Relationship between household wealth and childhood immunization in core-North Nigeria

Adebowale, Ayo Stephen; Obembe, Taiwo; Bamgboye, Eniola

doi:10.4314/ahs.v19i1.33

Cited by 22 publications

(30 citation statements)

References 27 publications

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“…Children living in female-headed households had relatively higher basic vaccination coverage of 39% (35)(36)(37)(38)(39)(40)(41)(42)(43)(44) in comparison to 30% (28)(29)(30)(31)(32) in male-headed households. For child characteristics, basic vaccination coverage was similar among female and male children at 31% (29)(30)(31)(32)(33) and 31% (29-34) respectively, while coverage decreased by birth order with 36% (32-40) and 23% (20)(21)(22)(23)(24)(25)(26) amongst first-born and sixth-born respectively. For healthcare characteristics, children of women who had a higher number of antenatal care visits during their pregnancy had higher basic vaccination coverage at 41% (39-44) for four or more visits and 11% (8.7-13) for no or unknown number of visits.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 94%

Childhood vaccination coverage by socioeconomic, geographic, maternal, child, and healthcare characteristics in Nigeria: equity impact analysis

Williams

Akande

Abbas

2022

Preprint

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Background: Nigeria has a high proportion of underimmunised children in the world. We estimated the inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and healthcare characteristics among children aged 12-23 months in Nigeria using a social determinants of health perspective. Methods: We conducted a systematic review focused on inequities in childhood immunisation in low- and middle-income countries to identify the social determinants of childhood immunisation. Using these determinants, we analysed basic vaccination coverage in Nigeria (1-dose BCG, 3-dose DTP-HepB-Hib (diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B), 3-dose polio, and 1-dose measles) of 6,059 children aged 12-23 months using the 2018 Nigeria Demographic and Health Survey. Results: We identified social determinants of immunisation - household wealth, religion, and ethnicity (socioeconomic characteristics); region and place of residence (geographic characteristics); maternal age at birth, maternal education, and maternal household head status (maternal characteristics); sex of child, and birth order (child characteristics); antenatal care and birth setting (healthcare characteristics). While basic vaccination coverage was 31% (95% CI: 29-33), 19% (18-21) of children aged 12-23 months had received none of the basic vaccines. After controlling for background characteristics, there was a significant increase in the odds of basic vaccination by household wealth, living in an urban area, antenatal care, delivery in a health facility, maternal age and maternal education. Children of Fulani ethnicity in comparison to children of Igbo ethnicity had lower odds of receiving basic vaccinations. Discussion: Children of Fulani ethnicity, living in rural areas, born in home settings, with young mothers living in the poorest households with no formal education and no antenatal care visits were associated with lower rates of basic vaccination in Nigeria. We recommend a proportionate universalism approach with targeted vaccination programmes proportionate to the level of disadvantage for addressing the immunisation barriers.

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Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 94%

Childhood vaccination coverage by socioeconomic, geographic, maternal, child, and healthcare characteristics in Nigeria: equity impact analysis

Williams

Akande

Abbas

2022

Preprint

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“…Religion remained an important demographic factor in Burkina Faso, Cameroon, Ethiopia, Kenya, India, and Nigeria [42, 98, 56, 101, 100, 57], though in Nigeria this factor was only identified when results were stratified by wealth [101]. In India, children who were part of the Muslim minority were less likely to be vaccinated, and notably this demographic factor further increased the gender disparity in immunisation coverage; i.e.…”

Section: Resultsmentioning

confidence: 99%

“…Immunisation coverage was lower among the poorest wealth quintiles in Bangladesh, Brazil, Burkina Faso, Cambodia, Gambia, Ghana, India, Indonesia, Kenya, the Kyrgyz Republic, Madagascar, Malawi, Mongolia, Mozambique, Myanmar, Nigeria, South Africa, and Swaziland [42, 51, 66, 67, 68, 69, 94, 103, 101, 80, 81, 107, 38]. With DTP3 dropout as a measure of incomplete vaccination status, Cambodia saw a decrease in pro-rich inequality over time, but coverage differences between wealth indices were still significant [39, 41].…”

Section: Resultsmentioning

confidence: 99%

Vaccine Equity in Low and Middle Income Countries: A Systematic Review and Meta-analysis

Ali

Hartner

Echeverría-Londoño

et al. 2022

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BackgroundEvidence to date has shown that inequality in health, and vaccine coverage in particular, can have ramifications to wider society. However, whilst individual studies have sought to characterise these heterogeneities in immunisation coverage at national level, few have taken a broad and quantitative view of the contributing factors to heterogeneity in vaccine coverage and impact. This systematic review aims to highlight these geographic, demographic, and sociodemographic characteristics through a qualitative and quantitative approach, vital to prioritise and optimise vaccination policies.MethodsA systematic review of two databases (PubMed and Web of Science) was undertaken using Medical Subject Headings (MeSH) and keywords to identify studies examining factors on vaccine inequality and heterogeneity in vaccine coverage. Inclusion criteria were applied independently by two researchers. Studies including data on key characteristics of interest were further analysed through a meta-analysis to produce a pooled estimate of the risk ratio using a random effects model for that characteristic.ResultsOne hundred and eight studies were included in this review. We found that inequalities in wealth, education, and geographic access can affect vaccine impact and vaccine dropout. We estimated those living in rural areas were not significantly different in terms of full vaccination status compared to urban areas but noted considerable heterogeneity between countries. We found that females were 3% (95%CI[1%, 5%]) less likely to be fully vaccinated than males. Additionally, we estimated that children whose mothers had no formal education were 28% (95%CI[18%,47%]) less likely to be fully vaccinated than those whose mother had primary level, or above, education. Finally, we found that individuals in the poorest wealth quintile were 27% (95%CI [16%,37%]) less likely to be fully vaccinated than those in the richest.ConclusionsWe found a nuanced picture of inequality in vaccine coverage and access with wealth disparity dominating, and likely driving, other disparities. This review highlights the complex landscape of inequity and further need to design vaccination strategies targeting missed subgroups to improve and recover vaccination coverage following the COVID-19 pandemic.RegistrationProspero CRD42021261927

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“…Since a higher educational level is linked with high income and participants with high levels of education are more likely to accept immunization due to its bene ts, it suggests why participants with low income have a relatively low acceptance of immunization. This nding is supported by a Nigerian study where disparities occurred in childhood immunization between the poor and rich households in the core-North part of Nigeria such that, the likelihood of receiving full immunization was 95% higher among children from rich household compared to those from poor households [29]. Information regarding immunization status was taken from the Child Health Record Book (Weighing Cards) and mothers' recall.…”

Section: Factors In Uencing Immunization Acceptancementioning

confidence: 99%

Factors Influencing Children Under-Five Immunization Coverage and Acceptance among Mothers and Caregivers in the Hohoe Municipality of Ghana

Djissem

Dalaba

Klu

et al. 2022

Preprint

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Background: Immunization is a cost-effective process of improving child survival in developing countries through the Expanded Program on Immunization (EPI). Childhood vaccination has shown to be effective in protecting children against vaccine-preventable diseases. Even though Ghana has adopted the World Health Organisation (WHO) initiative of EPI, a considerable portion of childhood morbidity and mortality is due to vaccine-preventable diseases in certain municipalities. This study identified factors influencing immunization coverage and acceptance among children under-five years in the Hohoe municipality of Ghana. Methods: A cross-sectional quantitative study was conducted in the Hohoe Municipality of Ghana. A total of 416 mothers of children under-five years old were randomly selected to participate in the study. Data was collected using questionnaires and entered into EpiData. The data was transferred into STATA 15 for cleaning and analysis. We conduct a descriptive statistical analysis to characterize the data and a simple logistic regression at 95% confidence interval was used to assess the association between dependent and independent variables of interest. The findings were presented in tables and charts with summary statistics.Results: A total of 70% of under-five children included in the study were fully immunized. All the basic vaccines recorded immunization coverage above 80%. While maternal age, ethnicity, educational level, and income were statistically significantly associated with under-five vaccination status, maternal age, ethnicity, educational level, employment status and income level were significant predictors of immunization acceptance among mothers and caregivers of children under-five.Conclusion: The immunization coverage of children under-five in the Hohoe municipality of Ghana is below the global recommended coverage of 80%. Maternal educational status, maternal age, ethnicity, employment status and income level were found to be significant predictors of both immunization coverage and acceptance. We recommend an immunisation health education interventions among pregnant women focusing on the significant findings from this study which may hopefully improve childhood immunisation uptake in the Hohoe Municipality of Ghana.

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Relationship between household wealth and childhood immunization in core-North Nigeria

Cited by 22 publications

References 27 publications

Childhood vaccination coverage by socioeconomic, geographic, maternal, child, and healthcare characteristics in Nigeria: equity impact analysis

Childhood vaccination coverage by socioeconomic, geographic, maternal, child, and healthcare characteristics in Nigeria: equity impact analysis

Vaccine Equity in Low and Middle Income Countries: A Systematic Review and Meta-analysis

Factors Influencing Children Under-Five Immunization Coverage and Acceptance among Mothers and Caregivers in the Hohoe Municipality of Ghana

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