Household Vulnerability and Childhood Immunization Status in Nigeria

Abstract

Immunization 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 1990s, wide variations exist between and within countries. In some developing countries, immunization rates increased substantially, but in sub-Saharan Africa, immunization rates plummeted, leaving millions of children vulnerable to life-threatening diseases. In Nigeria, coverage rates for routine immunization for 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 2013 Nigeria Demographic and Health Surveys (NDHS). The analytical weighted sample size was 5,824women of reproductive ages (15–49 years) with a live birth in the past 3 years, whose children were within age 12 to 23 months at the time of the survey. The data was 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 high of 23.6% in South-West, to a low of 9.1% in North-East. The overall household vulnerability status showed that children in more and most vulnerable households were 62% (OR = 0.38; p < .001; CI [0.32-0.46]) and 89%less likely (OR = 0.11; p < .001; CI [0.08-0.14]) to receive full vaccination compared with their counterpart in non-vulnerable households. The study revealed significant relationship between mothers’: (i) number of antenatal visits (OR = 1.66; p < .05; CI [0.25-1.77]); (ii) quality of antenatal care (OR = 2.61; p < .05; CI [1.45-4.67]); (iii) place of delivery (OR = 0.62; p < .05; CI [0.45-0.86]); (iv) assistance during delivery (OR = 0.41; p < .001; CI [0.28-0.57]); (v) time of postnatal check (OR = 1.81; p < .001; CI [1.49-2.19]) and full childhood immunization status.