Assessment of immunization status in the urban slums; mothers' education and low socio economic status remained crucial contributors to low immunization coverage among children in Pakistan: cross sectional study

Background: Substantial morbidity and mortality due to infectious diseases in children under five years of age is major public health concern in Pakistan. In this study, we determined the factors related to incomplete... [ view full abstract ]

Background: Substantial morbidity and mortality due to infectious diseases in children under five years of age is major public health concern in Pakistan. In this study, we determined the factors related to incomplete immunization in children between 0 to 18 months of age.
Methods: Cross-sectional survey was conducted in Gulshan Town using two stage cluster sampling. Random number list was used to select the UC’s. Systematic random sampling was used to select household with at least one infant of age 0-18 months. Data collection was based on a questionnaire. Vaccination coverage was assessed by vaccination card and parents’ recall. Chi-square test and multilevel logistic regression model were used to identify the determinants of partial and full immunization status.
Results: Approximately 74 % children were found to be partially vaccinated. Whereas about 14% were fully vaccinated and 13% were not at all vaccinated. Forgetting the schedule (68.1%), carelessness (4.8%), child sickness (0.5%) and not using vaccination (0.5%) were factors affecting low vaccination status. Children living in slum areas (OR = 1.53, 95% CI [1.24-1.89]) or belonging to low socioeconomic status (OR = 1.53, 95% CI [1.24-1.89]) were less likely to be completely immunized. Children of educated (OR = 1.53, 95% CI [1.24-1.89]) or partially educated (OR = 1.64, 95% CI [1.35-1.99]) mother were more likely to be immunized.
Conclusion: Immunization coverage among Pakistani children belonging to slum areas, low socioeconomic status and low educated mothers remained low. Knowledge and mothers education can serve as protective factors against low immunization coverage.
Keywords: Immunization, Mortality, Urban Slum, Infectious diseases