Key Concept

Key Evidence: Kenyan children born outside of a health facility with the aid of a traditional birth attendant were around 80% more likely to be non-vaccinated or under-vaccinated than children born in a government health facility.

Masters NB, Wagner AL, Carlson BF et al. 2018. Childhood vaccination in Kenya: socioeconomic determinants and disparities among the Somali ethnic community. International Journal of Public Health. 64(3).
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Key Evidence: In India, children whose mothers received tetanus vaccination during their pregnancy were 22-31% less likely to have delayed vaccination (depending on the vaccine) than children of unvaccinated mothers. Those born at home were nearly 3 times more likely to receive BCG vaccination late and 41% more likely to receive their first dose of DTP late than those born in a public health facility.

Choudhary TS, Reddy NS, Apte A et al. 2019. Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family survey-4. Vaccine. 37(17).
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Key Evidence: Children in Pakistan born to women who had 3 or 4 antenatal care (ANC) visits were 40-60% more likely to receive all required vaccines on time than children whose mothers made only 1 or 2 ANC visits.

Noh J-W, Kim Y-M, Akram N et al. 2018. Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan: a secondary analysis of cross-sectional survey data. PLoS One. 13(10).
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Key Evidence: The likelihood of a child 12-23 months of age in Myanmar having completed their vaccinations was more than 3 times greater if his or her mother had received tetanus vaccination during pregnancy, and almost 2 times greater if she made at least 4 antenatal care visits than mothers who hadn’t, after other factors, such as parents’ educational level, household income, residence (rural vs. urban) and mother’s age, were controlled for.

Nozaki I, Hachiya M, Kitamura T 2019. Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data. BMC Public Health. 19.
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Key Evidence: 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.

McGlynn N, Wilk P, Luginaah I, et al. 2015. Increased use of recommended maternal health care as a determinant of immunization and appropriate care for fever and diarrhoea in Ghana: an analysis pooling three demographic and health surveys. Health Policy and Planning. 30.
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Key Evidence: Ethiopian mothers use of any of three maternal health services — antenatal care, delivery services, or tetanus vaccination — significantly increased the likelihood of their children being fully immunized by 12-23 months of age. Therefore, national immunization initiatives should concentrate on improving access of pregnant women to these key maternal health services.

Regassa N, Bird Y, Moraros J 2019. Preference in the use of full childhood immunizations in Ethiopia: the role of maternal health services. Patient Preference and Adherence. 13.
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Key Evidence: A study in Ghana using nationally representative survey data found that children born in an institutional setting had a substantially higher proportion of full vaccination (73.9%) compared to those born at home (60.8%). Children born in a health facility—either public or private—had 1.71 times the odds of receiving a full vaccination schedule compared to children born at home.

Moran, E. B., Wagner, A. L., Asiedu-Bekoe, F., Abdul-Karim, A., Schroeder, L. F., & Boulton, M. L. 2020. Socioeconomic characteristics associated with the introduction of new vaccines and full childhood vaccination in Ghana. Vaccine. 38.
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