Multiple Indicator Cluster Surveys
Survey Design Workshop
Questionnaire for Children Under Five:
Immunization
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International goals and targets
Millennium Development Goals
MDG 4: Reduce Child Mortality by two thirds
among children under five
Indicator 4.3 - Proportion of 1 year old children
immunized against measles
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International goals and targets
World Fit for Children
By 2005, reduction in infant and under-five mortality rate by
at least 1/3, in pursuit of the goal of reducing it by 2/3 by
2015
Ensure full immunization of children under one year of age at
90% nationally, with at least 80% coverage in every district or
equivalent administrative unit
- Extend the benefits of new and improved vaccines and other
preventive health interventions to children in all countries (Hepatitis
B, Hib, Yellow Fever, etc)
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International goals and targets
World Fit for Children
Achieve sustainable elimination of vitamin A deficiency
by 2010
Indicator
Proportion (%) under fives who received at least one
high dose vitamin A supplement within the last 6
months.
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Global proportion of one year old children vaccinated
against measles; 1980-2007
100%
80%
60%
40%
20%
20
07
20
00
19
90
19
80
0%
Source: WHO/UNICEF National Coverage Estimates
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MICS Indicators
In MICS4, immunization indicators are defined as:
- The percentage of children aged 12-23 months who
received each specific vaccine: BCG, Polio, DPT,
Measles, Hepatitis B and Yellow Fever before their first
birthday (# 3.1 through 3.6)
- The module also collects information on Vitamin A
supplementation for children under age 5
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Content
Data on immunization are collected from:
• Vaccination cards
• Mother’s report (when card is not available)
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Preparation
(1) Obtain country
specific child
immunization card(s)
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Preparation
Age Group
(2) Obtain the most
current national
immunization schedule
for children
Vaccine
Usual location of
delivery
At birth or by 2 months
BCG and OPV (“zero”
dose)
Left shoulder
By mouth
2 months or 8 weeks
1st dose of Oral polio
Vaccine (OPV)
1st dose of pentavalent
(Hepatitis B, DPT + Hib)
By mouth
Began Pentavalent
in 1999
Upper thigh
4 months or 16 weeks
2nd dose of OPV
2nd dose of pentavalent
By mouth
Upper thigh
6 months or 24 weeks
3rd dose of OPV
3rd dose of Pentavalent
By mouth
Upper thigh
12 months or 1 year
Measles Mumps
Rubella (MMR)
Yellow Fever (YF)
Upper right arm
18 months or 1 year 6
months
Booster OPV and
DPT vaccine
By mouth
Upper thigh
45 months or 3 years
9 months
Booster OPV,
DPT,
MMR
By mouth
Upper Thigh
Upper right arm
15 years plus
DT vaccines for
pregnant women
Upper right arm
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Preparation
(3) Find out about the most recent immunization
campaigns
•
•
•
•
Polio National Immunization Days
Measles campaigns
Other vaccine campaigns (e.g., Yellow Fever)
Others (to distinguish between antigens and probe
for answers)
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Preparation
(4) Obtain samples of Vitamin A capsules to show
respondent
WHO/UNICEF recommendation:
All children between the ages of 6 to 59 months living in affected areas
should receive one high-dose vitamin A supplement every four to six
months
Ages 6-11 mos – 100,000 IU
Ages 12-59 mos – 200,000 IU
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Customization of
the questionnaire
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Customization of
the questionnaire
Change order for dates
according to common
practices
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Customization of
the questionnaire
Month
EXAMPLE:
Month/Day/Year
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Day
Customization of
the questionnaire
Remove any that do
not appear on vaccination
cards and are not in use
in your country
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Customization of
the questionnaire
Eligibility for VAS
Program
Countries with an under
five mortality rate
higher than 70 per
1000, or
Where vitamin A
deficiency is a public
health problem
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Customization of
the questionnaire
DPTHepHib1
Correct combinations if necessary
In countries where only
MMR is used instead of
measles vaccine alone,
leave only MMR in the list
DPTH1
DPTHepHib2
DPTH2
DPTHepHib3
DPTH3
MMR
MMR
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Customization of
the questionnaire
If both vaccines are in
use, retain both items
(insert new row in
order to separate
them)
MMR
MMR
MEASLES
Measles
YELLOW FEVER
YF
VITAMIN A (MOST RECENT)
VitA
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Customization of
the questionnaire
Changes need to be
reflected in questions
IM7 through IM17
administered only to
mothers/primary
caretakers of children
for whom vaccination
cards were not shown
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Customization of
the questionnaire
List most recent
immunization
campaigns
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Methodological issues
• Ensure a vaccine is given nationwide before including it on
the questionnaire
• Ensure a vaccine is given during last couple of years. Don’t
include vaccines that started to be administered just recently
• In some countries, vaccination cards are kept at health
centres and are not given to mothers
– In these countries, if necessary, health centres should be visited to
record information from the child’s health card
– However, the module should be used in its entirety during the
interview
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