Factors associated with maternal tetanus vaccination in Myanmar: An analysis of demographic and health survey data

Tun, Zaw; Ring, Zau; Tam, Clarence C.

doi:10.1016/j.vaccine.2022.01.018

Cited by 1 publication

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References 14 publications

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“…Prior research examining inequalities in childhood immunizations and using multi-national samples has found several factors which are significantly associated with disparities in coverage, including household wealth [6][7][8][9], maternal age [10], maternal education [8,9,11], and place of residence (urban/rural) [9,[11][12][13]. A number of single-country studies have examined factors associated with tetanus vaccination uptake by pregnant women in, for example, Afghanistan [14], Bangladesh [15,16], Ethiopia [17,18], The Gambia [19], India [20], Kenya [21], Myanmar [22], Sierra Leone [23], and Sudan [24]. Across these studies, higher levels of maternal education and household wealth have often been found to be associated with increased TTCV uptake, and in some (but not all) contexts, there were also significant associations between uptake and maternal age and place of residence.…”

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confidence: 99%

Inequalities in Immunization against Maternal and Neonatal Tetanus: A Cross-Sectional Analysis of Protection at Birth Coverage Using Household Health Survey Data from 76 Countries

et al. 2023

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Substantial progress in maternal and neonatal tetanus elimination has been made in the past 40 years, with dramatic reductions in neonatal tetanus incidence and mortality. However, twelve countries have still not achieved maternal and neonatal tetanus elimination, and many countries that have achieved elimination do not meet key sustainability thresholds to ensure long-lasting elimination. As maternal and neonatal tetanus is a vaccine-preventable disease (with coverage of the infant conferred by maternal immunization during and prior to pregnancy), maternal tetanus immunization coverage is a key metric for monitoring progress towards, equity in, and sustainability of tetanus elimination. In this study, we examine inequalities in tetanus protection at birth, a measure of maternal immunization coverage, across 76 countries and four dimensions of inequality via disaggregated data and summary measures of inequality. We find that substantial inequalities in coverage exist for wealth (with lower coverage among poorer wealth quintiles), maternal age (with lower coverage among younger mothers), maternal education (with lower coverage among less educated mothers), and place of residence (with lower coverage in rural areas). Inequalities existed for all dimensions across low- and lower-middle-income countries, and across maternal education and place of residence across upper-middle-income countries. Though global coverage changed little over the time period 2001–2020, this obscured substantial heterogeneity across countries. Notably, several countries had substantial increases in coverage accompanied by decreases in inequality, highlighting the need for equity considerations in maternal and neonatal tetanus elimination and sustainability efforts.

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