Peer-reviewed article
Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: a multilevel mixed-effects analysis
Satyajit Kundu, Subarna Kundu, Subarna Kundu, Subarna Kundu, Abdul‐Aziz Seidu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed data from three Bangladesh Demographic and Health Surveys (2011, 2014, 2017-18) to understand what factors influence childhood vaccination coverage and how coverage has changed over time. Full vaccination coverage among children aged 12-35 months increased from 86.17% in 2011 to 89.23% in 2017-18. Children from wealthier families, with more educated mothers, from urban areas, and whose mothers had more antenatal care visits were significantly more likely to be fully vaccinated. The study recommends targeted efforts to reach less educated mothers and low-income families to improve immunisation coverage.
Key points
- Overall full vaccination coverage increased from 86.17% in 2011 to 89.23% in 2017-18
- High wealth index, maternal education, and urban residence were associated with higher vaccination coverage
- Mothers aged over 24 years with at least four antenatal care visits were more likely to have fully vaccinated children
- Rangpur division showed the highest vaccination coverage increase from 2011-2014 (2.26%), while Sylhet division showed the highest increase from 2014-2017-18 (34.34%)
- Low-income families and mothers without high school education remain key groups for targeted vaccination improvement efforts
Limitations
The study is observational and based on survey data, so it identifies associations rather than causal relationships. The analysis cannot determine why certain factors are associated with vaccination coverage or explain the mechanisms behind regional variations in coverage changes.
Abstract
INTRODUCTION: This study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh. METHODS: Bangladesh's Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data for this study on vaccination coverage among children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed. RESULTS: The overall prevalence (weighted) of full vaccination among children aged 12-35 months were 86.17% in 2011, 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of vaccination coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%). CONCLUSION: To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children.