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

Abstract

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.

Determinants of full childhood immunization among children aged 12–23 months in sub-Saharan Africa: a multilevel analysis using Demographic and Health Survey Data

“…The potential variables associated with full childhood immunization were categorized as individual-and community-level variables. These variables have been selected based on different works of literature [12][13][14][15][16][17][18]. The individual-level variables include the age of mothers, wealth index, mothers employment status, maternal education level, father education level, number of living children, ANC visits during pregnancy, place of delivery, sex of household head, and PNC visit.…”

“…Previous studies conducted in various sub-Saharan African countries to identify factors related to full childhood immunization have been institutional-based and to consider only individual factors [12][13][14][15][16][17][18]. Nevertheless, childhood vaccination may be impacted by communitylevel factors such as media exposure [19,20], distance to health facilities [21,22], residence [23], country [24], and cluster (enumeration area) [24].…”

Nutritional and immunization status of under-five children of India and Bangladesh

“…They found that 82.8% children of working mothers were completely immunized as against 83.4% children of nonworking mothers. The difference was not significant enough [51]. Using data of a Government General Hospital in India, [52] also didn't find significant difference between the immunization status of children of unemployed and employed mothers, though in this case the percentage of complete immunization among children of employed mothers were slightly higher.…”

Childhood vaccine uptake in Africa: threats, challenges, and opportunities

“…11 Another population based study conducted in Eritrea demonstrated that mothers who attended primary level of education were more likely to have their children fully vaccinated than mothers who have not received any education. 12 A study conducted in Norway found out that HPV vaccine initiation increased with increasing maternal income. Also, HPV vaccination initiation was higher among girls with mothers of low education.…”