VoICE Immunization Evidence: Education Inequity
Across many South Asian and sub-Saharan African countries, children with mothers who received no formal education were nearly 3 times as likely to die before reaching age 5 as those born to mothers with some secondary education.
A study conducted in the urban poor in Delhi, India examining household and neighborhood-level determinants of childhood immunization found that the odds of complete vaccination in children were higher if the mother was literate (1.6x), if the child was born within the city limits (2.7x), born in a health facility (1.5x), and if they belonged to the wealthiest 20% of families sampled from this poor urban area (2.5x).
Nigerian Demographic Health Survey data suggests that community literacy influences immunization status. Children in communities with low levels of illiteracy were 82% less likely to be fully immunized than children in communities with medium levels of illiteracy.
A study conducted in Eastern Uganda found that Ugandan children whose mothers had some secondary schooling were 50% more likely to have received scheduled vaccinations by 6 months of age than children whose mothers had attended school only through primary level. This effect became more pronounced with delivery of the later doses of each vaccine (OPV2, 3 & DPT-HB-Hib 2,3).
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.
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.
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 containting vaccine and three doses of DTP vaccine than children of the most educated mothers.
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.