Family structure and full vaccination coverage among children aged 12-23 months in West Africa: Analysis of the interaction effects of maternal education
Maternal and child health
31
Issue: 1
(12 - 2017)
Childhood vaccination is affected by many maternal socio-economic and family characteristics but these
often change over time such that the pattern of relationship needs to be reappraised periodically. In this
study, we investigated the influence of family structure and interaction effects of maternal education on
full vaccination coverage in the West Africa. Random effects logistic regression was applied to the most
recent demographic and health survey data on children aged |2-23 months in six countries. Main
explanatory variable was sex of household head and family type. Children living in female-headed
households (FHHS) were less likely to be fully vaccinated in five out of six countries [Liberia
(OR=0.77), Mali (OR=0.64), Senegal (OR=0.80), Sierra Leone and Togo (OR=0.85)]. Polygyny was
negatively associated with full vaccination in three countries [Liberia 9OR=0.79), Mali (OR=0.88),
Togo (OR=0.80)]. Interaction effects showed that secondary/higher education enhanced better
vaccination coverage among children in FHHs in five countries. Children of single mothers and
polygynous women with secondary/higher education recorded higher likelihood of full vaccination.
There was a moderate association between family structure and childhood vaccination but the
relationship was modified by maternal education which either mitigated the negative influence or
amplified the positive effect of family characteristics. Immunization advocacy and awareness
programmes may need to target under-five mothers without formal education and those living in
female-headed households and polygynous families.
Keywords: Child immunization; Vaccination; Household head; Family type; Socio-economic status;
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