Migration and child immunization in Nigeria: individual- and community-level contexts

Abstract

BackgroundVaccine-preventable diseases are responsible for severe rates of morbidity and mortality in Africa. Despite the availability of appropriate vaccines for routine use on infants, vaccine-preventable diseases are highly endemic throughout sub-Saharan Africa. Widespread disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria. This study assessed the individual- and community-level explanatory factors associated with child immunization differentials between migrant and non-migrant groups.MethodsThe proportion of children that received each of the eight vaccines in the routine immunization schedule in Nigeria was estimated. Multilevel multivariable regression analysis was performed using a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities. Odds ratios with 95% confidence intervals were used to express measures of association between the characteristics. Variance partition coefficients and Wald statistic i.e. the ratio of the estimate to its standard error were used to express measures of variation.ResultsIndividual- and community contexts are strongly associated with the likelihood of receiving full immunization among migrant groups. The likelihood of full immunization was higher for children of rural non-migrant mothers compared to children of rural-urban migrant mothers. Findings provide support for the traditional migration perspectives, and show that individual-level characteristics, such as, migrant disruption (migration itself), selectivity (demographic and socio-economic characteristics), and adaptation (health care utilization), as well as community-level characteristics (region of residence, and proportion of mothers who had hospital delivery) are important in explaining the differentials in full immunization among the children.ConclusionMigration is an important determinant of child immunization uptake. This study stresses the need for community-level efforts at increasing female education, measures aimed at alleviating poverty for residents in urban and remote rural areas, and improving the equitable distribution of maternal and child health services.

Environmental Determinants of Child Mortality in Nigeria

“…Ozumba and Nwogu-Ikojo (2008) applied multiple regressions with autocorrelation adjustment to estimate mortality. Antai et al (2010) employ the multilevel logistic regression while Doctor (2011) uses multivariate logistic regression. All these studies find demographic, socio-economic and environmental factors (source of drinking water, sanitation facilities) to be significantly related to infant and child mortality.…”

A Systematic Review on Factors Affecting Community Participation towards Polio Immunization in Nigeria

“…Fourteen surveys had a response rate of over 50% for community participation in polio immunization program (Antai D, 2010;Alfred and Alfred, 2012;Nnenna et al, 2013;Baba and Ayivor, 2012;Iliayasu Z et al, 2014;Ogwumike et al, 2012;Oyefara J L, 2014;Awodele O,2010;Oladejo O P, 2013;Antai D, 2012;Singh et al, 2013;Rahji and Ndiko, 2013;Ita et al, 2012;Olawepo and Fashagba,2014).…”

“…Three of the studies (Antai D, 2010;Baba and Ayivor, 2012;Antai D, 2012) are retrospectives with secondary data (readymade), in which the first assessed the effect of individual and community level participation, the second evaluate the good, the bad and the ugly aspects of polio in Nigeria, and assessed the association between multiple dimensions of gender inequalities and full childhood immunization. The remaining fifteen articles (Alfred and Alfred, 2012;Nnenna et al, 2013;Iliayasu Z, et al, 2014;Itimi et al, 2012;Ogwumike et al, 2012;Ekure et al, 2013;Tagbo B N, et al, 2012;Oyefara J L, 2014;Awodele O. et al, 2010;Oladejo O P et al, 2013;Abdulraheemetet al, 2011;Singh et al, 2013;Rahji and Ndikom, 2013;Ita et al, 2012;Olawepo and Fashagba, 2014) were purely cross sectional descriptive studies.…”

“…Only one article was written by a professor in geography. Five surveys from pharmacists, pediatricians and doctors were conducted at practice settings which included teaching hospitals, general hospitals and laboratories (Nnenna et al, 2013;Iliayasu Z et al, 2014;Ogwumike et al, 2012;Tagbo B N et al, 2012;Awodele O et al, 2010), while thirteen conducted the research within the community settings (Antai D, 2010;Alfred and Alfred, 2012;Baba and Ayivor, 2012;Itimi et al 2012;Ekure et al, 2013;Oyefara J L, 2014;Oladejo O P, 2013;Antai D, 2012;Abdulraheem et al,2011Singh et al, 2013Rahji and Ndikom, 2013;Ita et al, 2012;Olawepo and Fashagba,2014). Two of the articles focused on rural households' perception and rural women childhood immunization (Alfred and Alfred, 2012;Olawepo Fashagba, 2014).…”

Provider’s and User’s Perspective about Immunization Coverage among Migratory and Non-migratory Population in Slums and Construction Sites of Chandigarh

“…[6][7][8] The satisfaction regarding the various parameters was compared in the migratory and non-migratory population. 9 A pretested structured schedule was used to elicit the response of the respondents regarding their satisfaction with the various aspects of immunization. The primary respondent was the mother of the child.…”