How to ensure full vaccination? The association of institutional delivery and timely postnatal care with childhood vaccination in a cross-sectional study in rural Bihar, India

Bibliographic Data

ID19592472
AuthorsMareike Schön (Universitätsmedizin Göttingen), Esther Heesemann (Center for Evaluation and Development), Christopher Ebert (0000-0002-5542-8712, RWI – Leibniz Institute for Economic Research), Malavika Ambale Subramanyam (0000-0002-2999-5211, Indian Institute of Technology Gandhinagar), Sebastian Vollmer (0000-0002-7863-0462, University of Göttingen), Sebastian Horn (0000-0002-8451-3043, Universitätsmedizin Göttingen, corresponding author)
EditorsCollins Otieno Asweto (0000-0003-3514-9836)
Year2022
Volume2
Issue5
Pagese0000411
Publication date2022-05-17
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000411
PMID36962219
OpenAlexW4280612060
LanguageEN
Citations received1
References cited37

Incomplete and absent doses in routine childhood vaccinations are of major concern. Health systems in low- and middle-income countries (LMIC), in particular, often struggle to enable full vaccination of children, which affects their immunity against communicable diseases. Data on child vaccination cards from a cross-sectional primary survey with 1,967 households were used to assess the vaccination status. The association of timely postnatal care (PNC) and the place of delivery with any-dose (at least one dose of each vaccine) and full vaccination of children between 10-20 months in Bihar, India, was investigated. Bivariate and multivariable logistic regression models were used. The vaccines included targeted tuberculosis, hepatitis B, polio, diphtheria/pertussis/tetanus (DPT) and measles. Moreover predictors for perinatal health care uptake were analysed by multivariable logistic regression. Of the 1,011 children with card verification, 47.9% were fully vaccinated. Timely PNC was positively associated with full vaccination (adjusted odds ratio (aOR) 1.48, 95% confidence interval (CI) 1.06-2.08) and with the administration of at least one dose (any-dose) of polio vaccine (aOR 3.37 95% CI 1.79-6.36), hepatitis B/pentavalent vaccine (aOR 2.11 95% CI 1.24-3.59), and DPT/pentavalent vaccine (aOR 2.29 95% CI 1.35-3.88). Additionally, delivery in a public health care facility was positively associated with at least one dose of hepatitis B/pentavalent vaccine administration (aOR 4.86 95% CI 2.97-7.95). Predictors for timely PNC were institutional delivery (public and private) (aOR 2.7 95% CI 1.96-3.72, aOR 2.38 95% CI 1.56-3.64), at least one ANC visit (aOR 1.59 95% CI 1.18-2.15), wealth quintile (Middle aOR 1.57 95% CI 1.02-2.41, Richer aOR 1.51 95% CI 1.01-2.25, Richest aOR 2.06 95% CI 1.28-3.31) and household size (aOR 0.95 95% CI 0.92-0.99). The findings indicate a correlation between childhood vaccination and timely postnatal care. Further, delivery in a public facility correlates with the administration of at least one dose of hepatitis B vaccine and thus impedes zero-dose vaccination. Increasing uptake of timely PNC, encouraging institutional delivery, and improving vaccination services before discharge of health facilities may lead to improved vaccination rates among children

Confidence interval · Cross-sectional study · Diphtheria · Environmental health · HBsAg · Hepatitis B vaccine · Hepatitis B virus · Logistic regression · Measles · Odds ratio · Polio vaccine · Poliomyelitis · Tetanus · Vaccination · Vaccine-preventable diseases · Child Nutrition and Water Access · Immune responses and vaccinations · Medicine · Vaccine Coverage and Hesitancy · Immunology · Internal Medicine · Pediatrics

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