Maternal education and child immunization: the mediating roles of maternal literacy and socioeconomic status

Abstract

IntroductionPrevious studies in Nigeria have documented significant association between maternal education and child immunization. However, little is known about the pathway through which maternal education improves immunization uptake. This study aims to examine whether maternal literacy and socioeconomic status mediates the relationship between maternal education and complete immunization coverage in children.MethodsNationally representative data from the first wave of the Nigeria General Household Survey-Panel were used, which includes 661 children aged one year and below. Regression analyses were used to model the association between maternal education and child's immunization uptake; we then examined whether maternal literacy and household economic status mediates this association.ResultsOf the 661 children, 40% had complete immunization. The prevalence ratio (PR) of complete immunization in children whose mothers were educated versus those whose mothers were not educated was 1.44 (95% CI: 1.16-1.77). Maternal literacy substantially reduced the estimated association between maternal education and complete immunization by 90%, whereas household economic status reduced the estimates by 27%.ConclusionThese findings suggest that complete immunization was higher in children whose mothers were educated, partly because maternal education leads to acquisition of literacy skills and better health-seeking behavior which then improves immunization uptake for their children. Socioeconomic status is an alternative pathway but with less substantial indirect effect.

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis

“…It has been hypothesized that children of mothers who are educated are more likely to complete their vaccination because maternal education helps a mother to follow health seeking behaviours that enhance child vaccination [8]. To assess the determinants of child immunization in general and the association of maternal education and immunization coverage in particular, studies have been carried out in different settings and different populations.…”

Nutritional status of children in a well-child clinic in Lagos, Nigeria

“…Therefore, children in such families are more likely to be well nourished, complete the recommended immunization cycles and have better educational outcomes over their life's course. They are also less likely to suffer from common health conditions such as diarrhoeal diseases, which afflict infants and young children in developing countries [25] It was also found that 97.5% of mothers with tertiary education had children with normal weight for age. A statistically significant association was found between mother's educational attainment and child's weight for age (P=0.01), making those who had not achieved a tertiary level of education more likely to have children with low birthweight (12.2% versus 2.5%).…”

Analysis of the effects of individual- and community- level predictors on migrant children's primary immunization in Yiwu city, east China

“…In this study, highly educated mothers showed significantly more chances to fully vaccinating their children than the mothers with lower education levels. Mother's high education background had been frequently considered as a positive determinant of the completeness of immunization in many countries, [17][18][19][20] because highly educated mothers can communicate with physicians more effectively and have a better understanding of the importance of vaccination which lead to better acceptance of vaccination. 21,22 This study had revealed that maternal ANC service utilization was significantly associated with reduced odds of vaccination and the completeness of primary immunization at both individual and community levels.…”

“…The length of time for continuously living in the surveyed areas was calculated through checking the date of the last immigration of the surveyed migrant children. The main reason for choosing children aged [13][14][15][16][17][18][19][20][21][22][23][24] months was that those children should have finished all primary vaccinations on the basis of the CEPI schedule, furthermore, they also had enough time to complete all the primary immunizations.…”