Abstract
IntroductionImmunization is the world’s most successful and cost-effective public health intervention as it prevents over 2 million deaths annually. However, over 2 million deaths still occur yearly from Vaccine preventable diseases, the majority of which occur in sub-Saharan Africa. Nigeria is a major contributor of global childhood deaths from VPDs. Till date, Nigeria still has wild polio virus in circulation. The objective of this study was to identify the individual and socioeconomic factors associated with immunization coverage in Nigeria through a secondary dataset analysis of Nigeria Demographic and Health Survey (NDHS), 2013.MethodsA quantitative analysis of the 2013 NDHS dataset was performed. Ethical approvals were obtained from Walden University IRB and the National Health Research Ethics Committee of Nigeria. The dataset was downloaded, validated for completeness and analyzed using univariate, bivariate and multivariate statistics.ResultsOf 27,571 children aged 0 to 59 months, 22.1% had full vaccination, and 29% never received any vaccination. Immunization coverage was significantly associated with childbirth order, delivery place, child number, and presence or absence of a child health card. Maternal age, geographical location, education, religion, literacy, wealth index, marital status, and occupation were significantly associated with immunization coverage. Paternal education, occupation, and age were also significantly associated with coverage. Respondent's age, educational attainment and wealth index remained significantly related to immunization coverage at 95% confidence interval in multivariate analysis.ConclusionThe study highlights child, parental and socioeconomic barriers to successful immunization programs in Nigeria. These findings need urgent attention, given the re-emergence of wild poliovirus in Nigeria. An effective, efficient, sustainable, accessible, and acceptable immunization program for children should be designed, developed and undertaken in Nigeria with adequate strategies put in place to implement them.
Highlights
Immunization is the world’s most successful and cost-effective public health intervention as it prevents over 2 million deaths annually
This results in an estimated 2.7 million child deaths annually from vaccine preventable diseases (VPDs), the majority of which occur in subSaharan Africa, which accounts for the increasing under-5 years-old mortality rate in sub-Saharan Africa and South Asia, as these two regions accounted for 82% of under-5 years-old deaths in 2011 [3]
Despite its over 30 years of implementation in Nigeria, hundreds of millions of US dollars spent and a significant population of healthcare workers engaged in the program, the national immunization coverage is still less than 30% [5,6]
Summary
Immunization is the world’s most successful and cost-effective public health intervention as it prevents over 2 million deaths annually. The objective of this study was to identify the individual and socioeconomic factors associated with immunization coverage in Nigeria through a secondary dataset analysis of Nigeria Demographic and Health Survey (NDHS), 2013. Existing immunization programs prevent over 2 to 3 million deaths annually that could have resulted from vaccine preventable diseases (VPDs), 19.4 million children missed out on basic vaccination globally in 2015 [2]. The study was designed to answer the following research questions: (A) is there an association between socioeconomic factors (education and income level) and percentage of completeness of immunization for Nigerian children, and (B) is there an association between individual factors (child's gender and birth order) and percentage of completeness of childhood immunization in Nigeria, using the health belief model (HBM) and the social ecological model (SEM) theoretical framework
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