Identifying households with low immunisation completion in Bangladesh

Johanna Andrews-Chavez, Animesh Biswas, Mervyn Gifford, Charli Eriksson, Koustuv Dalal

Department of Public Health Sciences, School of Health and Medical Sciences, ?rebro University, ?rebro, Sweden.
Department of Public Health Sciences, School of Health and Medical Sciences, ?rebro University, ?rebro, Sweden;.
Department of Public Health Sciences, University of Sk?vde, Sk?vde, Sweden.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA.

DOI: 10.4236/health.2012.411166                

Abstract

The objective of this study was to investigate if the mothers’ demographics and household characteristics—including type of use of cooking fuel, energy and toilet facilities—have any implication for complete immunisation rates among their children. A cross-sectional data analysis of a nationally representative sample of 4925 women with at least one child was performed. Chisquared tests and multivariate logistic regression analyses were used. Immunisation coverage was positively associated with the mother’s education and with household characteristics such as toilet facility, electricity and involvement in a microfinance group. These findings indicate the need for further advocacy for increased knowledge on the importance of vaccination and affordable public immunisation programs focusing on higher risk households such as those with pit facilities, lack of electricity and no participation in a microfinance group. Such households warrant further attention and can be targeted for immunisation coverage.

Keywords

Bangladesh; Children; Household Characteristics; Vaccination Completion

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	World Bank (2012) Public health at a glance: Immunization. http://go.worldbank.org/A0E6J0XVO0
[2]	Jamil, K., Bhuiya, A., Streatfield, K. and Chakrabarty, N. (1999) The immunization programme in Bangladesh: Impressive gains in coverage, but gaps remain. Health Policy Plan, 14, 49-58. doi:10.1093/heapol/14.1.49
[3]	Streefland, P., Chowdhury, A.M.R. and Ramos-Jimenez, P. (1999) Patterns of vaccination acceptance. Social Science & Medicine, 49, 1705-1716. doi:10.1016/S0277-9536(99)00239-7
[4]	Odusanya, O.O., Alufohai, E.F., Meurice, F.P. and Ahonk-hai, V.I. (2008) Determinants of vaccination coverage in rural Nigeria. BMC Public Health, 8, 381. doi:10.1186/1471-2458-8-381
[5]	National Institute of Popu-lation Research and Training (2007) Bangladesh demographic and health survey. Dhaka, Bangladesh and Calverton, 2007.
[6]	Perry, H., Weierbach, R., El-Arifeen, S. and Hossain, I. A. (1998) Comprehensive assessment of the quality of immunization services in one major area of Dhaka City, Bangladesh. Tropical Medicine & International Health, 3, 981-992. doi:10.1046/j.1365-3156.1998.00333.x
[7]	Bangladesh (2009) EPI factsheet. www.searo.who.int/vaccine/LinkFiles/EPI2009/Bangladesh09.pdf
[8]	Bhuiya, A., Bhuiya, I. and Chowdhury, M. (1995) Factors affecting acceptance of immunization among children in rural Bangladesh. Health Policy and Planning, 10, 304- 312. doi:10.1093/heapol/10.3.304
[9]	Khan, M.M., Kr?mer, A., Khandoker, A., Prüfer-Kr?mer, L. and Islam, A. (2011) Trends in sociodemographic and health-related indicators in Bangladesh, 1993-2007: Will inequities persist? Bulletin of the World Health Organization, 89, 583-592. doi:10.2471/BLT.11.087429
[10]	SEARO (2011) Country health profile. http://ban.searo.who.int/EN/Section28.htm
[11]	Rahman, M., Banerjee, M., Rahman, M. and Akhter, F.U. (2006) Vaccination status of tribal mothers and their under five children. My-mensingh Medical Journal, 15, 55- 57.
[12]	Jha, N., Kannan, A.T., Paudel, I.S. and Niraula, S. (2001) EPI vaccination in Nepal. The Southeast Asian Journal of Tropical Medicine and Public Health, 32, 547-552.
[13]	CDC (2012) Vaccines Safety. www.cdc.gov/vaccines/pubs/pinkbook/downloads/safety.pdf
[14]	CDC (2012) Understanding how vaccines work. www.cdc.gov/vaccines/spec-grps/hcp/downloads/vacsafe-understand-color-office.pdf
[15]	Rahman, M. and Obaida-Nasrin, S. (2010) Factors affecting acceptance of completeimmunization coverage of children under five years in rural Bangladesh. Saludpública de México, 52, 134-140. doi:10.1590/S0036-36342010000200005
[16]	Khan, M.N., Rahman, M.L., AwalMiah, A., Islam, M.S., Musa, S.A. and Tofail, F. (2005) Vaccination coverage survey in Dhaka District. Bangladesh Medical Research Council Bulletin, 31, 46-53.
[17]	Chowdhury, A.M., Bhuiya, A., Mahmud, S., Abdus Salam, A.K. and Karim, F. (2003) Immunization divide: Who do get vaccinated in Bangladesh? Journal of Health, Popu- lation, and Nutrition, 21, 193-204.
[18]	Rahman, M., Islam, M.A. and Mahalanabis, D. (1995) Mother’s knowledge about vaccine preventable diseases and immunization coverage in a population with high rate of illiteracy. Journal of Tropical Pediatrics, 41, 376-378.
[19]	Halla, A. (2004) Vaccination and child mortality. Lancet, 364, 2156-2157. doi:10.1016/S0140-6736(04)17604-6
[20]	Sanou, A., Simboro, S., Kouyaté, B., Dugas, M., Graham, J. and Bibeau, G. (2009) Assessment of factorsassociated with completeimmunization-coverage in children aged 12 - 23months: A cross-sectionalstudy in Nounadistrict, Burkina Faso. BMC International Health & Human Rights, 9, S10. doi:10.1186/1472-698X-9-S1-S10
[21]	Nath, B., Singh, J.V., Awasthi, S., Bhushan, V., et al. (2007) A study on determinants of immunization coverage among 12 - 23 months old children in urban slums of Lucknow District, India. Indian Journal of Medical Sci- ences, 61, 598-606. doi:10.4103/0019-5359.37046
[22]	Bitragunta, S., Murhekar, M.V., Hutin, Y.J., Penumur, P.P. and Gupte, M.D. (2008) Persistence of Diphtheria, Hyderabad, India, 2003-2006. Emerg-ing Infectious Diseases, 14, 1144-1146. doi:10.3201/eid1407.071167
[23]	Dasgupta, S., Huq, M., Khaliquzzaman, M., Pandey K. and Wheeler, D. (2006) Indoor air quality for poor fami- lies: New evidence from Bangladesh. Indoor Air, 16, 426-444. doi:10.1111/j.1600-0668.2006.00436.x
[24]	Dherani, M., Pope, D., Mascarenhas, M., Smith, K.R., Weber, M. and Bruce, N. (2008) Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: A systematic review and metaanalysis. Bulletin of the World Health Organization, 86, 390-398. doi:10.2471/BLT.07.044529
[25]	Bassani, D.G., Jha, P., Dhin-gra, N. and Kumar, R. (2010) Child mortality from solid-fuel use in India: A nationally- representative case-control study. BMC Public Health, 17, 491.
[26]	Rutstein, S.O. and Johnson, K. (2004) The DHS wealth index. DHS Comparative Reports No. 6, Calverton, 2004.
[27]	Phukan, R.K., Barman, M.P. and Mahanta, J. (2009) Factors associated with immunization coverage of children in Assam, India: Over the first year of life. Journal of Tropical Pediatrics, 55, 249-252. doi:10.1093/tropej/fmn025
[28]	Ibnouf, A.H.,Van den Borne, H.W. and Maarse, J.A.M. (2007) Factors influencing immunization coverage among children under five years of age in Khar-toum State, Sudan. South African Journal of Family Practice, 49, 14.
[29]	Brugha, R. and Kevany, J. (1995) Immunization determinants in the eastern region of Ghana. Health Policy and Planning, 10, 312-318. doi:10.1093/heapol/10.3.312
[30]	Parashar, S. (2005) Moving beyond the mother-child dyad: Women’s education, child immunization, and the importance of context in rural India. Social Science & Medicine, 61, 989-1000. doi:10.1016/j.socscimed.2004.12.023
[31]	Elliott, C. and Farmer, K. (2006) Immunization status of children under 7 years in the Vikas Nagar area, North India. Child Care Health and Development, 32, 415-421. doi:10.1111/j.1365-2214.2006.00623.x
[32]	Ramakrishnan, R., Rao, T.V., Sundaramoorthy, L. and Joshua, V. (1999) Magnitude of recall bias in the estimation of immunization coverage and its determinants. Indian Journal of Child Health, 36, 881-885.