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Inequalities in immunization coverage in Indonesia: a multilevel analysis.

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In Indonesia, only 58.22% of children are fully vaccinated. Factors like birth order, maternal education, and access to public healthcare centers significantly impact child immunization coverage.

Keywords:
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Area of Science:

  • Public Health
  • Epidemiology
  • Demography

Background:

  • Childhood immunization is a critical, cost-effective public health intervention.
  • Incomplete vaccination in children presents significant public health risks and societal costs.
  • Understanding determinants of immunization coverage is vital for improving child health outcomes in Indonesia.

Purpose of the Study:

  • To quantify the association between child, parent, and community-level factors and child immunization coverage in Indonesia.
  • To identify key determinants influencing complete vaccination status among Indonesian children.

Main Methods:

  • Utilized data from the 2017 Indonesian Demographic Health Survey, including 4753 children aged 12-24 months.
  • Employed multistage random sampling for data collection.
  • Analyzed data using descriptive statistics and multilevel logistic regression.

Main Results:

  • Overall, 58.22% of children in Indonesia were fully vaccinated.
  • First-born children had a lower likelihood of full immunization compared to subsequent children.
  • Maternal age at delivery, education, paternal occupation, antenatal care (ANC), region, and public healthcare center (PHC) availability significantly influenced immunization coverage.

Conclusions:

  • Significant socioeconomic and demographic disparities exist in immunization coverage across Indonesia.
  • Complete immunization is strongly associated with birth order, maternal and paternal factors, ANC, region, and PHC presence.
  • Enhancing community healthcare infrastructure is crucial for reducing inequalities in maternal and child health services.