Coverage and factors associated with tetanus toxoid vaccination status among females of reproductive age in Peshawar.

Abstract

To estimate the coverage and determine the factors associated with tetanus toxoid vaccination status among females of reproductive age. Cross-sectional study. District Peshawar, NWFP, from July to September 2002. A total of 646 females of reproductive age (15-49) years were selected from both urban and rural areas of Peshawar through stratified cluster sampling. A pre-tested structured questionnaire was administered to females. Two logistic regression models were built, one for all females and one for married females only. Overall 65.0% females were vaccinated (95% confidence interval (CI) (61.3%, 68.6%). For all females, the variables that were significantly associated with vaccination status were marital status (OR= 8.5, 95% CI (4.7, 15.6)), source of information regarding tetanus toxoid (TT) vaccination, knowledge regarding TT vaccination, visits of lady health worker (LHW) to a household (OR = 2.3, 95% CI (1.4, 3.9) and restriction on TT vaccination (OR = 28.7, 95% CI (3.5, 237.9)). For the married females, the variables that were significantly associated with vaccination status were source of information; visits of LHW to a household (OR = 2.8, 95% CI (1.5 to 5.2)) and an interaction between knowledge regarding TT vaccination and antenatal care visits. These findings are of public health concern as a majority of females is not vaccinated according to WHO recommendations. It is recommended that maternal and neonatal tetanus (MNT) vaccination campaigns should include lady health workers at implementation stage.