Household Vulnerability Dimensions, Maternal Health Practices and Childhood Immunization Status in Nigeria

Abstract

Immunisation is considered one of the most cost-effective public health interventions for reducing childhood morbidity, mortality, and disability globally. However, while global achievement of over 70% coverage rates was sustained in the 1990s, wide variations exist between and within countries. In some developing countries, immunisation rates increased substantially, but in sub-Saharan Africa, immunisation rates plummeted, leaving millions of children vulnerable to life-threatening diseases. In Nigeria, coverage rates for routine immunisation of all antigens still fall below 50%. The study examined the overall influence of household vulnerability dimensions, maternal health practices on childhood immunization status in Nigeria. The study used secondary data from the 2013 Nigeria Demographic and Health Surveys (NDHS). The analytical weighted sample size was 5,824 women of reproductive ages (15-49 years) with a live birth in the past three years, whose children were within age 12-23 months at the time of the survey. The data were analyzed using frequency distribution, chi-square test and binary logistic regression. The results showed a decreasing regional variation in the proportion of fully immunized children from a high of 23.6% in the South-West, to a low of 9.1% in the North-East. The overall household vulnerability status showed that children in more and most vulnerable households were 62% (OR = 0.38; p < 0.001; CI: 0.32-0.46) and 89% less likely (OR = 0.11; p < 0.001; CI: 0.08-0.14) to receive full vaccination compared with their counterpart in non-vulnerable households. The study revealed a significant relationship between mothers’: i) Number of antenatal visits (OR = 1.66; p < 0.05; CI: 0.25-23 1.77); ii) Quality of antenatal care (OR = 2.61; p < 0.05; CI: 1.45-4.67); iii) Place of delivery (OR = 0.62; p < 0.05; CI: 0.45-0.86); iv) Assistance during delivery (OR = 0.41; p < 0.001; CI: 0.28-0.57); v) Time of postnatal check (OR = 1.81; p < 0.001; CI: 1.49-2.19) and full childhood immunisation status. The study concluded that different dimensions of household vulnerability and maternal health-seeking behavior are key underlying factors of childhood immunization in Nigeria.