Peer-reviewed article
"Is there a link between women's empowerment and childhood vaccination?": A multilevel analysis using the Philippines Demographic and Health Survey Data 2017 and 2022.
Cochon KL, Poon PKM, Estrada JAG, Kim JH ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether women's empowerment is linked to childhood vaccination rates in the Philippines using data from 6,186 women surveyed in 2017 and 2022. While women's empowerment remained high, complete childhood vaccination stayed low at around 65-69%. Women with greater social independence were more likely to have fully vaccinated children, but decision-making power showed no association with vaccination rates. The findings suggest that women's education and social autonomy matter more than other aspects of empowerment for ensuring children receive vaccines.
Key points
- Complete childhood vaccination was 65.7% in 2017 and 69.3% in 2022, remaining persistently low despite high levels of women's empowerment
- Higher social independence was consistently associated with complete childhood vaccination (aOR 1.54-2.04 across survey years)
- Decision-making power showed no association with childhood vaccination in either survey year
- Lower tolerance to violence was positively associated with complete childhood vaccination in 2017 only
- Gender-equitable human capital development, particularly women's education, is recommended as an investment priority
Limitations
The study relied on self-reported vaccination data rather than verified records, which may introduce recall bias. The cross-sectional design cannot establish causation, only associations between women's empowerment and vaccination outcomes.
Abstract
BACKGROUND: Childhood vaccination reduces child mortality, morbidity, and improves developmental outcomes. In the Philippines, where vaccination rates are low, understanding sociocultural influences on childhood vaccination is essential. Given women’s crucial role in ensuring childhood vaccination, this study investigated the association of women’s empowerment with childhood vaccination. METHODS: Cross-sectional data were obtained from 6,186 partnered women aged 15–49 years who participated in the 2017/2022 Philippine Demographic and Health Surveys. Child vaccination status was assessed based on the self-reported receipt of vaccines in the Expanded Immunization Program of the Philippines. Multilevel logistic regression was conducted to assess the influence of three domains of the Survey-based Women’s emPowERment (SWPER) Index on the outcome. RESULTS: Women’s empowerment remained high in 2017 and 2022, while complete childhood vaccination remained low, rising marginally from 65.7% to 69.3%. At the municipality level, none of the empowerment domains were associated with childhood vaccination in either year. At the individual level, higher social independence increased complete childhood vaccination in both survey years (high social independence: aOR = 1.54 (95% CI: 1.12–2.13) in 2017 and aOR = 1.58 (95% CI: 1.13–2.20) for medium and aOR = 2.04 (95% CI: 1.13–2.20) for high social independence in 2022). Decision-making power showed no association with childhood vaccination in either year (p > 0.05), while lower tolerance to violence was positively associated with the outcome in 2017 only aOR = 2.10 (95% CI: 1.08–4.06) for low and aOR = 2.42 (95% CI:1.21–4.83) for medium tolerance to violence. CONCLUSION: Enabling conditions for partnered women were the most important empowerment predictor of childhood vaccination, highlighting the importance of investment in gender-equitable human capital development, such as improving women’s education.