The University of Southampton
University of Southampton Institutional Repository

Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria

Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria
Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria
Background
Substantial inequalities exist in childhood vaccination coverage levels. To increase vaccine uptake, factors that predict vaccination coverage in children should be identified and addressed.
Methods
Using data from the 2018 Nigeria Demographic and Health Survey and geospatial data sets, we fitted Bayesian multilevel binomial and multinomial logistic regression models to analyse independent predictors of three vaccination outcomes: receipt of the first dose of Pentavalent vaccine (containing diphtheria-tetanus-pertussis, Hemophilus influenzae type B and Hepatitis B vaccines) (PENTA1) (n=6059) and receipt of the third dose having received the first (PENTA3/1) (n=3937) in children aged 12-23 months, and receipt of measles vaccine (MV) (n=11839) among children aged 12-35 months.
Results
Factors associated with vaccination were broadly similar for documented versus recall evidence of vaccination. Based on any evidence of vaccination, we found that health card/document ownership, receipt of vitamin A and maternal educational level were significantly associated with each outcome. Although the coverage of each vaccine dose was higher in urban than rural areas, urban residence was not significant in multivariable analyses that included travel time. Indicators relating to socio-economic status, as well as ethnic group, skilled birth attendance, lower travel time to the nearest health facility and problems seeking health care were significantly associated with both PENTA1 and MV. Maternal religion was related to PENTA1 and PENTA3/1 and maternal age related to MV and PENTA3/1; other significant variables were associated with one outcome each. Substantial residual community level variances in different strata were observed in the fitted models for each outcome.
Conclusion
Our analysis has highlighted socio-demographic and health care access factors that affect not only beginning but completing the vaccination series in Nigeria. Other factors not measured by the DHS such as health service quality and community attitudes should also be investigated and addressed to tackle inequities in coverage.
1932-6203
Aheto, Justice
dfdbcbd6-229b-4af8-86b5-e698e62fe29f
Pannell, Oliver B
370b302f-0b96-4fa5-b96b-5330cfef2263
Dotse-Gborgbortsi, Winfred, Worlanyo
11fe21e7-431a-442b-a8c7-6a7cb05176d9
Trimner, Mary K.
ec8c94d7-8609-4dc2-a0fe-545586e0356d
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Rhoda, Dale A.
8d3b4461-4dda-4036-83d0-13666633495d
Cutts, Felicity T.
25ed9d13-371b-4f1a-a15d-ca20f7e0d502
Utazi, Chigozie
e69ca81e-fb23-4bc1-99a5-25c9e0f4d6f9
Aheto, Justice
dfdbcbd6-229b-4af8-86b5-e698e62fe29f
Pannell, Oliver B
370b302f-0b96-4fa5-b96b-5330cfef2263
Dotse-Gborgbortsi, Winfred, Worlanyo
11fe21e7-431a-442b-a8c7-6a7cb05176d9
Trimner, Mary K.
ec8c94d7-8609-4dc2-a0fe-545586e0356d
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Rhoda, Dale A.
8d3b4461-4dda-4036-83d0-13666633495d
Cutts, Felicity T.
25ed9d13-371b-4f1a-a15d-ca20f7e0d502
Utazi, Chigozie
e69ca81e-fb23-4bc1-99a5-25c9e0f4d6f9

Aheto, Justice, Pannell, Oliver B, Dotse-Gborgbortsi, Winfred, Worlanyo, Trimner, Mary K., Tatem, Andrew, Rhoda, Dale A., Cutts, Felicity T. and Utazi, Chigozie (2022) Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria. PLoS ONE, 17 (5 May), [e0269066]. (doi:10.1371/journal.pone.0269066).

Record type: Article

Abstract

Background
Substantial inequalities exist in childhood vaccination coverage levels. To increase vaccine uptake, factors that predict vaccination coverage in children should be identified and addressed.
Methods
Using data from the 2018 Nigeria Demographic and Health Survey and geospatial data sets, we fitted Bayesian multilevel binomial and multinomial logistic regression models to analyse independent predictors of three vaccination outcomes: receipt of the first dose of Pentavalent vaccine (containing diphtheria-tetanus-pertussis, Hemophilus influenzae type B and Hepatitis B vaccines) (PENTA1) (n=6059) and receipt of the third dose having received the first (PENTA3/1) (n=3937) in children aged 12-23 months, and receipt of measles vaccine (MV) (n=11839) among children aged 12-35 months.
Results
Factors associated with vaccination were broadly similar for documented versus recall evidence of vaccination. Based on any evidence of vaccination, we found that health card/document ownership, receipt of vitamin A and maternal educational level were significantly associated with each outcome. Although the coverage of each vaccine dose was higher in urban than rural areas, urban residence was not significant in multivariable analyses that included travel time. Indicators relating to socio-economic status, as well as ethnic group, skilled birth attendance, lower travel time to the nearest health facility and problems seeking health care were significantly associated with both PENTA1 and MV. Maternal religion was related to PENTA1 and PENTA3/1 and maternal age related to MV and PENTA3/1; other significant variables were associated with one outcome each. Substantial residual community level variances in different strata were observed in the fitted models for each outcome.
Conclusion
Our analysis has highlighted socio-demographic and health care access factors that affect not only beginning but completing the vaccination series in Nigeria. Other factors not measured by the DHS such as health service quality and community attitudes should also be investigated and addressed to tackle inequities in coverage.

Text
Aheto.et.al_Manuscript_Clean-F - Accepted Manuscript
Available under License Creative Commons Attribution.
Download (2MB)
Text
journal.pone.0269066 - Version of Record
Available under License Creative Commons Attribution.
Download (2MB)

More information

e-pub ahead of print date: 25 May 2022
Additional Information: Publisher Copyright: © 2022 Aheto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Identifiers

Local EPrints ID: 468205
URI: http://eprints.soton.ac.uk/id/eprint/468205
ISSN: 1932-6203
PURE UUID: 53ea4c91-0fcd-4d05-88dd-daf977da64a0
ORCID for Justice Aheto: ORCID iD orcid.org/0000-0003-1384-2461
ORCID for Oliver B Pannell: ORCID iD orcid.org/0000-0003-2559-2818
ORCID for Winfred, Worlanyo Dotse-Gborgbortsi: ORCID iD orcid.org/0000-0001-7627-1809
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X

Catalogue record

Date deposited: 05 Aug 2022 16:41
Last modified: 06 Aug 2022 02:02

Export record

Altmetrics

Contributors

Author: Justice Aheto ORCID iD
Author: Oliver B Pannell ORCID iD
Author: Mary K. Trimner
Author: Andrew Tatem ORCID iD
Author: Dale A. Rhoda
Author: Felicity T. Cutts
Author: Chigozie Utazi

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×