Peer-reviewed article
Effect of household relocation on child vaccination and health service utilisation in Dhaka, Bangladesh: a cross-sectional community survey
Lily Ming-Sha Horng, Nadira Sultana Kakoly, Jaynal Abedin, Stephen P. Luby ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how household relocation affects children's access to vaccination and health services in Dhaka, Bangladesh. Researchers compared nearly 10,000 children under 5 years old, dividing them into those who had recently moved (within 12 months) and those who had lived in the same place for over 2 years. Children in recently relocated households had lower vaccination coverage and were less likely to visit qualified medical providers when they had severe respiratory illness, even after accounting for other family differences.
Key points
- Full vaccination coverage was 80% in recently relocated children versus 85% in residentially stable children
- Only 69% of recently relocated children with severe ARI visited a qualified medical provider, compared to 82% of stable children
- After adjustment for demographics and socioeconomic factors, recently relocated children were 3% less likely to be fully vaccinated
- Recently relocated children were 12% less likely to visit a qualified provider for severe respiratory illness
Limitations
The study is cross-sectional, so it cannot establish causation or determine whether relocation causes reduced health service use or if other factors explain both relocation and lower vaccination rates. Vaccination status relied partly on maternal recall rather than verified records for all children.
Abstract
Objective To explore the relationship between household relocation and use of vaccination and health services for severe acute respiratory illness (ARI) among children in Dhaka, Bangladesh. Design Analysis of cross-sectional community survey data from a prior study examining the impact of Haemophilus influenzae type b vaccine introduction in 2009 on meningitis incidence in Bangladesh. Setting Communities surrounding two large paediatric hospitals in Dhaka, Bangladesh. Participants Households with children under 5 years old who either recently relocated < 12 months or who were residentially stable living > 24 months in their current residence (total n=10 020) were selected for this study. Primary outcome measures Full vaccination coverage among children aged 9-59 months and visits to a qualified medical provider for severe ARI among children under 5 years old. Results Using vaccination cards with maternal recall, full vaccination was 80% among recently relocated children (n=3795) and 85% among residentially stable children (n=4713; χ 2 =37.2, p<0.001). Among children with ARI in the prior year, 69% of recently relocated children (n=695) had visited a qualified medical provider compared with 82% of residentially stable children (n=763; χ 2 =31.9, p<0.001). After adjusting for demographic and socioeconomic characteristics, recently relocated children were less likely to be fully vaccinated (prevalence ratio [PR] 0.97; 95% CI 0.95 to 0.99; p=0.016) and to have visited a qualified medical provider for ARI (PR 0.88; 95% CI 0.84 to 0.93; p<0.001). Conclusions Children in recently relocated households in Dhaka, Bangladesh, have decreased use of vaccination and qualified health services for severe ARI.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Residential stability (not relocating; used as comparison group to understand the effect of relocation)
- Population
- Children aged 9-59 months in Dhaka, Bangladesh; 3,795 recently relocated (< 12 months) and 4,713 residentially stable (> 24 months)
Key finding
Full vaccination coverage 80% in recently relocated vs 85% in stable children (p<0.001)