The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

Anichukwu, Onyekachi Ibenelo; Asamoah, Benedict Oppong

doi:10.1136/bmjopen-2018-026324

Cited by 18 publications

(16 citation statements)

References 45 publications

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“…Our finding on the association between ANC attendance and complete childhood vaccination is consistent with studies from Ethiopia, 37 Nigeria, 38 South Africa, 39 Senegal 40 and Zimbabwe. 41 In those studies, low ANC attendance was associated with lower odds of complete childhood vaccination.…”

Section: Discussionsupporting

confidence: 91%

Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

et al. 2021

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ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.

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Section: Discussionsupporting

confidence: 91%

Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

et al. 2021

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“…This is consistent with several studies in other low-income and middle-income countries (LMICs) that demonstrate that increased health communications on immunisation during MHC utilisation was significantly associated with childhood immunisation. 51 54 However, given that the sequence of MHC utilisation is ANC-SBA-PNC, the absence of a significant effect for ANC in this study does not imply that adequate ANC attendance is not associated with RI. Instead, our data suggest that other factors such as accessibility to health facilities could have a stronger association with RI than adequately attending ANC.…”

Section: Discussionmentioning

confidence: 62%

“…Also, our study found that mothers who used MHC services were significantly more likely to have full immunised children suggesting that improving MHC utilisation, especially in underserved rural communities, might be an effective strategy in achieving the IA2030 national and subnational targets. 54 However, further studies, preferably randomised controlled trials, are needed to confirm if strategies aimed at improving MHC utilisation actually improve immunisation rate. Finally, our study demonstrates the importance of reporting vaccination coverage at the local/district level to draw attention to regional inequities at that level and identify regions/districts for more targeted interventions.…”

Section: Policy Implicationsmentioning

confidence: 99%

Factors associated with incomplete immunisation in children aged 12–23 months at subnational level, Nigeria: a cross-sectional study

et al. 2021

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ObjectivesNational immunisation coverage rate masks subnational immunisation coverage gaps at the state and local district levels. The objective of the current study was to determine the sociodemographic factors associated with incomplete immunisation in children at a sub-national level.DesignCross-sectional study using the WHO sampling method (2018 Reference Manual).SettingFifty randomly selected clusters (wards) in four districts (two urban and two rural) in Enugu state, Nigeria.Participants1254 mothers of children aged 12–23 months in July 2020.Primary and secondary outcome measuresFully immunised children and not fully immunised children.ResultsFull immunisation coverage (FIC) rate in Enugu state was 78.9% (95% CI 76.5% to 81.1%). However, stark difference exists in FIC rate in urban versus rural districts. Only 55.5% of children in rural communities are fully immunised compared with 94.5% in urban communities. Significant factors associated with incomplete immunisation are: children of single mothers (aOR=5.74, 95% CI 1.45 to 22.76), children delivered without skilled birth attendant present (aOR=1.93, 95% CI 1.24 to 2.99), children of mothers who did not receive postnatal care (aOR=6.53, 95% CI 4.17 to 10.22), children of mothers with poor knowledge of routine immunisation (aOR=1.76, 95% CI 1.09 to 2.87), dwelling in rural district (aOR=7.49, 95% CI 4.84 to 11.59), low-income families (aOR=1.56, 95% CI 1.17 to 2.81) and living further than 30 min from the nearest vaccination facility (aOR=2.15, 95% CI 1.31 to 3.52).ConclusionsAlthough the proportion of fully immunised children in Enugu state is low, it is significantly lower in rural districts. Study findings suggest the need for innovative solutions to improve geographical accessibility and reinforce the importance of reporting vaccination coverage at local district level to identify districts for more targeted interventions.

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“…Consistent with prior research on immunization coverage [ 3 , 29 , 30 ], the current study found that women who gave birth at home and other places had increased chances of experiencing measles vaccination dropout. For instance, a study on the impact of maternal health care utilization on routine immunization coverage of children in Nigeria found that ANC attendance irrespective of the number of visits had positive effects on the child being fully immunized after adjusting for covariates [ 31 ]. Additionally, in Ethiopia [ 29 ] it was reported that delivery at health facilities was significantly associated factors with full immunization, likely because some vaccines, such as BCG and OPV 0 are habitually given immediately after birth at the health facilities.…”

Section: Discussionmentioning

confidence: 99%

Determinants of pentavalent and measles vaccination dropouts among children aged 12–23 months in The Gambia

et al. 2022

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Background Every year, vaccination averts about 3 million deaths from vaccine-preventable diseases (VPDs). However, despite that immunization coverage is increasing globally, many children in developing countries are still dropping out of vaccination. Thus, the present study aimed to identify determinants of vaccination dropouts among children aged 12–23 months in The Gambia. Methods The study utilized cross-sectional data obtained from the Gambia Demographic and Health Survey 2019–20 (GDHS). The percentage of children aged 12–23 months who dropped out from pentavalent and measles vaccination were calculated by (1) subtracting the third dose of pentavalent vaccine from the first dose of Pentavalent vaccine, and (2) subtracting the first dose of measles vaccine from the first dose Pentavalent vaccine. Generalized Estimating Equation models (GEE) were constructed to examine the risk factors of pentavalent and measles vaccinations dropout. Results Approximately 7.0% and 4.0% of the 1,302 children aged 12–23 months had dropped out of measles and pentavalent vaccination respectively. The multivariate analyses showed that when caregivers attended fewer than four antenatal care sessions, when children had no health card or whose card was lost, and resided in urban areas increased the odds of pentavalent dropout. On the other hand, when women gave birth in home and other places, when children had no health card, and being an urban areas dweller increased the odds of measles dropout. Conclusion Tailored public health interventions towards urban residence and health education for all women during ANC are hereby recommended.

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The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

Cited by 18 publications

References 45 publications

Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

Factors associated with incomplete immunisation in children aged 12–23 months at subnational level, Nigeria: a cross-sectional study

Determinants of pentavalent and measles vaccination dropouts among children aged 12–23 months in The Gambia

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