Investing in maternal health improves immunization rates and overall health of mothers and children

Use of recommended maternal health care services — defined as at least 4 antenatal care visits, having a skilled attendant at birth, and delivery in a health facility — was a predictor of timely vaccination of mothers’ infants in a study conducted in Ghana. Compared to children whose mothers received one or two of these services, infants born to mothers who received all three interventions were roughly 30% more likely to be fully vaccinated by 12-23 months of age, while children whose mothers received none of these services were only about half as likely to be fully vaccinated. Investing in maternal health, which creates familiarity with the health system and increases mothers’ knowledge about disease prevention, can improve the health of both the mother and her children beyond infancy.

Immunization can help reduce the risk of stunting caused by diarrhea in children

A pooled analysis of nine studies assessing the effects of diarrhea on stunting prior to the age of 24 months showed that the odds of stunting were significantly increased with each diarrheal episode. Each day of diarrhea prior to attaining 24 months of age also contributed to the risk of stunting. For each five episodes of diarrhea, the odds of stunting increased by 13%. In addition, once a child becomes stunted, only 6% of those stunted at 6 months of age recovered by 24 months of age.

The empowerment of women is associated with higher odds of childhood vaccinations

A systematic review of studies from countries in Africa and Southeast Asia investigated the relationship between a woman’s “agency” (defined as the woman’s ability to state her goals and to act upon them with motivation and purpose) and childhood immunizations in lower-income settings. The review found a general pattern among studies in which higher agency among mothers was associated with higher odds of childhood immunizations. Empowering women in these settings shows promise as a means to improve child health.

Undernourished children have a higher likelihood for diarrhea and pneumonia but immunization can improve infant growth

Multiple studies show that

  1. Diarrhea and pneumonia impair children’s growth and that underlying malnutrition is a major risk factor for these conditions.
  2. “Episodes of diarrhea may predispose to pneumonia in undernourished children” and
  3. Immunization against influenza (in mothers) and Streptococcus pneumoniae may improve infant growth. In addition, new studies from Bangladesh, Colombia, Ghana, and Israel further support the paradigm that malnutrition is a key risk factor for diarrhea and pneumonia.

Vaccines are most cost-effective in low income countries

An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.