Peer-reviewed article
Childhood vaccination coverage by socioeconomic, geographic, maternal, child, and healthcare characteristics in Nigeria: equity impact analysis
Sarah V Williams, Tanimola Makanjuola Akande, Kaja Abbas ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined gaps in childhood vaccination coverage across different groups of children in Nigeria aged 12-23 months. Researchers found that only 31% of children received basic vaccinations, with significant disparities based on household wealth, maternal education, ethnicity, and access to healthcare. Children from the poorest households, those born at home, and those with uneducated mothers had much lower vaccination rates. The findings highlight the need for targeted approaches to reach the most disadvantaged children.
Key points
- Overall basic vaccination coverage in Nigeria was 31%, with 19% of children aged 12-23 months receiving none of the basic vaccines
- Household wealth, maternal education, antenatal care, and health facility delivery were significantly associated with higher odds of vaccination
- Children of Fulani ethnicity had lower odds of receiving basic vaccinations compared to Igbo children
- Children from poorest households, born at home, with young mothers lacking formal education and antenatal care had lowest vaccination odds
- Basic vaccination coverage was below target levels for all population groups studied
Limitations
This is a cross-sectional analysis using survey data from 2018, which can identify associations but not causal relationships. The study cannot explain why these disparities exist or test interventions to address them.
Abstract
Abstract Background Nigeria has a high proportion of the world’s underimmunised children. We estimated the inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and healthcare characteristics among children aged 12-23 months in Nigeria using a social determinants of health perspective. Methods We first conducted a systematic review focused on inequities in childhood immunisation in low- and middle-income countries to identify the social determinants of childhood immunisation. To identify inequities in basic vaccination coverage in Nigeria (1-dose BCG, 3-dose DTP-HepB-Hib (diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B), 3-dose polio, and 1-dose measles) of 6,059 children aged 12-23 months using the 2018 Nigeria Demographic and Health Survey, we conducted multiple logistic regression to analyse the association of basic vaccination with these determinants. Results We identified social determinants of immunisation: household wealth, religion, and ethnicity (socioeconomic characteristics); region and place of residence (geographic characteristics); maternal age at birth, maternal education, and maternal household head status (maternal characteristics); sex of child, and birth order (child characteristics); antenatal care and birth setting (healthcare characteristics). While basic vaccination coverage was 31% (95% CI: 29–33), 19% (95% CI:18–21) of children aged 12-23 months had received none of the basic vaccines. After controlling for background characteristics, there was a significant increase in the odds of basic vaccination by household wealth, antenatal care, delivery in a health facility, maternal age and maternal education. Children of Fulani ethnicity in comparison to children of Igbo ethnicity had lower odds of receiving basic vaccinations. Conclusions Children from the poorest households, of Fulani ethnicity, who were born in home settings, and with young mothers with no formal education nor antenatal care, were associated with lower odds of basic vaccination in Nigeria. Basic vaccination coverage is below target levels for all groups and we recommend a proportionate universalism approach for addressing the immunisation barriers.