The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study
The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study
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DOI：
10.1136/bmjopen-2018-026324
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Asamoah, Benedict Oppong
中科院分区：
文献类型：
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作者：
Anichukwu, Onyekachi Ibenelo;Asamoah, Benedict Oppong
目的了解尼日利亚孕产妇保健服务(MHC)使用情况对儿童常规免疫接种率的影响，采用双变量和多变量Logistic回归分析方法，设计个体水平横断面研究，考察MHC使用情况与儿童常规免疫接种率之间的关系。制定《尼日利亚人口与健康调查2013》。调查对象为5506名15-49岁妇女，调查前5年出生的儿童年龄为12-23个月。主要指标为儿童完全免疫和未完全免疫儿童。结果12个月前儿童常规疫苗完全接种率为25.8%。无论就诊次数多少，产前护理(ANC)就诊次数(调整后OR(AOR)(1-3次就诊)2.4，95%CI 1.79至3.27；AOR(4-7)(就诊次数)3.2，95%CI 2.52至4.13；AOR(>；=8次就诊)3.5，95%CI 2.64至4.50)，熟练分娩(SBA)(AOR 1.9，95%CI 1.65至2.35)；产妇产后护理(AOR 1.7，95%CI 1.46~2.06)在调整协变量(ANC、SBA和PNC彼此除外)后对儿童全面免疫有积极影响。进一步分析(对每项MHC服务逐级调整)显示中介作用，导致PNC的效果不显著。结论尼日利亚儿童完全免疫的比例很低。非裔儿童接种、SBA和产妇PNC参与对儿童充分接种疫苗有积极影响。研究结果表明，旨在最大限度地提高尼日利亚MHC利用率的战略可以有效地实现全国儿童常规免疫接种覆盖率至少80%的目标。
Objective To examine the impact of maternal healthcare (MHC) utilisation on routine immunisation coverage of children in Nigeria.Design Individual level cross-sectional study using bivariate and multivariable logistic regression analyses to examine the association between MHC utilisation and routine immunisation coverage of children.Setting Nigeria Demographic and Health Survey 2013.Participants 5506 women aged 15-49 years with children aged 12-23 months born in the 5 years preceding the survey.Primary outcome measures Fully immunised children and not fully immunised children.Results The percentage of children fully immunised with basic routine childhood vaccines by the age of 12 months was 25.8%. Antenatal care (ANC) attendance irrespective of the number of visits (adjusted OR (AOR)(1-3 visits) 2.4, 95% CI 1.79 to 3.27; AOR(4-7) (visits) 3.2, 95% CI 2.52 to 4.13; AOR(>= 8 visits) 3.5, 95% CI 2.64 to 4.50), skilled birth attendance (SBA) (AOR 1.9, 95% CI 1.65 to 2.35); and maternal postnatal care (PNC) (AOR 1.7, 95% CI 1.46 to 2.06) had positive effects on the child being fully immunised after adjusting for covariates (except for each other, ie, ANC, SBA and PNC). Further analyses (adjusting stepwise for each MHC service) showed a mediation effect that led to the effect of PNC not being significant.Conclusions The percentage of fully immunised children in Nigeria was very low. ANC attendance, SBA and maternal PNC attendance had positive impact on the child being fully immunised. The findings suggest that strategies aimed at maximising MHC utilisation in Nigeria could he effective in achieving the national coverage target of at least 80% for routine immunisation of children.