Maternal sociodemographic factors that influence full child immunisation uptake in Nigeria
Background. With vaccine-preventable disease accounting for many <5-year deaths in most developing countries, it is imperative to determine the factors responsible for poor immunisation coverage in these countries.
Objective. To identify maternal sociodemographic factors associated with child immunisation uptake in Nigeria.
Methods. Data from a nationally representative sample of mothers (aged 15 - 49 years) were obtained from the 2008 Nigeria demographic and health survey. Logistic regressions were used to examine the association between maternal sociodemographic variables and child immunisation uptake.
Results. The overall uptake of full immunisation based on the National Programme on Immunisation schedule was 30.6%. There was wide variation in full immunisation uptake in the different regions in Nigeria, with 51% in the South-West, 46.5% in the South-East, 39.5% in the South-South, 6.4% in the North-West, 11.8% in the North-East and 28.2% in the North-Central. Approximately 40.2% of children surveyed had never received any form of vaccination. The most common reasons given for non-vaccination of these children were lack of information about immunisation, fear of side-effects and the immunisation centres being too far away. It was noted that uptake of vaccines with multiple dosing schedules dropped with each successive dose. Decreased likelihood for full immunisation was seen in mothers <18 years old (odds ratio (OR) 0.53; confidence interval (CI) 0.34 - 0.84) and mothers residing in the northern regions. Increased likelihood for full immunisation was seen in mothers from middle and rich classes (OR 1.26, CI 1.03 - 1.66 and OR 1.69, CI 1.27 - 2.25, respectively), mothers with higher educational level (OR 3.77, CI 1.52 - 9.32), mothers with access to media (OR 1.84, CI 1.21 - 1.68), mothers resident in urban areas (OR 1.36, CI 1.22 - 1.51) and mothers who had institutional deliveries (OR 1.86, CI 1.44 - 2.40).
Conclusion. Full immunisation uptake in Nigeria is poor. Cultural disparity in different regions of Nigeria may account for the wide variation in immunisation coverage observed.