The Knowledge Hub

Attending antenatal care visits increases the likelihood of fully immunized children in Nigeria and other countries

Mothers in Nigeria were between 2-4 times more likely to have fully immunized children if they attended 1-3 antenatal care (ANC) visits, between 2.5-8 times more likely if they attended 4-7 ANC visits, and between nearly 3-14 times more likely if they attended at least 8 ANC visits compared to those who had no ANC.

Similar findings have been seen in many LMICs, including Senegal, Bangladesh, Indonesia, India, Zimbabwe, and Southwest Ethiopia.

Anichukwu OI, Asamoah BO. 2019. The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: A cross-sectional study. BMJ Open. 9(6).

Mothers who received proper care during and after childbirth were more likely to have fully immunized children

Mothers who had skilled birth attendance and post-natal care were approximately 6 times were likely to have fully immunized children.

Anichukwu OI, Asamoah BO. 2019. The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: A cross-sectional study. BMJ Open. 9(6).

Immunization rates are low among pregnant adolescents in rural areas with less education and lower wealth

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 OE, 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(1).

Investments in polio eradication in Africa improved overall immunization systems and increased coverage of routine vaccinations

A systematic review of 8 African countries that had wild polio virus transmission and significant polio eradication activities found evidence that the huge investments made in polio have strengthened capacity in almost all aspects of the overall immunization systems, especially in the areas of microplanning, service delivery, capacity-building (especially supportive supervision and on-the-job training), and program management. This led to substantial increases in coverage of other routine vaccinations – BCG, DPT, measles – in all 8 countries over a 25-year period (1989-2014), including a more than a 3-fold increase in DPT3 coverage in 2 countries and a more than a 2-fold increase in 3 other countries.

Anya BPM, Moturi E, Aschalew T et al.. 2016. Contribution of polio eradication initiative to strengthening routine immunization: lessons learnt in the WHO African region. Vaccine. 34(43).

Children in rural-urban migrant populations in China, India, and Nigeria have lower immunization rates, requiring special efforts to improve vaccination rates and reduce health inequities and disease outbreaks

According to a systematic review and meta-analysis, children who are rural-urban migrants in China, India and Nigeria were less likely to be fully-immunized by the age of one year than non-migrant urban residents and the general population. These inequities in vaccination rates — often concealed in national averages — call for special efforts to improve immunization rates in this rapidly growing sub-population to reduce both health inequities and the risk of infectious disease outbreaks in the wider society.

Awoh AB, Plugge E. 2016. Immunisation coverage in rural-urban migrant children in low and middle-income countries (LMICs): a systematic review and meta-analysis. Journal of Epidemiology and Community Health. 70(3).

Children from the poorest households in Nigeria are less likely to be immunized than those from wealthier households

In a Southwest state of Nigeria, children in the poorest category (quintile) of households were 14 times more likely to be partially immunized or not immunized, and those in the next poorest category were eight times more likely to be partially immunized or not immunized than children in the wealthiest group, after adjusting for factors such as education, religion, and ethnicity.

Ijarotimi IT, Fatiregun AA, Adebiyi OA et al. 2018. Urban-rural differences in immunization status and associated demographic factors among children 12-59 months in a southwestern state, Nigeria. PLoS One. 13(11).

Nigerian children of mothers with less education are less likely to be vaccinated compared to those with educated mothers

Children born to mothers in Southwest Nigeria who had no formal education were four times more likely to be unvaccinated or partially vaccinated than those born to mothers who completed primary school and were six times more likely to be partially vaccinated or unvaccinated than children whose mothers completed a post-secondary education.

Ijarotimi IT, Fatiregun AA, Adebiyi OA et al. 2018. Urban-rural differences in immunization status and associated demographic factors among children 12-59 months in a southwestern state, Nigeria. PLoS One. 13(11).

Fear of Ebola in West Africa caused financial losses and staff shortages in Nigerian hospitals

Fear of Ebola during the 2014-2016 epidemic in 3 West African countries had a major impact on the health sector in neighboring Nigeria, where hospitals some hospitals also turned away febrile patients to prevent being associated with Ebola while staff in other hospitals abandoned their posts.

Bali S, Stewart KA, Pate MA. 2016. Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria. BMJ Global Health. 1(3).

Efforts to eradicate polio have also led to improved access to other vaccines

The expertise and assets gained through efforts to eradicate polio at least partially explain the improvement between 2013 and 2015 in vaccination coverage of DPT3 in six out of ten “focus” countries of the Polio Eradication Endgame strategic plan. This includes substantial increases in vaccination rates in India, Nigeria, and Ethiopia, which, combined, reduced the number of children not fully vaccinated with DPT by 2 million in 2 years.

van den Ent MMVX, Mallya A, Sandhu H et al.. 2017. Experiences and lessons from polio eradication in 10 focus countries of the polio endgame strategic plan. Journal of Infectious Diseases. 216(1).

Maternal education interventions improve immunization rates for children across a community

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.

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.