time employment and return to work in European countries. To study the associations between breastfeeding, any and almost exclusive (infants receiving breast milk as their only milk) breastfeeding, at 4 months of infant’s age and the socio-demographic and occupational characteristics of mothers. We used the EDEN mother–child cohort, a prospective study of 2002 singleton pregnant women in two French university hospitals. We selected all mothers (n = 1,339) who were breastfeeding at discharge from the maternity unit. Data on feeding practices were collected at the maternity unit and by postal questionnaires at 4, 8 and 12 months after the birth. Among infants breastfed at discharge, 93 % were still receiving any breastfeeding (83 % almost exclusive breastfeeding) at the 3rd completed week of life, 78 % (63 %) at the 1st completed month, and 42 % (20 %) at the 4th completed month. Time of return to work was a major predictor for stopping breastfeeding: the sooner the mothers returned to work, the less they breastfed their babies at 4 months of infant’s age, independently of full-time or part-time employment. The association was stronger for almost exclusive breastfeeding mothers than for any breastfeeding ones. In a society where breastfeeding is not the norm, women may have difficulties combining work and breastfeeding. Specific actions need to be developed and assessed among mothers who return to work and among employers.     

Hospital and other influences on the uptake and maintenance of breast feeding: the development of infant feeding policy in a district

Hospital practices in the post-natal period are now recognised as one of a wide range of influences affecting the success of breast feeding. A study of 48 non-medical maternity unit staff and 250 recently delivered mothers at a District General Hospital was carried out in order to identify obstacles and sources of support in the establishment and maintenance of breast feeding. This study formed part of an evaluation of local policy development which included the appointment of a Baby Feeding Adviser. Eighty-two percent of mothers (95% confidence interval; 87.0-96.4) began breast feeding, and this fell to 57.4% (50.6-64.2) at 6 weeks. A majority of mothers reported that advice was at least partly conflicting, and of those who began breast feeding 92.7% had used supplements within 2 days. In multivariate analysis, factors significantly associated with a lower rate of initial breast feeding were: non-attendance at antenatal classes, Caucasian ethnicity, social class and religious denomination. Social factors were much less important in the maintenance of breast feeding, but mothers who had undergone Caesarian section were more likely to give up breast feeding by 6 weeks. The reported quality of advice and support from the hospital and community were not associated with the maintenance of breast feeding. Many of the maternity unit midwifery staff reported inadequate time for discussion of feeding with mothers. Although two-thirds of the staff felt that there should be an infant feeding policy or were not sure, most of those favouring a policy felt that it should not actively promote breast feeding. Their main reason for this view was the fear of inducing guilt in bottle-feeding mothers. The social and service-related factors associated with the initiation and maintenance of breast feeding may be useful for targeting additional support for some mothers. The ambivalence and concerns among maternity unit midwifery staff about promoting breast feeding must be addressed if successful policy implementation is to be achieved. Plans for implementing change and evaluation are described.     

The response of mothers to health education and the incidence of gastro-enteritis among their babies in Ile-Ife,Nigeria

The study was carried out among 100 nursing mothers attending infant welfare clinics in order to evaluate their behavioural response to methods of hygiene taught to them about their babies' feeding utensils by health workers.The respondents studied were those with children whose ages ranged between 0 and 12 months, irrespective of birth order.One major purpose of organizing educational talks and of demonstrating food preparations and hygiene is to reduce and possibly prevent the prevalence of intestinal infections, especially during the transition from breast to bottle feeding and to the use of solids.Therefore, the incidence of gastro-enteritis among babies who attended the clinic was investigated.In the analysis of their behavioural response, consideration was given to the environmental conditions under which respondents lived.The response of the mothers was positive to health education. There was a significant difference in the incidence of diarrhoea among babies at the 1% level after exposure of their mothers to health education.     

Evaluating satisfaction with maternity care in women from minority ethnic communities: development and validation of a Sylheti questionnaire.

OBJECTIVE: To develop a reliable and valid questionnaire to evaluate satisfaction with maternity care in Sylheti-speaking Bangladeshi women. DESIGN: Two-stage, psychometric study. Firstly, focus groups, in-depth interviews and iterative methods for translation and cultural adaptation were used to develop a Sylheti questionnaire, called the survey of Bangladeshi women's experience of maternity services from an English language questionnaire. Secondly, quantitative psychometric methods were used to field test and evaluate the acceptability, reliability and validity of this questionnaire. SETTING: Four hospitals providing maternity services in London, UK. STUDY PARTICIPANTS: Two hundred and forty-two women from the London Bangladeshi communities, who were in the antenatal (at least 4 months pregnant) or postnatal phase (up to 6 months after delivery). Women spoke Sylheti; a language with no accepted written form. Two purposive samples of 40 women in the antenatal or postnatal phase, one convenience sample of six women in the antenatal phase and three consecutve samples of 60 women in the postnatal phase participated in stage one. In stage two, 135 women (main sample) completed the questionnaire two months after delivery (82% response rate); 50 women (retest sample) from the main sample completed a second questionnaire two weeks later (96% response rate). MAIN OUTCOME MEASURES: Women's views about maternity care elicited by qualitative methods and measured quantitatively using the survey of Bangladeshi women's experience of maternity services. RESULTS: The 121-item questionnaire was acceptable to women and showed good internal consistency (Cronbach's alphas 0.76-0.91), stability (test-retest reliability 0.72-0.84) and construct validity (e.g. able to detect group differences). CONCLUSION: By combining qualitative and quantitative methods, it is possible to adapt an instrument to provide an acceptable, reliable and valid Sylheti questionnaire. The approach taken in developing this questonnaire provides a model for developing outcome measures for use with other minority ethnic communities.     

Maternal employment and breast-feeding initiation: findings from the Millennium Cohort Study

Maternal employment rates have increased rapidly in recent years and little is known about how this influences whether women start breast feeding. We examined data from the Millennium Cohort Study to determine whether a mother's employment status (full-time, part-time, self-employed, on leave, not employed/student) and employment characteristics are related to breast-feeding initiation. This analysis comprised 14 830 white mothers from Britain and Ireland (6917 employed) with singleton babies, born from 2000 to 2002. Information was obtained on infant feeding history and mother's employment when the cohort child was 9 months old. We found that women employed full-time were less likely to initiate breast feeding than mothers who were not employed/students, after adjustment for confounding factors [adjusted rate ratio (aRR) = 0.92; 95% confidence interval (CI) 0.89, 0.96]; however, there were no differences in breast-feeding initiation between mothers employed part-time, self-employed, or on leave and mothers who were not employed/students. Among employed mothers, those who returned to work within 4 months postpartum were less likely to start breast feeding than women who returned at 5 or 6 months [aRR = 0.95; 95% CI 0.92, 0.99], and women who returned within the first 6 weeks were much less likely to start breast feeding [aRR = 0.85; 95% CI 0.77, 0.94]. Mothers returning for financial reasons were also less likely to initiate breast feeding [aRR = 0.96; 95% CI 0.93, 0.99] than those who returned for other reasons. Policies to increase breast feeding should address how both the time and circumstances of a mother's return to employment postpartum influence whether she decides to start breast feeding.     

Maternity Leave in Taiwan

Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk versus formula. We found that the time when mothers returned to work coincided with the duration of guaranteed leave. In particular, mothers with a labor pension plan resumed work significantly earlier than mothers with no pension plan, and mothers with no pension plan returned to work significantly later than those with pension plans. The short leave of absence guaranteed under existing policies translated into mothers spending less time with their children and being more likely to exclusively use formula by 6 months after birth. In contrast, mothers who resumed work later than 6 months after birth were more likely to have not worked before birth or to have quit their jobs during pregnancy. Implications and recommendations for parental leave policy in Taiwan are discussed.     

Mailed dietary surveys: response rates, error rates, and the effect of omitted food items on nutrient values.

Mailed surveys may be a cost-effective way to collect dietary information in large populations. We sent a brief quantified food frequency survey to a random sample of 2,000 prepaid health plan members between the ages of 20 and 65 years for two consecutive years. Logistic regression was used to predict the probability of: (1) responding to the questionnaire, (2) completing all 60 items in the questionnaire correctly so that all information could be used (responding entirely correctly), and (3) completing all 60 items in the questionnaire incorrectly so that no information was usable (responding entirely incorrectly). In a follow-up survey of a subsample of respondents, Spearman correlation coefficients were used to compare nutrient intakes calculated from questionnaires that had omitted data with those from the same questionnaires after the missing information was completed by telephone interview. About 50% of all persons surveyed returned the questionnaire. Response rates were highest among persons who had taken a voluntary multiphasic health examination, among women, and among older persons. Only 22.9% of the respondents in year 1 and 27.7% of the respondents in year 2 responded entirely correctly; a small percentage of respondents (12.1%) omitted more than 10 food items. Responding entirely correctly was inversely related to age and related to race. Most correlations between nutrient intakes calculated from questionnaires with omitted data and those from the same questionnaire subsequently completed by telephone interview were greater than 0.90 and increased as the number of omitted items decreased. If a relatively low overall response rate is acceptable, food frequencies collected through the mail can be an effective way to gather dietary information.     

Infant formula samples and breast feeding among Philippine urban poor

An experiment was performed on the maternity wards of three public hospitals in Cebu City, Philippines to determine whether the distribution of free samples of infant formula reduced the likelihood that mothers would breast feed or caused mothers to terminate nursing early. Samples were given or withheld alternately for 2 week intervals to mothers as they left maternity wards. They were followed for 8 months in the first experiment (N = 273) and for 2 months in a replication (N = 284). We found that there were no statistically significant differences between those who received samples and those who did not in initiation or maintenance of breast feeding. Mothers in both groups frequently turned to mixed schedules, but these varied from day to day depending on money to buy other forms of milk, or on the mother's health, or her plan to be away from the baby for one or more feeding periods. After the baby reached an age of 2-3 months, mothers, with few exceptions, used diluted sweetened condensed milk as a supplement and/or substitute for their own milk. It was found that, while mothers recognize the nutritional, economic and health benefits of breast feeding, they may terminate early on the basis of folk beliefs. Receiving formula samples, however, had no measured effect on their breast feeding practices.     

Comparison of characteristics between respondents and nonrespondents in a national survey of Japanese elderly using six year follow-up study]

PURPOSES: The purpose of this study were twofold: 1) to examine differences between respondents and nonrespondents in sociodemographic or health characteristics, 2) to study nonresponse effects on relationships between variables, using a 6 year follow-up study for both respondents and nonrespondents at the initial survey. METHODS: The data were collected in 1987 through a national survey of Japanese adults aged 60 and over. A total of 2,200 interviews were completed from the list of 3,288 names. In 1993, 1,010 nonrespondents excluding persons who had died, moved, or whose addresses were unknown in the prior interview, were recontacted through a mail questionnaire. A total of 559 persons completed the mail questionnaire. Of the original 2,200 baseline interviewees, some by proxy interviews, 2,260 persons were reinterviewed, at the same time as the mail survey. Sociodemographic and health variables (age and sex), social indicators (educational attainment, marital status, and job status), health status (mortality, existence of diseases, and activities of daily living), subjective well-being (life satisfaction, self-rated health, and economic satisfaction) were compared between respondents and nonrespondents. Relationships between self-rated health and sociodemographic or health variables were examined by multiple regression analysis. RESULTS: 1. Compared to people who participated in the survey, norespondents were likely to be male, in the lower age categories, and with higher educational attainment at the follow-up survey. Also, life satisfaction and self-rated health were lower in nonrespondents than in respondents. Reasons for nonresponse varied but appeared to be somewhat related to characteristics of nonrespondents. 2. No significant relationships between self-rated health and sociodemographic or health variables appeared for the respondent group and also when including the nonrespondent group. CONCLUSION: While differences between respondents and nonrespondents on certain variables were significant, relationships between self-rated health and sociodemographic variables were not observed.     

Increasing response rates to a smoking survey for U.S. Navy enlisted women

This study examined the effectiveness of several persistent strategies to increase the response to a smoking survey among newly enlisted U.S. Navy women. The stepped approach, which included the use of incentives, repeated mailings, alternative survey administration modes, and reminders, was evaluated in terms of effects on response rates and response bias. Demographic and baseline smoking-related characteristics were compared for those responding on time to the initial mailed follow-up survey, reluctant respondents who did not respond initially but eventually completed a survey after further prompting, and non-respondents. Results showed that incentives and persistent efforts were effective in substantially increasing the response among 2,231 eligible participants, more than doubling the response rate (from 24.9% to 52.7%). The characteristics of on-time, reluctant, and non-respondents did not differ significantly in terms of sociodemographic characteristics. On the other hand, on-time respondents were different from both reluctant respondents and non-respondents in terms of smoking-related behaviors.     

运用健康信念模式分析影响蒙、汉族婴幼儿母乳喂养的因素

目的比较蒙、汉族婴幼儿母乳喂养状况,探讨健康信念模式在分析母乳喂养影响因素中的作用,为提高母乳喂养率提供建议。方法依据健康信念模式自行设计问卷,采用分层随机整群抽样方法,对117名蒙族婴幼儿母亲和218名汉族婴幼儿母亲进行入户访谈式问卷调查,资料收集时间为2004年4月。结果蒙、汉族婴幼儿4个月母乳喂养率分别为79.5%和73.4%,平均开奶时间为54.5小时,平均断母乳时间为15.4个月,蒙、汉族差异无显著性。蒙族母亲较汉族母亲感知到的母乳喂养益处更多,而障碍更少,二者的差异有显著性。运用健康信念模式分析显示,母乳喂养障碍和母亲年龄是影响母乳喂养的主要因素,R2=0.462,母乳喂养障碍越少,母亲越年轻,越有利于母乳喂养。结论母乳喂养障碍为影响母乳喂养的主要可变因素,蒙、汉族婴幼儿母乳喂养水平相当;健康信念模式可以在一定程度上解释和预测母乳喂养行为。     

Duration of breast feeding and risk of developmental delay in Taiwanese children: a nationwide birth cohort study

The purpose of this study was to examine the relationship between duration of breast feeding and four developmental domains: gross motor, fine motor, language, and personal/social skills. This study included 14,621 infants from birth to 18 months of age. In the Taiwan Birth Cohort Study, four developmental screening items adapted from the Denver Development Screening Test were most appropriate for children aged 15 to 18 months. The proportion of young children who had mastered specific milestones increased consistently with longer duration of breast feeding. The adjusted odds ratios of the risk of developmental delay for the longest duration of breast feeding vs. never breast-fed were 0.69 [95% confidence interval (CI) 0.57, 0.83] for gross motor, 0.64 [95% CI 0.53, 0.77] for fine motor, 0.74 [95% CI 0.60, 0.91] for language, and 0.76 [95% CI 0.64, 0.90] for personal/social skills. Regardless of when the mothers returned to work, duration of breast feeding was found to have an inverse association with developmental delay in young children. The protection against developmental delays remained significant for those children who were breast-fed for more than 6 months. Children who were breast-fed for longer than 6 months had a lower risk of developmental delay than those who were never breast-fed. These data support the hypothesis that duration of breast feeding is positively related to young children's neurodevelopment.     

陕西部分农村母亲婴幼儿喂养知信行现况调查

目的:了解农村婴幼儿喂养现状,为进一步干预提供依据。方法:采用定量方法利用自编问卷对陕西泾阳县6个乡的311名儿童母亲进行现况调查;采用定性方法组织12名儿童母亲进行专题小组讨论,了解影响母亲喂养行为的因素。使用中位数、均数、标准差、频数、卡方检验等方法分析定量资料;使用分类归纳法分析定性资料。结果:定量调查显示,88.4%的母亲认为婴儿6个月内纯母乳喂养好,但6个月内纯母乳喂养率为55.3%;44.4%的母亲了解正确添加辅食的时间,但适时添加辅食率为26.1%;分别有92.9%、97.4%、76.2%的母亲认为应该每天给6个月及以上的孩子吃鸡蛋、蔬菜或肉类,但每周给6个月及以上的孩子添加6次及以上鸡蛋的比例为38.9%、蔬菜47.9%;给7个月及以上孩子每周添加1次以上肉类的比例只有21.6%。定性结果表明,没有坚持纯母乳喂养的母亲主要是自认为母乳不足而过早加辅食;过晚添加辅食的母亲主要是认为8个月以下的孩子对乳类以外的食物难以消化;不给孩子添加肉类食物的母亲主要是认为孩子1岁牙长好了才能消化肉类。结论:6个月婴儿纯母乳喂养率和适时添加辅食率低于同期其他农村地区水平,辅食种类单调,动物性食物摄入明显不足。建议加强对妇幼保健人员的培训,更新相关知识,提高健康教育技能;开发适合农村家长的科普书报、杂志等健康教育材料。     

母亲孕期增重及婴儿喂养方式与儿童肥胖的相关性分析

目的分析母亲孕期增重和婴儿的喂养方式与儿童肥胖之间的关系,为制定降低儿童肥胖率的相关措施提供参考。方法选取湖北省江陵县人民医院所在区域内的4家幼儿园中的951名儿童及其家长作为研究对象,采用问卷调查的方式对儿童及母亲的孕期情况进行调查。调查的内容包括:儿童的身高、体重、婴儿喂养方式等。采用单因素分析和多因素Logistic回归分析儿童肥胖与母亲孕期增重和婴儿喂养方式之间的关系。结果发放调查问卷951份,收回有效调查问卷940份,调查问卷的回收率为98.84%。受访儿童中肥胖的发生率为10.00%(94/940)。单因素分析结果表明,母亲孕期体重增加>15 kg的儿童肥胖发生率高于孕期体重增加未超过15 kg的儿童,差异有统计学意义(P<0.05),婴儿6个月内纯母乳喂养的儿童肥胖率低于未进行纯母乳喂养的儿童,差异有统计学意义(P<0.05)。Logistic回归分析显示,母亲孕期体重增加>15 kg是儿童肥胖的危险因素(P<0.05),婴儿6个月内纯母乳喂养是儿童肥胖的保护因素(P<0.05)。结论母亲孕期体重增加>15 kg和婴儿6个月内纯母乳喂养是儿童肥胖的影响因素,应引导孕妇适当控制体重增长,鼓励产妇采用纯母乳喂养婴儿,降低儿童肥胖发生率。     

The combined effect of employment status and transcultural marriage on breast feeding: a population-based survey in Taiwan

In recent decades there has been a marked rise in both the labour market participation of women with infants and transcultural marriage in Taiwan. The objectives of this study were to explore the combined effect of employment status and transcultural marriage on the prevalence and factors relating to initiation and continuation of breast feeding in Taiwan. We used multistage stratified systematic sampling to recruit 2048 postpartum women from the Taiwan National Birth Registration database for the period November to December 2003. They were interviewed at home within 6 months of delivery using a structured questionnaire; 87% of the sampled population completed the interview. We used logistic regression analysis to estimate the odds ratio (OR) of breast-feeding initiation and Cox regression (survival) analysis to predict continued breast feeding. The prevalences of initial breast feeding for employed Taiwanese mothers, unemployed Taiwanese mothers, employed foreign-born mothers and unemployed foreign-born mothers were 84.4%, 83.7%, 79.1% and 79.7%, respectively. Among the four groups of mothers who initiated breast feeding, 12.9%, 27.2%, 14.7% and 39.7% of their infants, respectively, were still breast feeding at the age of 6 months. Factors associated with initiation of breast feeding were high maternal education (OR 3.80; 95% confidence interval [CI] 1.81, 7.98) and normal spontaneous delivery (OR 1.36; 95% CI 1.04, 1.78). The main reason for not breast feeding in 52% of the mothers was insufficient or no milk. There existed a combined effect of employment status and transcultural marriage on the continuation of breast feeding. Employed Taiwanese mothers were earlier than others at weaning. Unemployed foreign-born mothers breast fed the longest [hazard ratio (HR) 0.54; 95% CI 0.42, 0.70]. Other factors related to late weaning were high maternal education (HR 0.67; 95% CI 0.47, 0.96), older maternal age (HR 0.76; 95% CI 0.61, 0.94), mother sleeping with baby at night (HR 0.68; 95% CI 0.59, 0.78), and no supplemental baby food before the age of 6 months (HR 0.78; 95% CI 0.68, 0.90). The initiation of breast feeding was high but it decreased dramatically after the postpartum period in Taiwan. There was a significant combined effect of employment status and transcultural marriage on the continuation of breast feeding. Employment is a persistent barrier to continued breast feeding.     

Children vaccination coverage surveys: Impact of multiple sources of information and multiple contact attempts

BackgroundMonitoring vaccination coverage is an essential component of vaccination program evaluation. In Québec (Canada), children vaccination coverage surveys are conducted every two years since 2006. The objectives of this study were to evaluate the impact of supplementing data based on vaccination booklets with data from vaccine providers, on the final estimated vaccination coverage and to compare vaccination coverage between respondents to each survey contact attempt.MethodsData from six cross-sectional surveys were used, which included 3508 children aged 2 years. Parents were invited to transcribe the information available in their child’s vaccination booklet on the questionnaire received by mail. The survey included a maximum of 4 contact attempts to obtain a response. Data were completed among vaccine providers identified by parents. The main outcome was a complete vaccination status by 24 months of age.ResultsThe addition of data from vaccine providers to those present in vaccination booklets increased the proportion of children fully vaccinated from 5.5% to 23.7% depending on the survey year. The proportion of children fully vaccinated by 24 months of age estimated among respondents to contact 1 was only 2.1% higher than the estimates among all respondents.ConclusionsWithout validation among vaccine providers for children with missing doses according to vaccination booklets, results underestimated vaccination coverage in the target population. Conducting multiple contact attempts increased the response rate but had limited impact on the validity of estimates. It would be useful in future surveys to present the coverage obtain from respondents to each contact attempt.