Studies have shown that maternal education is significantly associated with immunization coverage for themselves and for their children. – VoICE
Key Concept

Key Evidence: A study of delayed vaccination in India found that children whose mothers had no formal education were 37-81% more likely to have delayed vaccinations than children of mothers with 12 or more years of schooling [depending on the vaccine]. Children whose mothers had a primary school eduction fared only slightly better with 33-62% greater odds of getting their vaccination late, when compared to those with highly educated mothers.

From the VoICE Editors: Data in this analysis was from the National Family and Health Survey 4. 

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: Maternal education benefits immunization rates of all community members, not only mothers’ own children. In Nigeria, children’s odds of being fully immunized improved by 1.06 times for every additional year of education the mothers received. Children’s odds of being fully immunized increased by 1.2 times for each additional year of maternal education in the community.

From the VoICE Editors: The authors controlled for factors including maternal employment, average household wealth, whether the child was born in a hospital, urban status of communities, and geographic location of communities.

Burroway, R., Hargrove, A. 2018. Education is the antidote: Individual- and community-level effects of maternal education on childhood immunizations in Nigeria. Social Science and Medicine. 213.
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Key Evidence: The use of antenatal care (ANC) services among pregnant adolescents in low- and middle-income countries, including tetanus toxoid vaccination, was lowest among women who lived in rural areas, had completed less education, and who were of poorer wealth quintiles.

Banke-Thomas QE, Banke-Thomas AO, Ameh CA 2017. Factors influencing ultilisation of maternal health services by adolescent mothers in Low- and middle-income countries: a systematic review. BMC Pregnancy Childbirth. 17(65).
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Key Evidence: A study looking at WHO data from member states shows that globally, coverage of the third dose of DTP is 26% higher among children born to mothers with some secondary education compared to mothers with no education.

Hinman, A.R., and McKinlay, M.A. 2015. Immunization equity. Vaccine. 33(2015).
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Key Evidence: Data from the Kenya Demographic and Health Survey show that women with a primary school education were 2 to 5 times more likely to have their infants vaccinated (depending on the vaccine) and women with a secondary school education were 2.5 to 9 times more likely to have their infants vaccinated than mothers with less than a primary education or no education [after adjusting for wealth, age, religion and other variables]. Targeted communications activities to sensitize less educated women on the value of vaccination could be a short-term measure to close this gap.

Onsomu EO, Abuya BA, Okech IN et al. 2015. Maternal education and immunization status among children in Kenya. Maternal and Child Health Journal. 19.
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Key Evidence: A study conducted in Pakistan, designed to explore the association of maternal education and empowerment with childhood polio vaccination, showed that mothers with more education are more likely to vaccinate their children – 74% of children of mothers with higher education were completely vaccinated compared to 67% of those with primary education and only 47% of those with no education.

Khan, M.T., Zaheer, S., Shafique,K. 2017. Maternal education, empowerment, economic status, and child polio vaccination uptake in Pakistan: a population based cross sectional study. BJM Open. 7(3).
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Key Evidence: Researchers looking at vaccination coverage in 45 low- and middle-income countries found that maternal education is a strong predictor of vaccine coverage. Children of the least educated mothers are 55% less likely to have received measles containing vaccine and three doses of DTP vaccine than children of the most educated mothers.

Arsenault, C., Harper, S., Nandi, A., et al. 2017. Monitoring equity in vaccination coverage: A systematic analysis of demographic and health surveys from 45 Gavi-supported countries. Vaccine. 5(6).
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Key Evidence: A study that examined the gender gap in immunization coverage in a rural area of Bangladesh showed that poverty, low maternal education, and second or higher birth order had a stronger negative effect on the likelihood of full immunization coverage for girls compared to boys. In other words, girls from households in this area that were below the poverty line were 11% less likely to be fully immunized than boys from households below the poverty line. Girls were also 6% less likely than boys to be fully vaccinated if their mothers did not attend high school and 5% less likely than boys to be vaccinated if they were not the first born child in the family.

Hanifi, S.M., Ravn, H., Aaby, P., et al. 2018. Where girls are less likely to be fully vaccinated than boys: Evidence from a rural area in Bangladesh. Vaccines. online April 2018.
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