Factors associated with non-utilization of child immunization in Pakistan: evidence from the Demographic and Health Survey 2006-07

Abstract

BackgroundThe proportion of incompletely immunized children in Pakistan varies from 37-58%, and this has recently resulted in outbreaks of measles and polio. The aim of this paper is to determine the factors associated with incomplete immunization among children aged 12-23 months in Pakistan.MethodsSecondary analysis was conducted on nationally representative cross-sectional survey data from the Pakistan Demographic and Health Survey, 2006-07. The analysis was limited to ever-married mothers who had delivered their last child during the 23 months immediately preceding the survey (n = 2,435). ‘Complete immunization’ was defined as the child having received twelve doses of five vaccines, and ‘incomplete immunization’ was defined if he/she had missed at least one of these twelve doses. The association between child immunization status and determinants of non-utilization of vaccines was assessed by calculating unadjusted and adjusted odds ratios (AOR) with 95% confidence intervals using a multivariable binary logistic regression.ResultsThe findings of this research showed that nearly 66% of children were incompletely immunized against seven preventable childhood diseases. The likelihood of incomplete immunization was significantly associated with the father’s occupation as a manual worker (AOR = 1.47; 95% CI: 1.10-1.97), lack of access to information (AOR = 1.35; 95% CI: 1.09-1.66), non-use of antenatal care (AOR = 1.33; 95% CI: 1.07-1.66), children born in Baluchistan region (AOR = 1.74; 95% CI: 1.12-2.70) and delivery at home (AOR = 1.39; 95% CI: 1.14-1.69).ConclusionsDespite governmental efforts to increase rates of immunization against childhood diseases, the proportion of incompletely immunized children in Pakistan is still high. Targeted interventions are needed to increase the immunization rates in Pakistan. These interventions need to concentrate on people with low socioeconomic and educational status in order to improve their knowledge of this topic.

Immunization Status of Internally Displaced Iraqi Children During 2017

“…Culturally the father is considered the bread winner and is expected to provide for the financial needs of the family. Relating to this Bugvi et al [25] working in Pakistan declared in their study that maternal occupation did significantly affect immunization coverage of children in the general population. A poor unskilled mother is unlikely to immunize her child.…”

Routine immunization services in Pakistan: seeing beyond numbers

“…Detailed analysis of coverage reports submitted at sub-district and district level offices is not routinely conducted, with few districts reporting vaccine coverage exceeding 100% (17,18) Low vaccine demand also accounts for declining rates of completed vaccination among children. Vaccine demand is correlated with parental knowledge of vaccine importance, parental education and socioeconomic status (43,47,48). Published data indicate that higher maternal education is positively associated with vaccine uptake (4,10,14,22).…”

“…It has been widely established that "belief in the goodness of vaccination" is considerably more important for motivating caregivers than scientific knowledge about vaccines (14,22,48,(52)(53)(54). Mothers unaware of vaccine side-effects were more likely to have their children vaccinated (22) and, paradoxically, fear of common side-effects was linked to vaccine refusal (14,22), indicating the importance of proper counselling of caregivers before and after vaccinating a child.…”

“…Most public facilities in Pakistan function between 09.00 and 14.00 hours, thus limiting access to services to a few hours in the day. Women attending antenatal services, receiving prenatal tetanus vaccinations or delivering at a health facility were more likely to have their children vaccinated (4,10,13,48), indicating that positive health-seeking behaviours are associated with improved uptake of services over time and between generations.…”

Child Immunization in Pakistan: Socio-Institutional and Regional Aspects

“…The results have shown that children born in the hospital are more likely to be immunized as compare to those who were born at home. It explains the complementary effect of place of delivery of the child and its immunization (Bugvi et al, 2014). …”