Background
A brief introduction about China’s immunization policies and practices
Methods
Search terms and strategy
Inclusion and exclusion criteria
Data extraction and conceptual framework
Results
Search results
Description of included studies
Three successful Strategies to improve immunization for migrant population
Ref # | Authors | Year | Study Sample | Study Location | Main Findings |
---|---|---|---|---|---|
22 | You | 1992 | All the children up to 7 years old | Rugao City, Jiangsu Province | A newborn baby had to pay for a lump-sum immunization insurance for 7 years (18–25 Yuan), right after the baby was discharged from maternal and children hospitals. The lump-sum immunization insurance up to 7 years was a barrier for migrant children to receive immunizations. |
23 | Xu et al. | 1995 | 6121 migrant children less than one year old | Linyi City, Shandong Province | A shorter period of immunization insurance (only one year after the delivery instead of 7 years) used for migrant population with much lower premium and it was very effective for migrant children to receive 5 basic vaccines in the first year. |
24 | Li et al. | 2008 | 2859 migrant children aged 0–7 | Baicheng City, Jilin Province | The rate of appropriate immunizations for migrant children increased from 80% in 2004 to 95% in 2006, after this national policy "Regulation about Vaccine and Immunization Management" was implemented in 2005 |
25 | Liao | 2008 | 1859 migrant families | Chengdu City, Sichuan Province | A positive relationship between immunization certificates and age-appropriate immunization rates was found. 95% of migrant children in Chengdu City, Sichuan Province had immunization certificates and their age-appropriate immunization rates were more than 90%. |
26 | Gao | 2008 | 120 migrant children | Yangzhou City, Jiangsu Province | A positive relationship between immunization certificates and age-appropriate immunization rates was found. 95.8% of migrant children had immunization certificates in Yangzhou City, Jiangsu Province, and their 5 vaccine’immunizations rates were 87.5% |
27 | Yin et al. | 2008 | 436 migrant children | Panzhihua City, Sichuang Province | A positive relationship between immunization certificates and age-appropriate immunization rates was found. 97.71% of migrant children in Panzhihua City, Sichuan Province had immunization certificates and 5 vaccines (except hepatitis B) were more than 85% |
28 | Nakano et al. | 1997 | 91 children | Myanmar border, Yunan Province | The former family planning policy had been believed to be one of most important reasons for the low immunization rates for migrant children |
29 | Li et al. | 1994 | 194 migrant children | Wujiang City, Jiangsu Province | Migrant families had more children violating the family planning policy. 13.92% of 194 migrant children were out of family planning policies in Wujiang City, Jiangsu Province in 1993. |
30 | Wang | 1996 | 61 polio cases | Wuhua County, Guangdong Province | Investigated 61 polio outbreak cases in Wuhua County, Guangdong Province in 1993, and found that 39 cases were for children violating the family planning policy or migrant children and none of them had a complete polio immunization history |
31 | Han et al. | 2014 | 1610 migrant children | Guangdong Province | Migrant children living in a poor family had a low up-to-date immunization rates. |
32 | Zhang and Wang | 1999 | All migrant children | Jiangle County, Fujiang Province | Examined immunization for special population in Jiangle County, Fujian Province, and found this policy "Management Plan for Special Population’s Expanded Program for Immunization" was very effective to improve immunization for migrant children. |
33 | National People's Congress | 1989 | Entire population | China | People’s Republic of China’s Law about Preventing and Controlling Communicable Diseases (national law) |
34 | National People's Congress | 2004 | Entire population | China | Revision of People’s Republic of China’s Law about Preventing and Controlling Communicable Diseases (national law) |
35 | State Council | 2005 | Entire population | China | Regulation about Vaccine and Immunization Management (national policy) |
36 | Ministry of Health | 1998 | Entire population | China | Management Plan for Special Population’s Expanded Program for Immunization (national policy) |
Content | Process | Effect | Context |
---|---|---|---|
Stop charging immunization service fee or immunization insurance. | Immunizations for migrant population were responsible by the local living places, while they were not in their original Hukou places. After 2005, all the immunization funds were allocated directly to the local immunization clinics based on the total population in each area, and migrants were also included. Immunization clinics had financial incentives to provide immunization services to migrants. | In 2004, only 80% of migrant children in Baicheng City, Jilin Province had appropriate immunizations, and this rate increased to more than 95% in 2006 right after “Regulation about Vaccine and Immunization Management” was implemented in 2005 [24]. | The revision of “People’s Republic of China’s Law about Preventing and Controlling Communicable Diseases” in 2004 specified that EPI immunizations should be free of charge. In 2005, the State Council announced “Regulation about Vaccine and Immunization Management” and specified that five EPI immunizations should be provided to people free of charge without extra immunization service fees or immunization insurance. |
Manage immunization certificates well. | Immunization certificates were checked when children received annual physical examinations and got into kindergartens and schools. Catch-up programs were provided to children without up-to-date immunization records in their immunization certificates or without immunization certificates. | In 2007, 95% of migrant children in Chengdu City, Sichuan Province had immunization certificates and their age-appropriate immunization rates were more than 90% [25]. In 2008, 95.8% of migrant children had immunization certificates in Yangzhou City, Jiangsu Province, and their 5 vaccine’ immunizations rates were 87.5% [26]. | “Regulation about Vaccine and Immunization Management” in 2005 specified that the immunization certificate should be issued to newborn babies within one month after delivery by the local residential immunization stations. |
Pay more attentions to special children for their immunization, including migrant children, children violating family planning policies, and children without ability to pay immunization service fees or insurance. | For children without ability to pay, immunization service fees or insurance were waivered. Local immunization staffs tried to search for special children without up-to-date immunizations, and provide appropriate immunization services to them. The local immunization staffs tried to collect information about newborn children by collaborating with other departments. It was allowable not to record their real names and/or addresses for children violating family planning policies, but the immunization certificates were still issued to them. | After the immunization policy for special population was implemented in Jiangle County, Fujian Province, 80% of migrant people received timely immunization information and 90% of parents with migrant children went to immunization clinics to receive EPI immunizations [32]. Catch-up immunizations were provided to children without up-to-date immunizations, and immunization insurance was also waived. | In 1998, the former Ministry of Health announced “Management Plan for Special Population’s Expanded Program for Immunization” and tried to improve immunization work for special children. |