The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

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; AOR_{4-7 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.

Keywords: antenatal; maternal health care utilisation; postnatal care; routine immunisation coverage; skilled birth attendance.