Factors affecting acceptance of immunization among children in rural Bangladesh

Abstract

This paper uses the Bangladesh Fertility Survey 1989 data to identify the factors affecting acceptance of immunization among children in rural Bangladesh. Acceptance of DPT, measles and BCG vaccinations were the dependent variables. The independent variables included proximity to health facilities, frequency of visit by health worker, respondent's mobility, media exposure, education, age, economic status of household, region of residence, and gender of child. Logistic regression analysis was performed to assess the net effects of the variables in addition to univariate analysis. Among the independent variables, proximity to health facility, frequency of health worker's visit, mother's mobility, education, age, gender of child, ownership of radio, economic condition of household, and region of residence showed statistically significant association with acceptance of immunization. The effect of frequency of health worker's visit was dependent on region of residence, possession of radio, and mother's education. The effect of mother's ability to visit health centre alone was also dependent on ownership of radio, economic condition of household, and mother's education.

PIP: The Bangladesh Fertility Survey conducted during 1989 provided a total of 8467 ever married women under the age of 50 years who were interviewed from December 1988 to April 1989. A 2-stage probability sample design was used for sample selection. The analysis was restricted to 5743 children 1 year or older. In bivariate and multivariate analyses acceptance of DPT, BCG, and measles vaccinations were the dependent variables. Logistic regression analysis assessed the net effects of independent variables in addition to univariate analysis. Children residing within 1 mile of the health facility had a 50% higher chance of being immunized than those residing within 1-2 miles, who also had a 33% higher chance than those residing more than 3 miles away. Similarly, children from localities with more than 6 visits a year from a family welfare assistance had 2.1 times and with 1-6 visits had 1.31 times higher chances of immunization than those who were not visited at all. Children of mothers who could visit health centers alone had a 52% higher chance of being immunized. Children of mothers with more than lower primary level of schooling had an 80% higher chance of being immunized than those of mothers without any schooling. The likelihood of immunization was 40% and 38% higher among children of mothers younger than 20 and in the 20-28 year age group than among those 30 years and older. Children from households with a radio had a 47% higher chance of being immunized than those who had no radio. Male children were 20% more likely to be immunized than female children. In addition, children from households with better socioeconomic standing had a twice higher chance of immunization. Children who came from Khulna, Rajshahi, and Dhaka Divisions had 79%, 42%, and 30% higher chances of being immunized, respectively, than those from Chittagong Division. Interaction effects indicated that mothers' ability to visit health centers alone was also dependent on ownership of radio, household economic conditions, and mothers' education