Living standard and access to tetanus toxoid immunization among women in Bangladesh

Abstract

Background Although Bangladesh has an impressive track record in the reduction of maternal and child mortality, tetanus, a dreadful disease, impedes the way to achieve Sustainable Development Goal (SDG) in this respect. Sufficient doses of tetanus toxoid containing vaccine during pregnancy ensure immunity against tetanus to mothers as well as newborns. Since inequalities persist across vaccination programs globally, in this paper, an attempt has been made to examine whether tetanus toxoid immunization (TTI) status among the women of reproductive age in Bangladesh for their most recent live birth born preceding 2 years of the survey changes with their living standard index (LSI). Methods Five domains of deprivation such as energy use, improved sanitation, drinking water, housing and assets ownership were used to compute the LSI using a approach proposed by Alkire and Foster. The adjusted association between LSI and TTI was established by using logistic regression model. For the purpose of statistical analysis, a nationally representative cross-sectional data extracted from Bangladesh Multiple Indicator Cluster Survey (BMICS), 2019 have been used. Result The bivariate analysis revealed that 79.5% (95% CI 78.0–81.0) of women with low and 83.1% (95% CI 81.3–84.9) with moderate living standards had sufficient vaccination coverage for their most recent pregnancies while this percentage was higher for the women who belonged to high living standard (85.2, 95% CI = 84.2–86.2). A strong evidence for greater odds of sufficient immunization with TT among the women maintaining a high standard of living (AOR = 1.24, 95% CI = 1.08–1.42, p < 0.01) was found from regression analysis. Conclusion The results depict existing living standard disparity with respect to TT vaccination coverage among women in Bangladesh. Present research suggests that immunization campaigns need to be conducted especially for the disadvantaged people to improve their health care and immunization service utilization among women within the age bracket of 15 to 49. This study proposed a scientific way to enhance TT vaccination among Bangladeshi women, which could help Bangladesh attain a widespread tetanus protection and thus, meet the SDGs for maternal and child mortality reduction.

Tetanus in Uganda: Clinical Outcomes of Adult Patients Hospitalized at a Tertiary Health Facility Between 2011 and 2020

“…This probably highlights missed opportunities for tetanus vaccination, and it calls for efforts to ensure universal access to tetanus vaccination. In a study by Islam et al [ 26 ], TT vaccination among women correlated with living conditions, whereas another study in East Africa found that less educated women, those who traveled long distances to health facilities, and those who had less access to health information from electronic media were more likely to miss tetanus vaccination [ 27 ].…”

Women’s multidimensional empowerment index and essential newborn care practice in Bangladesh: The mediating role of skilled antenatal care follow-ups

“…To build their families, each woman in a household has physical as well mental contributions. However, previous studies used a principal component analysis (PCA) [ 36 , 46 ] or a factor analysis [ 35 , 54 ] to measure the women’s empowerment index, where the studies developed several factors (or PCs) for MEI, but we have used a weighting approach giving equal weights to each dimension for getting a composite index of women’s empowerments following a technique of multidimensional poverty measures developed by Alkire and Foster and other research in the current study [ 37 , 55 ]. This composite index assigns a score to each woman, with higher scores signifying greater empowerment.…”

Do education and living standard matter in breaking barriers to healthcare access among women in Bangladesh?

“…Details of the dimensions, indicators and weights of living standard have given in Table 2 . The study used the cut-off values of UNDP report to categorize the living standard of a household into three categories: low (if deprivation score exceeds 0.5), moderate (if deprivation score was between 0.33 and 0.5) and high (if deprivation score does not exceed the cut-off point 0.33) [ 30 , 31 ].…”

“…In the present study, the spousal education and living standard are considered as important predictors of barriers to healthcare access among women, where living standard is a latent phenomenon derived from some household facilities such as electricity access, modern cooking fuels, improved sanitation facility, improved drinking water, improved housing materials. and household assets following the multidimensional poverty index [ 30 , 31 ].…”