Coverage and determinants of childhood immunization in Nigeria: A systematic review and meta-analysis

Rudan, Igor; Jacobs, Wura; Amuta, Ann O.; Ogundipe, Oluwatomisin; Mosaku, Oluwaseun; Gadanya, Muktar A; Oni, Gbolahan A.

doi:10.1016/j.vaccine.2017.04.034

Cited by 49 publications

(50 citation statements)

References 39 publications

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“…A survey conducted in Eritrea in 2017 among children aged 24-35 months to assess the national EPI coverage, found that 92% of children of mothers with middle or higher education were fully immunized compared with only 78% of children of mothers with no education [6]. other studies conducted in Nigeria and Ethiopia found that children of educated mothers were more likely to be fully immunized than children of uneducated mothers [9][10][11]. Conversely, a study conducted in Uganda in 2010, found that infants whose mothers had a secondary education were at least 50% less likely to miss scheduled vaccinations compared to those whose mothers had only primary education [12].…”

Section: Introductionmentioning

confidence: 99%

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis

2020

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Background: Although vaccination coverage in Eritrea has improved in recent years, some children are still missing out, and it's important to identify risk factors for lower coverage in order to target campaigns and interventions. The objective of this study was to assess: (1) the impact of maternal education on full immunization of children aged 12-23 months, and (2) whether the association was confounded or modified by other factors. Methods: This study was a secondary data analysis of the Eritrean Population and Health Survey 2010 (EPHS 2010). In this analysis 1323 mothers of children aged 12-23 months were included. The outcome of the study was full immunization, defined as receiving all the WHO recommended basic vaccines: one dose of Bacillus Calmette-Gué rin (BCG), three doses of diphtheria-pertussis-tetanus(DPT), three doses of polio, and one dose of measles vaccine. The primary exposure was maternal education. Data on immunization coverage came from vaccination cards and from mothers' or caretakers' verbal reports. Bivariate and multivariable logistic regression analyses were performed. Result: Full vaccination coverage among children aged 12-23 months was 83%. Most children received BCG (95%), DPT1 (97%), DPT2 (96%), DPT3 (93%), polio1 (97%), polio2 (97%), polio3 (91%) and measles (92%). In unadjusted analyses, children of mothers with primary (OR = 2.75, 95% CI 1.74-4.37), and middle or above (OR = 3.16, 95% CI 2.09-4.78) education were more likely to be fully immunised. However, after adjusting for wealth, region, ANC visit, and vaccination card ownership, only the effect for primary education remained significant (OR = 2.34, 95% CI 1.30-4.21). Conclusion: The result of this study suggested that children of mothers who attained primary level were more likely to be fully vaccinated than children of mothers with no education. The association was influenced by wealth index of household, mothers ANC visit, region, and possession of vaccination card. The Expanded Program on Immunization of the Ministry of Health should target strategies to enhance full immunization among children of mothers with no education.

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Section: Introductionmentioning

confidence: 99%

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis

2020

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“…In the northern Nigerian state of Sokoto, only 3% of children receive the third dose of pentavalent vaccine by their first birthday ((UNICEF) 2017). The Routine Immunization (RI) program in Nigeria has faced many challenges including a shortage of vaccines and supplies, poor quality routine data that make planning and delivering adequate services difficult, and insufficient numbers of trained health workers deployed in rural areas (Babalola 2009;Babalola and Lawan 2009;Dunkle et al 2014;Adeloye et al 2017;Fatiregun and Etukiren 2014;Ophori et al 2014). Supplyside issues are frequently cited as the reason children are not fully immunized; however, lack of knowledge and community norms are the primary reasons children are not immunized at all (Babalola 2011).…”

Section: Introductionmentioning

confidence: 99%

Engaging traditional barbers to identify and refer newborns for routine immunization services in Sokoto, Nigeria: a mixed methods evaluation

Dougherty

Abdulkarim

Aliyu

et al. 2020

Int J Public Health

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Objectives This study evaluates the effectiveness of an intervention that engaged traditional barbers to inform parents about the importance of vaccination and then refer newborns for vaccination services. Methods We conducted a pre-post quasi-experimental study (n = 2639) to evaluate changes in the coverage of three birth antigens among children aged 0–5 months in response to the intervention. We also conducted in-depth interviews and focus group discussions to assess the enabling factors and challenges associated with implementation. Results We found mothers who received a yellow referral card from a traditional barber were two to three times more likely to vaccinate their children with the three birth antigens. Qualitative findings indicated that the intervention influenced parent’s decision to vaccinate their newborn because the barbers were considered a trusted community advisor. Challenges stemmed from the low levels of literacy among community leaders and barbers that resulted in the need for continuous training, low-literacy training materials and supervision. Conclusions Efforts to increase vaccine coverage rates in northern Nigeria should consider expanding the role of traditional barbers to encourage parents to accept vaccines.

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“…Yet little is known about predictors for their practices at the individual level (in this study, we define household, maternal and child-level characteristics as ‘individual’ characteristics of a child, as they affect each child uniquely in their combination). Existing studies focus mainly on identifying local or regional-level characteristics of their practice3–14: a comparatively larger body of evidence is available for the Nigerian setting (eg, Begum et al 3 for iron–folic acid supplementation, Odusanya et al 4 and Adeloye et al 6 on vaccination coverage and Ogbo et al 8 on breast feeding). Haile et al 9 and Belew et al 13 investigate vitamin A supplementation (VAS) and dietary diversity and meal frequency, respectively, in Ethiopia (or its subregions).…”

Section: Introductionmentioning

confidence: 99%

Individual-level predictors of practices of nutrition-specific and nutrition-sensitive interventions for infants and young children in West and Central Africa: a cross-sectional study

2020

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ObjectivesTo explore the role of individual-level and household-level characteristics for practice of nutrition-specific and nutrition-sensitive interventions.DesignSecondary data analysis (cross-sectional).SettingWest and Central Africa.ParticipantsData are from the Demographic and Health Surveys in the time period between 1986 and 2016. The final sample included between 116 325 and 272 238 observations depending on the outcome.Primary and secondary outcome measuresNutrition-specific and nutrition-sensitive interventions were identified based on the UNICEF Conceptual Framework for child undernutrition. These were early breastfeeding initiation, minimum dietary diversity, full age-appropriate immunisation, iodised salt usage, vitamin A supplementation, iron supplementation, deworming in children aged 1 to 5, clean cooking fuel, safe drinking water and improved sanitation. Explanatory variables include household, mother and child characteristics. Linear probability models were fitted for each outcome, both unadjusted as well as fully adjusted including primary sampling unit fixed effects.ResultsPrevalence of early breastfeeding initiation was 54.31% (95% CI: 53.22% to 55.41%), minimum dietary diversity 13.89% (95% CI: 13.19% to 14.59%), full age-appropriate immunisation 13.04% (95% CI: 12.49% to 13.59%), iodised salt usage 49.66% (95% CI: 46.79% to 52.53%), vitamin A supplementation 52.87% (95% CI: 51.41% to 54.33%), iron supplementation 10.73% (95% CI: 10.07% to 11.39%), deworming 31.33% (95% CI: 30.06% to 32.60%), clean cooking fuel usage 3.02% (95% CI: 2.66% to 3.38%), safe drinking water 57.85% (95% CI: 56.10% to 59.59%) and improved sanitation 42.49% (95% CI: 40.77% to 44.21%). There was a positive education and wealth gradient for the practices of all interventions except deworming. Higher birth order was positively associated with the practice of early breastfeeding initiation, minimum dietary diversity, vitamin A supplementation and negatively associated with full immunisation and improved sanitation.ConclusionsHousehold, maternal, and child-level characteristics explain practices of nutrition-specific and nutrition-sensitive interventions beyond intervention delivery at the regional level.

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Coverage and determinants of childhood immunization in Nigeria: A systematic review and meta-analysis

Cited by 49 publications

References 39 publications

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis

Engaging traditional barbers to identify and refer newborns for routine immunization services in Sokoto, Nigeria: a mixed methods evaluation

Individual-level predictors of practices of nutrition-specific and nutrition-sensitive interventions for infants and young children in West and Central Africa: a cross-sectional study

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