Migration and child immunization in Nigeria: individual- and community-level contexts

BMC Public Health

Research Article

Diddy Antai¹ 

[1] Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden;Division of Global Health & Inequalities, The Angels Trust, Nigeria, Abuja, Nigeria;

关键词: Migration Status;    Migrant Group;    Oral Polio Vaccine;    Full Immunization;    Variance Partition Coefficient;   

DOI  :  10.1186/1471-2458-10-116

 received in 2009-04-15, accepted in 2010-03-09,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundVaccine-preventable diseases are responsible for severe rates of morbidity and mortality in Africa. Despite the availability of appropriate vaccines for routine use on infants, vaccine-preventable diseases are highly endemic throughout sub-Saharan Africa. Widespread disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria. This study assessed the individual- and community-level explanatory factors associated with child immunization differentials between migrant and non-migrant groups.MethodsThe proportion of children that received each of the eight vaccines in the routine immunization schedule in Nigeria was estimated. Multilevel multivariable regression analysis was performed using a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities. Odds ratios with 95% confidence intervals were used to express measures of association between the characteristics. Variance partition coefficients and Wald statistic i.e. the ratio of the estimate to its standard error were used to express measures of variation.ResultsIndividual- and community contexts are strongly associated with the likelihood of receiving full immunization among migrant groups. The likelihood of full immunization was higher for children of rural non-migrant mothers compared to children of rural-urban migrant mothers. Findings provide support for the traditional migration perspectives, and show that individual-level characteristics, such as, migrant disruption (migration itself), selectivity (demographic and socio-economic characteristics), and adaptation (health care utilization), as well as community-level characteristics (region of residence, and proportion of mothers who had hospital delivery) are important in explaining the differentials in full immunization among the children.ConclusionMigration is an important determinant of child immunization uptake. This study stresses the need for community-level efforts at increasing female education, measures aimed at alleviating poverty for residents in urban and remote rural areas, and improving the equitable distribution of maternal and child health services.

【 授权许可】

CC BY   
© Antai; licensee BioMed Central Ltd. 2010