Incomplete childhood immunization in Nigeria : a multilevel analysis of individual and contextual factors
Autor: | Sulaimon T. Adedokun, Victor Adekanmbi, Olalekan A. Uthman, Charles Shey Wiysonge |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
Pediatrics Psychological intervention Logistic regression Health Services Accessibility 0302 clinical medicine Health facility Residence Characteristics RA0421 Epidemiology Odds Ratio Medicine 030212 general & internal medicine Children Incomplete lcsh:Public aspects of medicine Contextual Multilevel model 1. No poverty Prenatal Care Multilevel Multilevel Analysis Female Research Article medicine.medical_specialty Adolescent 030231 tropical medicine Mothers Nigeria Factors 03 medical and health sciences Young Adult Humans Demography business.industry Immunization Programs Public health Public Health Environmental and Occupational Health Infant lcsh:RA1-1270 Odds ratio Health Surveys Health Literacy Cross-Sectional Studies Logistic Models Immunization Biostatistics business Model |
Zdroj: | BMC Public Health BMC Public Health, Vol 17, Iss 1, Pp 1-10 (2017) |
ISSN: | 1471-2458 |
Popis: | 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.\ud 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).\ud 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.\ud 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. |
Databáze: | OpenAIRE |
Externí odkaz: |