THE FACTORS OF PRIMARY CHILDHOOD IMMUNIZATION UPTAKE AMONG THE URBAN POOR CHILDREN IN MALAYSIA
Keywords:Childhood immunization, Predictors, Urban poor, Malaysia
Reducing childhood immunization coverage has led to re-emerging of vaccine-preventable diseases among young children. This study aimed to identify the prevalence and predictors of complete childhood immunization among the low socioeconomic urban households’ children in Malaysia. A nationwide survey data from the National Health and Morbidity Survey (NHMS) 2016 was utilized to extract 2668 completed data of respondents who had a household income of less than RM 4,000 and living in urban areas were included in the analysis. The children’s home-based cards were used to verify the data on the primary childhood immunization status. Related data from the household and child health modules were extracted three levels of analysis were conducted using SPSS Version 25 that were descriptive analysis, bivariate analysis and multivariable analysis. The prevalence of complete primary childhood immunization uptake was 89.5%. Mothers of 20 to 29 years old, 30 to 39 years old, and 40 years old and above had 2.704 (aOR=2.704, 95% CI:1.255-5.827), 3.305 (aOR=3.305, 95% CI:1.526-7.160), 3.058 (aOR=3.058, 95% CI:1.165-8.029) higher odds of having children with complete childhood immunization status compared to those younger. Meanwhile, mothers who were self-employed, students and utilized private healthcare facilities had 0.2773 (aOR=0.273, 95% CI:0.138-0.540), 0.063 (aOR=0.063, 95% CI:0.014-0.288) and 0.200 (aOR=0.200, 95% CI:0.118-0.338) lower odds towards complete primary childhood immunization uptake among their children. Below global recommended coverage of complete primary immunization uptake was observed among the urban poor children. Mothers who were young, self-employed, students and utilizing private healthcare facilities should be targeted to improve immunization coverage among children or urban localities.
Okwo-Bele JM, Cherian T. The expanded programme on immunization: A lasting legacy of smallpox eradication. Vaccine 2011; 30 (29): SUPPL. 4.
Keja K, Chan C, Hayden G, Henderson RH. Expanded programme on immunization. World health statistics quarterly Rapport trimestriel de statistiques sanitaires mondiales 1988; 41(2):59–63.
WHO. Global Vaccine Action Plan 2011-2020, 2017. https://www.who.int/publications/i/item/global-vaccine-action-plan-2011-2020 (accessed 10 May 2021).
WHO. Routine immunization: Regional and country profiles 2019. https://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/data-and-statistics/routine-immunization-regional-and-country-profiles (accessed 10 May 2021)
WHO. Polio Outbreak in Malaysia 2020. https://www.who.int/westernpacific/emergencies/polio-outbreak-in-malaysia (accessed 5 Oct 2020)
Restrepo-Méndez MC, Barros AJD, Wong KLM, et al. Inequalities in full immunization coverage: Trends in low-and middle-income countries. Bulletin of the World Health Organization 2016; 94(11):794-805A.
Crocker-Buque T, Mindra G, Duncan R, et al. Immunization, urbanization and slums: A systematic review of factors and interventions. BMC Public Health 2017; 17(1):556.
Mayan SNA, Nor RM. The Resistance of the Urban Poor in Selangor, Malaysia to Get Out of the Shackles of Poverty. International Journal of Academic Research in Business and Social Sciences 2020; 10(9):602–11.
Institute for Public Health. National Health and Morbidity Survey 2016 (NHMS 2016): Maternal and Child Health. Vol. I: Methodology and General Findings 2016. https://iku.moh.gov.my/images/IKU/Document/REPORT/2016/NHMS2016ReportVolumeII-MaternalChildHealthFindingsv2.pdf (accessed 20 Dec 2020).
Devasenapathy N, Jerath SG, Sharma S, et al. Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: A cross-sectional study. BMJ Open 2016; 6(8): e013015.
Mutua MK, Kimani-Murage E, Ettarh RR. Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated? BMC Public Health 2011; 11 (6).
Lim KK, Chan YY, Noor Ani A, et al. Complete immunization coverage and its determinants among children in Malaysia: findings from the National Health and Morbidity Survey (NHMS) 2016. Public Health 2017; 153:52–7.
Che Abdullah A, Afiah NM. Practice of Childhood Immunizations Among Parents and Their Associated Factors in Hulu Langat, Selangor, Malaysia. International Journal of Public Health and Clinical Sciences 2016; 3(6): 94-104.
Zamzaireen Z, Muhamad H, Faisal I. Predictors of Adherence Toward Childhood. International Journal of Public Health and Clinical Sciences 2017;4(5):111–24.
Weiner JL, Fisher AM, Nowak GJ, et al. Childhood Immunizations First-Time Expectant Mothers’ Knowledge, Beliefs, Intentions, and Behaviors. American Journal of Preventive Medicine 2015; 49(6): S426–34.
Dummer TJB, Cui Y, Strang R, Parker L. Immunization completeness of children under two years of age in Nova Scotia, Canada. Canadian Journal of Public Health 2012; 103(5):363–7. https://pubmed.ncbi.nlm.nih.gov/23617989/.
Barata RB, de Almeida Ribeiro MCS, de Moraes JC, et al. Socioeconomic inequalities and vaccination coverage: Results of an immunisation coverage survey in 27 Brazilian capitals, 2007-2008. Journal of Epidemiology and Community Health 2012; 66(10): 934–41.
Ahmad NA, Jahis R, Kuang Kuay L, Jamaluddin R, Aris T. Primary Immunization among Children in Malaysia: Reasons for Incomplete Vaccination. Journal of Vaccines & Vaccination 2017; 8(3). https://www.longdom.org/open-access/primary-immunization-among-children-in-malaysia-reasons-for-incomplete-vaccination-2157-7560-1000358.pdf.