Maternal education is associated with vaccination status of infants less than 6 months in Eastern Uganda: a cohort study

Victoria Nankabirwa,Thorkild Tylleskär,James K Tumwine,Halvor Sommerfelt

doi:10.1186/1471-2431-10-92

Victoria Nankabirwa, Thorkild Tylleskär + Show 2 more

Open Access

https://doi.org/10.1186/1471-2431-10-92

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Abstract

BackgroundDespite provision of free childhood vaccinations, less than half of all Ugandan infants are fully vaccinated. This study compares women with some secondary schooling to those with only primary schooling with regard to their infants' vaccination status.MethodsA community-based prospective cohort study conducted between January 2006 and May 2008 in which 696 pregnant women were followed up to 24 weeks post partum. Information was collected on the mothers' education and vaccination status of the infants.ResultsAt 24 weeks, the following vaccinations had been received: bacille Calmette-Guérin (BCG): 92%; polio-1: 91%; Diphteria-Pertussis-Tetanus-Hepatitis B-Haemophilus Influenza b (DPT-HB-Hib) 3 and polio-3: 63%. About 51% of the infants were fully vaccinated (i.e., had received all the scheduled vaccinations: BCG, polio 0, polio 1, DPT-HB-Hib1, polio 2, DPT-HB-Hib 2, polio 3 and DPT-HB-Hib 3). Only 46% of the infants whose mothers' had 5-7 years of primary education had been fully vaccinated compared to 65% of the infants whose mothers' had some secondary education. Infants whose mothers had some secondary education were less likely to miss the DPT-HB-Hib-2 vaccine (RR: 0.5, 95% CI: 0.3, 0.8), Polio-2 (RR: 0.4, 95%CI: 0.3, 0.7), polio-3 (RR: 0.5, 95%CI: 0.4, 0.7) and DPT-HB-Hib-3 (RR: 0.5, 95%CI: 0.4, 0.7). Other factors showing some association with a reduced risk of missed vaccinations were delivery at a health facility (RR = 0.8; 95%CI: 0.7, 1.0) and use of a mosquito net (RR: 0.8; 95%CI: 0.7, 1.0).ConclusionInfants whose mothers had a secondary education were at least 50% less likely to miss scheduled vaccinations compared to those whose mothers only had primary education. Strategies for childhood vaccinations should specifically target women with low formal education.

Highlights

Despite provision of free childhood vaccinations, less than half of all Ugandan infants are fully vaccinated
Routine childhood vaccinations against tuberculosis, polio, diphtheria, pertussis, tetanus, measles, hepatitis B and haemophilus influenza B have been shown to be effective in protecting children against these diseases in low and middle income countries (LMIC) [1,2,3]
This is despite the fact that the Ugandan Ministry of Health provides free childhood vaccinations and has conducted several national immunization days (NIDs) [11]

Summary

Introduction

Despite provision of free childhood vaccinations, less than half of all Ugandan infants are fully vaccinated. Routine childhood vaccinations against tuberculosis, polio, diphtheria, pertussis, tetanus, measles, hepatitis B and haemophilus influenza B have been shown to be effective in protecting children against these diseases in low and middle income countries (LMIC) [1,2,3] These vaccinations are highly cost-effective with respect to life years saved [4,5]. Thirty years later, only 36% of all one-year old Ugandan children are fully immunized [8] and vaccinepreventable diseases continue to be a major contributor to under-five mortality and morbidity [9,10] This is despite the fact that the Ugandan Ministry of Health provides free childhood vaccinations and has conducted several national immunization days (NIDs) [11]. The Uganda national expanded programme on immunization (UNEPI) schedule is BCG and polio at birth; polio+ Diphteria-Pertussis-Tetanus-Hepatitis B-Haemophilus

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