Parental and family dynamics have a direct impact on a child’s immunization status. – VoICE
Key Concept

Key Evidence: In households with seven or more members, the odds of a child receiving full immunization coverage were roughly 20% lower than in households with only three members, even after accounting for the effect of wealth quintile, religion, and population density.

Shrivastwa, N., Wagner, A.L., Boulton, M.L. 2019. Analysis of State-Specific Differences in Childhood Vaccination Coverage in Rural India. Vaccines. 7(42).
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Key Evidence: An equity impact analysis of the 2016 Ethiopia Demographic and Health Survey dataset for full vaccination coverage among children aged up to 36 months found that children living in female-headed households were 49% less likely to have full vaccination coverage compared to children living in male-headed households.

Geweniger, A., & Abbas, K. M. 2020. Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal, and child characteristics. Vaccine. 38(20).
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Key Evidence: Children of Bangladeshi mothers younger than 34 years were more than three times as likely to have incomplete vaccination compared to children of mothers older than 35 years.

Sheikh, N., Sultana, M., Ali, N., et al. 2018. Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh. Tropical Medicine and Infectious Disease. 3(72).
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Key Evidence: Children who were born as the fourth or fifth child in their household were more than twice as likely to be incompletely vaccinated with BCG, measles vaccine, and pentavalent vaccine than those who were born as the second or third child in their household.

Sheikh, N., Sultana, M., Ali, N., et al. 2018. Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh. Tropical Medicine and Infectious Disease. 3,72.
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Key Evidence: In a systematic review of qualitative research from low- and middle-income countries, women’s low social status was shown to be a barrier to their children accessing vaccinations. Specific barriers included access to education, income, resource allocation, and autonomous decision-making related to time. The authors suggest that expanding the responsibility for children’s health to both parents (mothers and fathers) may be one important element in removing persistent barriers to immunization often faced by mothers.

Merten, S., Hilber, A.H., Biaggi, C., et al. 2015. Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.. PloS ONE. 10(8).
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