Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004–2016

Holipah, Holipah; Maharani, Asri; Sujarwoto, Sujarwoto; Hinoura, Takuji; Kuroda, Yoshiki

doi:10.3390/vaccines8030518

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…Socioeconomic status has been repeatedly identified as an independent determinant of child immunization [ 12 , 30 ]. Similarly, regional disparities in complete immunization have also been repeatedly identified [ 12 , 13 ]. These findings indicate an urgent need to increase equal access to healthcare resources across diverse geographic and socioeconomic groups in Indonesia.…”

Section: Discussionmentioning

confidence: 99%

“…We also collected socio-demographic data points of the respondents, especially those related to women’s empowerment and child immunization, based on prior studies [ 12 , 13 ]. These variables included the region of residence, area of residence, mothers’ age, birth order of the child, age difference with the husband, the education level of the husband, and household wealth quintile.…”

Section: Methodsmentioning

confidence: 99%

“…The first category is enabling resources, such as education and wealth, which intersect with general socioeconomic status. Accordingly, previous studies using Indonesian data identified these factors as the primary determinants of immunization coverage in children [ 12 , 13 ]. Another category is agency in decision-making.…”

Section: Introductionmentioning

confidence: 99%

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Women’s Empowerment Facilitates Complete Immunization in Indonesian Children: A Cross-sectional Study

Wirawan

Gustina²,

Pramana

et al. 2022

J Prev Med Public Health

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Objectives: The primary objective of this study was to examine the effect of women’s empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association.Methods: We utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12-23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women’s empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women’s empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group.Results: The primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women’s empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles.Conclusions: To our knowledge, this study is the first to explore women’s empowerment as a determinant of child immunization in Indonesia. The results indicate that women’s empowerment must be considered in Indonesia’s child immunization program. Women’s empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women’s empowerment on health outcomes.

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