Explaining socio-economic inequalities in immunization coverage in Nigeria
John E Ataguba1, Kenneth O Ojo2, Hyacinth E Ichoku3
1Health Economics Unit, School of Public Health and Family Medicine, Health Sciences Faculty, University of Cape Town, Anzio Road, Observatory, 7925, South Africa John.Ataguba@uct.ac.za.
Insights
Child immunization coverage in Nigeria is unequal, favoring wealthier families. Factors like mother's education and socioeconomic status drive these disparities, hindering progress against vaccine-preventable diseases.
Area of Science:
- Global Health
- Pediatrics
- Public Health Policy
Background:
- Millions of children under five die annually from infectious causes or neonatal complications, particularly in developing nations.
- Immunization is a critical intervention to reduce childhood mortality and morbidity.
- Despite free provision in Nigeria, immunization coverage remains low, leading to high rates of vaccine-preventable diseases.
Purpose of the Study:
- To assess inequalities in full and partial child immunization coverage in Nigeria.
- To analyze the 'intensity' of immunization coverage and identify factors contributing to disparities.
- To inform policies aimed at reducing immunization coverage gaps.
Main Methods:
- Utilized nationally representative data to analyze child immunization coverage.
- Employed statistical methods to identify socioeconomic and demographic determinants of immunization disparities.
- Examined factors including maternal literacy, child's region and location, and socioeconomic status.
Main Results:
- Significant disparities in immunization coverage were observed, with wealthier children receiving higher coverage.
- Maternal literacy, geographic region, child's location (urban/rural), and socioeconomic status were identified as key factors explaining these disparities.
- Low immunization coverage contributes to high mortality from vaccine-preventable diseases in Nigeria.
Conclusions:
- Addressing socioeconomic and educational inequalities is crucial for improving child immunization rates in Nigeria.
- Integrating community social values into health policies can enhance acceptability and compliance with immunization programs.
- Reducing immunization disparities is essential for Nigeria's progress towards sustainable development and improved child survival.
Abstract:
Globally, in 2013 over 6 million children younger than 5 years died from either an infectious cause or during the neonatal period. A large proportion of these deaths occurred in developing countries, especially in sub-Saharan Africa. Immunization is one way to reduce childhood morbidity and deaths. In Nigeria, however, although immunization is provided without a charge at public facilities, coverage remains low and deaths from vaccine preventable diseases are high. This article seeks to assess inequalities in full and partial immunization coverage in Nigeria. It also assesses inequality in the 'intensity' of immunization coverage and it explains the factors that account for disparities in child immunization coverage in the country. Using nationally representative data, this article shows that disparities exist in the coverage of immunization to the advantage of the rich. Also, factors such as mother's literacy, region and location of the child, and socio-economic status explain the disparities in immunization coverage in Nigeria. Apart from addressing these issues, the article notes the importance of addressing other social determinants of health to reduce the disparities in immunization coverage in the country. These should be in line with the social values of communities so as to ensure acceptability and compliance. We argue that any policy that addresses these issues will likely reduce disparities in immunization coverage and put Nigeria on the road to sustainable development.
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