Factors associated with incomplete child immunization in Pakistan: findings from Demographic and Health Survey 2017-18

Ali, Ahmad; Zar, Abu; Wadood, Ayesha

doi:10.1016/j.puhe.2022.01.003

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Mothers who had media exposure have 41% less chances of incomplete immunization for their children. Similar results were found in other studies [ 27 ], and [ 42 ]. The child born to mothers aged 35 years and above were less likely to become incompletely immunized [ 43 ] as the women are quite mature and particular about immunization.…”

Section: Discussionsupporting

confidence: 93%

“…In the child nutrition and health sector, Pakistan’s progress has been substantially slower in comparison to all South Asian countries [ 26 ]. In Pakistan, the percentage of children born in health facilities increased substantially [ 27 ], and [ 1 ]. The effect of health facilities has an input on child immunization results that was the reason that 66% of children in Pakistan were vaccinated but still pace is low to achieve the target of 90% of vaccinated children till 2022.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Contextual factors influencing incomplete immunization and investigation of its geospatial heterogeneity in Pakistan: a cross-sectional study based on PDHS (2017–18)

Kamal,

Waseem,

Siddiqa

et al. 2023

BMC Public Health

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Background Immunization is one of the most effective public health initiatives, saving millions of lives and lowering the risk of diseases such as diphtheria, tetanus, influenza, and measles. Immunization saves an estimated 2–3 million lives per year. A study of the regional variations in incomplete immunization will be useful in identifying gaps in the performance of immunization programs that are not noticed by standard vaccination programs monitoring. The primary goal of this study was to identify factors influencing child immunization status and to examine regional variations in incomplete immunization among children aged 12 to 23 months in Pakistan. Methods For the current study, the data were taken from the Demographic and Health Survey for Pakistan (PDHS 2017–2018). Ever-married women who had children aged 12–23 months were included in this study. The immunization status of children was used as an outcome variable. In order to determine the effects of different factors on incomplete immunization, multilevel logistic model was used. To study the geographical variation of incomplete immunization, hotspot analysis was done using ArcGIS 10.7 and SaTScan software and to identify significant predictors of incomplete immunization, GWR 4 software was used. Results Place of delivery, gender of child, mother’s educational level and region were identified as significant determinants of incomplete immunization of children in Pakistan. Chances of incomplete immunization of children were found significantly lower for educated mothers (AOR = 0.52, 95% CI 0.34–0.79) and mothers who had delivered children in the health facilities (AOR = 0.51, 95% CI 0.32–0.83). Female children were more likely (AOR = 1.44, 1.95% CI 1.04–1.99) to be incompletely immunized as compared to male children. FATA (AOR = 11.19, 95% CI 4.89–25.6), and Balochistan (AOR = 10.94, 95% CI 5.08–23.58) were found at the highest risk of incomplete immunization of children as compared to Punjab. The significant spatial heterogeneity of incomplete immunization was found across Pakistan. The spatial distribution of incomplete immunization was clustered all over Pakistan. The high prevalence of incomplete immunization was observed in Balochistan, South Sindh, North Sindh, South KPK, South FATA, Gilgit Baltistan, Azad Jammu Kashmir, South and East Punjab. Drang and Harcho were identified as hotspot areas of incomplete immunization in Gilgit Baltistan. Secondary clusters with a high risk of incomplete immunization were found in regions Balochistan, Sindh and FATA. Conclusion Gender biasedness towards female children, regarding complete immunization of children prevailed in Pakistan. Spatial heterogeneity was also found for incomplete immunization of children. To overcome the problem access to health facilities is the foremost step. Government should target hotspot areas of incomplete immunization of children to provide primary health care facilities by opening health care units in these areas. The government in collaboration with the media should launch awareness campaigns in those areas to convince people that complete immunization is the right of every child regardless of gender.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Contextual factors influencing incomplete immunization and investigation of its geospatial heterogeneity in Pakistan: a cross-sectional study based on PDHS (2017–18)

Kamal,

Waseem,

Siddiqa

et al. 2023

BMC Public Health

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“…Another study supported that the knowledge of immunization was found to be related to mother's education and residing area 19 . More or less similar factors were studied by A. Ali at al and Desalew A, et al in Pakistan and south Ethiopia respectively 20,21 .…”

Section: Discussionmentioning

confidence: 75%

Association of Educational Status of Mothers and Incomplete Immunization in Children

Aslam

Farhan

Erum

et al. 2023

ashkmdc

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Objective: To determine the association of educational status of mothers and incomplete immunization in children presented at Tertiary Care Hospital, Karachi. Methods: This Case-control study was conducted at Pediatric department, Abbasi Shaheed Hospital, Karachi; from July 2018 to January 2019. The data were prospectively collected from 434 subjects with consent out of which 217 had an incomplete vaccination status and 217 had completed vaccination status. Case group included unvaccinated children whose mothers were uneducated (mothers were labeled un-educated who were never enrolled in school, madrasa and received primary education), whereas control group included vaccinated children whose mothers were educated (mothers were labeled educated who were enrolled in school, madrasa and received primary education).Quantitative data were presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Chi-square test was applied to compare both groups and the odds ratio was calculated. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Using post-stratification chi-square test, a p-value of ?0.05 was considered as significant. Results: A total of 434 (217 cases and 217 controls) were included in this study. The mean age was 3.27±1.79 years (case) and 3.49±1.40 years (controls). Educational status of mothers was assessed verbally. Uneducated mothers are defined as those who did not receive formal education of any level, while educated mothers are defined as those who were enrolled in school or madarsa and received primary education or more. On the basis of which the uneducated mothers in case group were 144 (66.4%) while in control group was 52 (24%).Children with incomplete immunization were 6.25 times more likely to have uneducated mothers than those with complete immunization, after controlling for the other factors. Conclusion: This study has strengthened the value of maternal education in context of complete childhood immunization because acquisition of literacy and health-seeking behavior enhance vaccine uptake for their children.

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“…Within this study population, only 31 % of the children had completed their scheduled immunization up to Penta-3, lower than previously reported province-wide figures of 59 % in PDHS 2017–18 and 73 % reported by the Third-Party Verification of Immunization Coverage Survey (TPVICS) [18] , [19] . To the best of our knowledge, this is the first study reporting determinants of coverage of Pentavalent-3 vaccine from high-risk union-councils of Karachi, whereas previous publications have been based on mainstream population datasets from Pakistan [20] , [21] , [22] . Rate of refusal in our survey was minimal, with only 1 % refusing to participate.…”

Section: Discussionmentioning

confidence: 99%

Social determinants of low uptake of childhood vaccination in high-risk squatter settlements in Karachi, Pakistan – A step towards addressing vaccine inequity in urban slums

Habib,

Zaidi,

Riaz

et al. 2024

Vaccine: X

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Factors associated with incomplete child immunization in Pakistan: findings from Demographic and Health Survey 2017-18

Cited by 6 publications

References 13 publications

Contextual factors influencing incomplete immunization and investigation of its geospatial heterogeneity in Pakistan: a cross-sectional study based on PDHS (2017–18)

Contextual factors influencing incomplete immunization and investigation of its geospatial heterogeneity in Pakistan: a cross-sectional study based on PDHS (2017–18)

Association of Educational Status of Mothers and Incomplete Immunization in Children

Social determinants of low uptake of childhood vaccination in high-risk squatter settlements in Karachi, Pakistan – A step towards addressing vaccine inequity in urban slums

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