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Health policy
Research
Coverage and factors associated with full immunisation among children aged 12–59 months in Bangladesh: insights from the nationwide cross-sectional demographic and health survey
  1. Abdur Razzaque Sarker1,2,
  2. Raisul Akram1,
  3. Nausad Ali1,
  4. Marufa Sultana1
  1. 1 International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
  2. 2 Bangladesh Institute of Development Studies, Dhaka, Bangladesh
  1. Correspondence to Abdur Razzaque Sarker; razzaque{at}bids.org.bd

Abstract

Objective To estimate the coverage and factors associated with full immunisation coverage among children aged 12–59 months in Bangladesh.

Study design The study is cross sectional in design. Secondary dataset from Bangladesh Demographic and Health Survey was used for this analysis. Immunisation status was categorised as ‘fully immunised’ if the children had received all the eight recommended vaccine doses otherwise ‘partially/unimmunised’.

Settings Bangladesh.

Participant Children aged 12–59 months were the study participants. Participants were randomly selected through a two-stage stratified sampling design. A total of 6230 children were eligible for the analysis.

Results About 86% of the children (5356 out of 6230) were fully immunised. BCG has the highest coverage rate (97.1%) followed by oral polio vaccine 1 (97%) and pentavalent 1 (96.6%), where the coverage rate was the lowest for measles vaccine (88%). Coverage was higher in urban areas (88.5%) when compared with rural ones (85.1%). Full immunisation coverage was significantly higher among children who lived in the Rangpur division (adjusted OR (AOR)=3.46; 95% CI 2.45 to 4.88, p<0.001), were 48–59 months old (AOR=1.32; 95% CI 1.06 to 1.64, p=0.013), lived in a medium size family (AOR=1.56; 95% CI 1.32 to 1.86, p<0.001), had parents with a higher level of education (AOR=1.96; 95% CI 1.21 to 3.17, p=0.006 and AOR=1.55; 95% CI 1.05 to 2.29, p=0.026) and belonged to the richest families (AOR=2.2; 95% CI 1.5 to 3.21, p<0.001). The likelihood of being partially or unimmunised was higher among children who had the father as their sole healthcare decision-maker (AOR=0.69; 95% CI 0.51 to 0.92, p<0.012).

Conclusions There were significant variations of child immunisation coverage across socioeconomic and demographic factors. These findings will inform innovative approaches for immunisation programmes, and the introduction of relevant policies, including regular monitoring and evaluation of immunisation coverage—particularly for low-performing regions, so that the broader benefit of immunisation programmes can be achieved in all strata of the society.

  • health policy
  • public health
  • coverage
  • bangladesh

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-028020

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    Footnotes

    • Contributors ARS and MS participated in the design of the study. All authors performed the analysis and prepared the manuscript. ARS, RA and MS provided data analysis advice and revision of the manuscript. All authors read and approved the final 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 This study did not require ethical approval as it used unidentifiable secondary DHS dataset. According to the DHS, written informed consent was obtained from mothers/caretakers on behalf of the children enrolled in the survey. The DHS data are publicly accessible and were made available to us upon request by Measure DHS. No identifiable information was included in the dataset and no attempt was made to identify any individual interviewed in the survey.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The electronic datasets analysed in this study are available for legitimate research purposes from the Measure DHS website (https://dhsprogram.com/data/).

    • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.