FULL IMMUNIZATION STATUS: ITS ASSOCIATION WITH MATERNAL EDUCATION AND DECISION MAKING AUTONOMY IN THE PHILIPPINES
BY : CYNDI MAE C. TAI (2010)
ABSTRACT :
BACKGROUND : VACCINE-PREVENTABLE DISEASES HAVE LARGELY CONTRIBUTED TO INFANT MORBIDITY AND MORTALITY. AS A RESPONSE TO THIS PUBLIC HEALTH PROBLEM, THE EXPANDED PROGRAM ON IMMUNIZATION WAS PUT INTO PLACE. HOWEVER COMMITMENT TO IMMUNIZATION IS NOT SUSTAINED. AS WOMEN ARE VITAL PLAYERS THAT DETERMINE PROTECTION OF CHILDREN AGAINST DISEASES, THEIR ROLE AS CARETAKERS IS A PROMISING FOCAL POINT FOR INTERVENTION WORTH EXAMINING.
TWO OF THE MOST IMPORTANT MATERNAL CHARACTERISTICS SHOWN TO INFLUENCE UTILIZATION OF INFANT IMMUNIZATION INCLUDE EDUCATION AND DECISION MAKING AUTONOMY. HOWEVER, STUDIES PROVIDE CONTRADICTING RESULTS. AS SUCH, THIS STUDY AIMS TO DETERMINE WHETHER OR NOT THESE MATERNAL FACTORS ARE SIGNIFICANTLY ASSOCIATED WITH FULL-IMMUNIZATION STATUS OF CHILDREN IN THE PHILIPPINES.
METHODOLOGY : SECONDARY ANALYSIS OF THE 2003 NATIONAL DEMOGRAPHIC AND HEALTH SURVEY WAS CARRIED OUT. CROSS SECTIONAL STUDY OF 12 TO 36 MONTH OLD CHILDREN LIVING WITH BOTH PARENTS AND BORNE BY WOMEN BETWEEN 15 TO 49 YEARS OLD WAS DONE. THOSE WHO CLAIMED TO BE IMMUNIZED BUT WHOSE MOTHERS WERE UNABLE TO PRODUCE VACCINATION CARDS WERE EXCLUDED FROM THE STUDY. A TOTAL OF 2,434 CHILDREN WERE INCLUDED IN THE STUDY. PCA WAS USED TO GENERATE INDEX SCORES THAT REPRESENT THE SOCIO-ECONOMIC STANDING AND DECISION MAKING AUTONOMY OF EACH RESPONDENT. MULTIVARIATE LOGISTIC REGRESSION ANALYSIS REVEALED SIGNIFICANT ASSOCIATION BETWEEN FULL IMMUNIZATION STATUS AND BOTH MATERNAL CHARACTERISTICS.
RESULTS : WOMEN WITH AT MOST PRIMARY LEVEL OF EDUCATION AND LOW DECISION MAKING AUTONOMY ARE APPROXIMATELY TWO TIMES (OR=2.13; 90% CI=1.37-3.31 AND OR=1.60; 90% CI=1.20-2.12, RESPECTIVELY) MORE LIKELY TO HAVE CHILDREN WHO ARE NOT FULLY IMMUNIZED COMPARED TO THOSE WITH AT LEAST TERTIARY EDUCATION AND HIGH DECISION MAKING AUTONOMY. MOREOVER, MATERNAL EDUCATION AND DECISION MAKING AUTONOMY WERE FOUND TO MODIFY THE EFFECT OF EACH OTHERS ASSOCIATION WITH FULL IMMUNIZATION STATUS.
CONCLUSIONS : LACK OF EDUCATION AND DECISION MAKING AUTONOMY CAN SIGNIFICANTLY AFFECT THE FULL-IMMUNIZATION COVERAGE IN THE PHILIPPINES. RESULTS FURTHER SUGGEST THAT BOTH FACTORS RELATIONSHIP WITH THE OUTCOME IS SYNERGISTIC. CONTINUED INVESTMENTS ON EDUCATION AND EMPOWERMENT OF WOMEN SHOULD THUS BE SIMULTANEOUSLY EXPLORED TO MAXIMIZE THEIR POSITIVE EFFECT ON FULL- IMMUNIZATION COVERAGE.
ABSTRACT :
BACKGROUND : VACCINE-PREVENTABLE DISEASES HAVE LARGELY CONTRIBUTED TO INFANT MORBIDITY AND MORTALITY. AS A RESPONSE TO THIS PUBLIC HEALTH PROBLEM, THE EXPANDED PROGRAM ON IMMUNIZATION WAS PUT INTO PLACE. HOWEVER COMMITMENT TO IMMUNIZATION IS NOT SUSTAINED. AS WOMEN ARE VITAL PLAYERS THAT DETERMINE PROTECTION OF CHILDREN AGAINST DISEASES, THEIR ROLE AS CARETAKERS IS A PROMISING FOCAL POINT FOR INTERVENTION WORTH EXAMINING.
TWO OF THE MOST IMPORTANT MATERNAL CHARACTERISTICS SHOWN TO INFLUENCE UTILIZATION OF INFANT IMMUNIZATION INCLUDE EDUCATION AND DECISION MAKING AUTONOMY. HOWEVER, STUDIES PROVIDE CONTRADICTING RESULTS. AS SUCH, THIS STUDY AIMS TO DETERMINE WHETHER OR NOT THESE MATERNAL FACTORS ARE SIGNIFICANTLY ASSOCIATED WITH FULL-IMMUNIZATION STATUS OF CHILDREN IN THE PHILIPPINES.
METHODOLOGY : SECONDARY ANALYSIS OF THE 2003 NATIONAL DEMOGRAPHIC AND HEALTH SURVEY WAS CARRIED OUT. CROSS SECTIONAL STUDY OF 12 TO 36 MONTH OLD CHILDREN LIVING WITH BOTH PARENTS AND BORNE BY WOMEN BETWEEN 15 TO 49 YEARS OLD WAS DONE. THOSE WHO CLAIMED TO BE IMMUNIZED BUT WHOSE MOTHERS WERE UNABLE TO PRODUCE VACCINATION CARDS WERE EXCLUDED FROM THE STUDY. A TOTAL OF 2,434 CHILDREN WERE INCLUDED IN THE STUDY. PCA WAS USED TO GENERATE INDEX SCORES THAT REPRESENT THE SOCIO-ECONOMIC STANDING AND DECISION MAKING AUTONOMY OF EACH RESPONDENT. MULTIVARIATE LOGISTIC REGRESSION ANALYSIS REVEALED SIGNIFICANT ASSOCIATION BETWEEN FULL IMMUNIZATION STATUS AND BOTH MATERNAL CHARACTERISTICS.
RESULTS : WOMEN WITH AT MOST PRIMARY LEVEL OF EDUCATION AND LOW DECISION MAKING AUTONOMY ARE APPROXIMATELY TWO TIMES (OR=2.13; 90% CI=1.37-3.31 AND OR=1.60; 90% CI=1.20-2.12, RESPECTIVELY) MORE LIKELY TO HAVE CHILDREN WHO ARE NOT FULLY IMMUNIZED COMPARED TO THOSE WITH AT LEAST TERTIARY EDUCATION AND HIGH DECISION MAKING AUTONOMY. MOREOVER, MATERNAL EDUCATION AND DECISION MAKING AUTONOMY WERE FOUND TO MODIFY THE EFFECT OF EACH OTHERS ASSOCIATION WITH FULL IMMUNIZATION STATUS.
CONCLUSIONS : LACK OF EDUCATION AND DECISION MAKING AUTONOMY CAN SIGNIFICANTLY AFFECT THE FULL-IMMUNIZATION COVERAGE IN THE PHILIPPINES. RESULTS FURTHER SUGGEST THAT BOTH FACTORS RELATIONSHIP WITH THE OUTCOME IS SYNERGISTIC. CONTINUED INVESTMENTS ON EDUCATION AND EMPOWERMENT OF WOMEN SHOULD THUS BE SIMULTANEOUSLY EXPLORED TO MAXIMIZE THEIR POSITIVE EFFECT ON FULL- IMMUNIZATION COVERAGE.