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Abstract
Objective To examine the impact of maternal healthcare (MHC) utilisation on routine immunisation coverage of children in Nigeria.
Design Individual level cross-sectional study using bivariate and multivariable logistic regression analyses to examine the association between MHC utilisation and routine immunisation coverage of children.
Setting Nigeria Demographic and Health Survey 2013.
Participants 5506 women aged 15–49 years with children aged 12–23 months born in the 5 years preceding the survey.
Primary outcome measures Fully immunised children and not fully immunised children.
Results The percentage of children fully immunised with basic routine childhood vaccines by the age of 12 months was 25.8%. Antenatal care (ANC) attendance irrespective of the number of visits (adjusted OR (AOR)1–3 visits 2.4, 95% CI 1.79 to 3.27; AOR4–7 visits 3.2, 95% CI 2.52 to 4.13; AOR≥ 8 visits 3.5, 95% CI 2.64 to 4.50), skilled birth attendance (SBA) (AOR 1.9, 95% CI 1.65 to 2.35); and maternal postnatal care (PNC) (AOR 1.7, 95% CI 1.46 to 2.06) had positive effects on the child being fully immunised after adjusting for covariates (except for each other, ie, ANC, SBA and PNC). Further analyses (adjusting stepwise for each MHC service) showed a mediation effect that led to the effect of PNC not being significant.
Conclusions The percentage of fully immunised children in Nigeria was very low. ANC attendance, SBA and maternal PNC attendance had positive impact on the child being fully immunised. The findings suggest that strategies aimed at maximising MHC utilisation in Nigeria could be effective in achieving the national coverage target of at least 80% for routine immunisation of children.
- antenatal
- maternal health care utilisation
- routine immunisation coverage
- skilled birth attendance
- postnatal care
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Footnotes
Contributors OIA: conceptualised the research study, developed the study design, acquired data, analyzed and drafted the manuscript. BOA: involved in developing the study design, interpretation and contributed to the writing of the manuscript. All authors read and approved the final draft of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Ethics approval A request to download and use the NDHS 2013 dataset for this study was submitted to the DHS Program in charge of the dataset. The DHS Program is a United States Agency for International Development (USAID) funded project. The permission to download and use the NDHS 2013 dataset for this study was given. The NDHS 2013 dataset contained no personal information of the respondents. The questionnaires and procedures used in the NDHS 2013 were reviewed and approved by the International Classification of Functioning, Disability and Health (ICF) Institutional Review Board in Nigeria. The procedure for informed consent in the NDHS 2013 was that the respondents gave verbal informed consent which was then signed by the interviewer prior to the interview.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The datasets used for this study are available on request from the DHS Program [at http://dhsprogram.com/data/available-datasets.cfm].
Patient consent for publication Not required.