Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data

Abstract

Background Immunization is one of the most effective measures for preventing disease when vaccination coverage is sufficient. Although vaccination coverage is known to be influenced by social and cultural barriers, the determinants of childhood immunization in Myanmar remain poorly understood. This study analyzed factors that influenced complete vaccination status (one dose each for Bacillus Calmette-Guérin and measles and three doses each for diphtheria-pertussis and polio) using 2015 data from the Myanmar Demographic Health and Survey. Methods Data from 12 to 23-month-old children and their mothers were extracted from the nationally representative survey results. Bivariate and multivariate analyses with survey-weighted logistic regression were performed to examine the relationships between vaccination status and various sociodemographic and medical factors. The independent variables for the analyses included area of residence, economic status, maternal age, marital status, education, literacy, employment status, antenatal care attendance, tetanus vaccination, place of delivery, postnatal evaluations, child’s sex, number of children, previous child death, decision maker(s) regarding child’s health, frequency of healthcare visits, paternal education, and paternal occupation. Results A representative sample of 904 cases were extracted for the analysis. The overall complete vaccination rate was 55.4%. In the multivariate analysis with backward step-wise selection, complete vaccination was independently associated with middle or high economic status (adjusted odds ratio [AOR]: 2.64, 95% confidence interval [CI]: 1.85–3.78), older maternal age (AOR: 2.87, 95% CI: 1.62–5.10), ≥4 antenatal care visits (AOR: 1.87, 95% CI: 1.28–2.73), and maternal tetanus vaccination before delivery (AOR: 3.26, 95% CI: 1.82–5.85). Conclusion The first Demographic and Health Survey in Myanmar revealed that only approximately one-half of 12–23-year-old children had received complete vaccination, which was lower than the estimated rate from routine administrative coverage. Our results indicate that incomplete immunization status was associated with low economic status, younger maternal age, fewer antenatal care visits, and no maternal tetanus vaccination. These findings may help improve the targeting and strategic implementation of the Expanded Programme on Immunization.

Predictors of immunization coverage among 12–23 month old children in Ethiopia: systematic review and meta-analysis

“…Similarly, mothers who took TT vaccination were almost five times more likely to complete vaccination for their children compared to those who were not vaccinated. This finding is comparable with a study done in Myanmar [ 84 ] that revealed an association between TT vaccination and immunization coverage among children 12–23 months. Maternal service utilization such as ANC and TT vaccinations are found to be proxy indicators that enhanced 19 and 13% immunization coverage among children aged 12–23 months respectively [ 88 ].…”

“…Mothers who followed ANC were more likely to complete vaccination for their children compared to their counterparts. This finding is in line with studies conducted in Pakistan [ 73 ], Myanmar [ 84 ] Indonesia [ 78 ], Senegal [ 59 ] India [ 85 ], and Philippines [ 86 ], and a study done in 46 low and middle income countries (LMIC) [ 87 ]. Mothers who are following both ANC and PNC are more likely to interact with health care providers and exposed to information about maternal and newborn health services [ 78 ].…”

Prenatal Factors Associated With Breach Of The Basic Vaccination Scheme In Under 5 Years Of Age

“…El seguimiento prenatal adecuado se asocia a menor número de complicaciones obstétricas como a concientizar a la madre sobre cuidados y conductas pertinentes a seguir en la gestación, siendo los principales; el cumplimiento de las inmunizaciones y los controles prenatales (8,13) . En el Perú según el MINSA los controles prenatales tienen que ser mínimo 6 CPN para considerar adecuado seguimiento y garantizar el bienestar de bebe si son menos o ningún control prenatal puede generar alto riesgo para la madre como él bebe por lo cual muchas veces afecta el desarrollo (8) .…”

Measles vaccination among children in border areas of Yunnan Province, Southwest China

“…Moreover, policies and implementations of immunization programs vary substantially across countries. For instance, the national immunization coverage for MCV1 in Myanmar was lower than that in China in 2015 (86% versus 99%) [ 10 , 11 ]. A study from China in 2017 also showed that measles antibody level among Myanmar migrants was lower than that among local residents [ 12 ].…”