Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors
Date
2017-03
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
ENGLISH SUMMARY : Background: Under-five mortality remains high in sub-Saharan Africa despite global decline. One quarter of these deaths are preventable through interventions such as immunization. The aim of this study was to examine the
independent effects of individual-, community- and state-level factors on incomplete childhood immunization in
Nigeria, which is one of the 10 countries where most of the incompletely immunised children in the world live.
Methods: The study was based on secondary analyses of cross-sectional data from the 2013 Nigeria Demographic
and Health Survey (DHS). Multilevel multivariable logistic regression models were applied to the data on 5,754
children aged 12–23 months who were fully immunized or not (level 1), nested within 896 communities (level 2)
from 37 states (level 3).
Results: More than three-quarter of the children (76.3%) were not completely immunized. About 83% of children
of young mothers (15–24 years) and 94% of those whose mothers are illiterate did not receive full immunization.
In the fully adjusted model, the chances of not being fully immunized reduced for children whose mothers attended
antenatal clinic (adjusted odds ratio [aOR] = 0.49; 95% credible interval [CrI] = 0.39–0.60), delivered in health facility
(aOR = 0.62; 95% CrI = 0.51–0.74) and lived in urban area (aOR = 0.66; 95% CrI = 0.50–0.82). Children whose mothers
had difficulty getting to health facility (aOR = 1.28; 95% CrI = 1.02–1.57) and lived in socioeconomically disadvantaged
communities (aOR = 2.93; 95% CrI = 1.60–4.71) and states (aOR = 2.69; 955 CrI =1.37–4.73) were more likely to be
incompletely immunized.
Conclusions: This study has revealed that the risk of children being incompletely immunized in Nigeria was influenced
by not only individual factors but also community- and state-level factors. Interventions to improve child immunization uptake should take into consideration these contextual characteristics.
Description
CITATION: Adedokun, S. T., et al. 2017. Incomplete childhood immunization in Nigeria : a multilevel analysis of individual and contextual factors. BMC Public Health, 17:236, doi:10.1186/s12889-017-4137-7.
The original publication is available at http://bmcpublichealth.biomedcentral.com
The original publication is available at http://bmcpublichealth.biomedcentral.com
Keywords
Immunization -- Nigeria
Citation
Adedokun, S. T., et al. 2017. Incomplete childhood immunization in Nigeria : a multilevel analysis of individual and contextual factors. BMC Public Health, 17:236, doi:10.1186/s12889-017-4137-7