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The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013

BACKGROUND: In 2017, about 20% of the world’s children under 1 year of age with incomplete DPT vaccination lived in Nigeria. Fully-immunised child coverage (FIC), which is the percentage of children aged 12–23 months who received all doses of routine infant vaccines in their first year of life in Ni...

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Autores principales: Obanewa, Olayinka Aderopo, Newell, Marie Louise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988360/
https://www.ncbi.nlm.nih.gov/pubmed/31996184
http://dx.doi.org/10.1186/s12889-020-8170-6
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author Obanewa, Olayinka Aderopo
Newell, Marie Louise
author_facet Obanewa, Olayinka Aderopo
Newell, Marie Louise
author_sort Obanewa, Olayinka Aderopo
collection PubMed
description BACKGROUND: In 2017, about 20% of the world’s children under 1 year of age with incomplete DPT vaccination lived in Nigeria. Fully-immunised child coverage (FIC), which is the percentage of children aged 12–23 months who received all doses of routine infant vaccines in their first year of life in Nigeria is low. We explored the associations between child, household, community and health system level factors and FIC, in particular focussing on urban formal and slum, and rural residence, using representative Nigeria Demographic Health Survey (NDHS) data from 2003, 2008 and 2013. METHOD: Multilevel logistic regression models were applied for quantitative analyses of NDHS 2003, 2008 and 2013 data, singly, pooled overall and stratified by rural/urban, and within urban by formal and slum. We also quantify Population Attributable Risk (PAR) of FIC. RESULTS: FIC for rural, urban formal and slum rose from 7.4, 25.6 and 24.9% respectively in 2003 to 15.8, 45.5 and 38.5% in 2013, and varied across sociodemographics. In pooled NDHS analysis, overall and stratified, final FIC adjusted odds (aOR) were: 1. Total population - delivery place (health facility vs home, aOR = 1.13, 95% CI = 0.73–1.73), maternal education (higher vs no education, aOR = 3.92, 95% CI = 1.79–8.59) and place of residence (urban vs rural, aOR = 1.69, 95% CI = 0.89–3.22). 2. Rural, urban formal and slum stratified: A.Rural – delivery place (aOR = 1.47, 95% CI = 1.12–1.94), maternal education (aOR = 4.99, 95% CI = 2.48–10.06). B.Urban formal - delivery place (aOR = 2.62, 95% CI = 1.43–4.79), maternal education level (aOR = 9.18, 95% CI = 3.05–27.64). C.Slums - delivery place (aOR = 5.39, 95% CI = 2.18–13.33), maternal education (aOR = 5.03, 95% CI = 1.52–16.65). The PAR revealed the highest percentage point increase in FIC would be achieved in all places of residence by maternal higher education: rural-38.15, urban formal-22.88 and slum 23.76, while non-attendance of antenatal care was estimated to lead to the largest reduction in FIC. CONCLUSION: Although low FIC in rural areas may be largely due to lack of health facilities and immunisation education, the intra-urban disparity is mostly unexplained, and requires further qualitative and interventional research. We show the FIC point increase that can be achieved if specific sociodemographic variable (risk) are addressed in the various communities, thus informing prioritisation of interventions.
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spelling pubmed-69883602020-02-03 The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013 Obanewa, Olayinka Aderopo Newell, Marie Louise BMC Public Health Research Article BACKGROUND: In 2017, about 20% of the world’s children under 1 year of age with incomplete DPT vaccination lived in Nigeria. Fully-immunised child coverage (FIC), which is the percentage of children aged 12–23 months who received all doses of routine infant vaccines in their first year of life in Nigeria is low. We explored the associations between child, household, community and health system level factors and FIC, in particular focussing on urban formal and slum, and rural residence, using representative Nigeria Demographic Health Survey (NDHS) data from 2003, 2008 and 2013. METHOD: Multilevel logistic regression models were applied for quantitative analyses of NDHS 2003, 2008 and 2013 data, singly, pooled overall and stratified by rural/urban, and within urban by formal and slum. We also quantify Population Attributable Risk (PAR) of FIC. RESULTS: FIC for rural, urban formal and slum rose from 7.4, 25.6 and 24.9% respectively in 2003 to 15.8, 45.5 and 38.5% in 2013, and varied across sociodemographics. In pooled NDHS analysis, overall and stratified, final FIC adjusted odds (aOR) were: 1. Total population - delivery place (health facility vs home, aOR = 1.13, 95% CI = 0.73–1.73), maternal education (higher vs no education, aOR = 3.92, 95% CI = 1.79–8.59) and place of residence (urban vs rural, aOR = 1.69, 95% CI = 0.89–3.22). 2. Rural, urban formal and slum stratified: A.Rural – delivery place (aOR = 1.47, 95% CI = 1.12–1.94), maternal education (aOR = 4.99, 95% CI = 2.48–10.06). B.Urban formal - delivery place (aOR = 2.62, 95% CI = 1.43–4.79), maternal education level (aOR = 9.18, 95% CI = 3.05–27.64). C.Slums - delivery place (aOR = 5.39, 95% CI = 2.18–13.33), maternal education (aOR = 5.03, 95% CI = 1.52–16.65). The PAR revealed the highest percentage point increase in FIC would be achieved in all places of residence by maternal higher education: rural-38.15, urban formal-22.88 and slum 23.76, while non-attendance of antenatal care was estimated to lead to the largest reduction in FIC. CONCLUSION: Although low FIC in rural areas may be largely due to lack of health facilities and immunisation education, the intra-urban disparity is mostly unexplained, and requires further qualitative and interventional research. We show the FIC point increase that can be achieved if specific sociodemographic variable (risk) are addressed in the various communities, thus informing prioritisation of interventions. BioMed Central 2020-01-29 /pmc/articles/PMC6988360/ /pubmed/31996184 http://dx.doi.org/10.1186/s12889-020-8170-6 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Obanewa, Olayinka Aderopo
Newell, Marie Louise
The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013
title The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013
title_full The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013
title_fullStr The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013
title_full_unstemmed The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013
title_short The role of place of residency in childhood immunisation coverage in Nigeria: analysis of data from three DHS rounds 2003–2013
title_sort role of place of residency in childhood immunisation coverage in nigeria: analysis of data from three dhs rounds 2003–2013
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988360/
https://www.ncbi.nlm.nih.gov/pubmed/31996184
http://dx.doi.org/10.1186/s12889-020-8170-6
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