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As a leading indicator of child health, under-five mortality was incorporated in the United Nations Millennium Development Goals with the aim of reducing the rate by two-thirds between 1990 and 2015. Under-five mortality in Nigeria is alarmingly high, and many of the diseases that result in mortality are vaccine preventable. This study evaluates the uptake of childhood immunization in Nigeria from 1990 to 2008. A multi-year trend analysis was carried out using Alternating Logistic Regression on 46,130 children nested within 17,380 mothers in 1938 communities from the Nigerian Demographic and Health Surveys from 1990 to 2008. The findings reveal that mother-level and community-level variability are significantly associated with immunization uptake in Nigeria. The model also indicates that children delivered at private hospitals have a higher chance of being immunized than children who are delivered at home. Children from the poorest families (who are more likely to be delivered at home) have a lower chance of being immunized than those from the richest families (OR=0.712; 95% CI, 0.641–0.792). Similarly, the chance of children with a mother with no education being immunized is decreased by 17% compared with children whose mother has at least a primary education. In the same way, children of mothers who are gainfully employed and those of older mothers have statistically significantly higher odds of being immunized. Children of households with a female head are less likely to be immunized than those from male-headed households. The statistical significance of the community–survey year interaction term suggests an increase in the odds of a child being immunized over the years and spread over communities. Evidence-based policy should lay more emphasis on mother- and community-level risk factors in order to increase immunization coverage among Nigerian children.

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A. Adeiga , S. Omilabu , R. Audu , F. Sanni , G. Lakehinde , O. Balogun & O. Olagbaju (2005) Infant immunization coverage in difficult-to-reach area of Lagos Metropolis. African Journal of Clinical and Experimental Microbiology 6, 227231.

D. Antai (2009) Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of individual and contextual determinants. BMC Infectious Diseases 9, 181.

X. Bosch-Capblanch , K. Banerjee & A. Burton (2012) Unvaccinated children in years of increasing coverage: how many and who are they? Evidence from 96 low- and middle-income countries. Tropical Medicine and International Health 17, 697710.

V. Carey , S. Zeger & P. Diggle (1993) Modelling multivariate binary data with alternating logistic regressions. Biometrika 80, 517526.

G. A. Kayode , V. T. Adekanmbi & O. A. Uthman (2012) Risk factors and a predictive model for under-five mortality in Nigeria: evidence from Nigeria demographic and health survey. BMC Pregnancy and Childbirth 12, 10.

K. Liang & S. Zeger (1986) Longitudinal data analysis using generalized linear models. Biometrika 73, 1322.

G. Molenberghs & E. Lesaffre (1994) Marginal modelling of correlated ordinal data using a multivariate placket distribution. Journal of the American Statistical Association 89, 633644.

P. O. Ogunjuyigbe (2004) Under-five mortality in Nigeria: perception and attitudes of the Yorubas towards the existence of ‘Abiku’. Demographic Research 11(2), 4356.

J. S. Preisser , T. A. Arcury & S. A. Quandt (2003) Detecting patterns of occupational illness clustering with alternating logistic regressions applied to longitudinal data. American Journal of Epidemiology 158, 495501.

A. Sorungbe (1989) Expanded programme on immunization in Nigeria. Reviews of Infectious Diseases 11, S509511.

A. Rammohan , N. Awofeso & R. C. Fernandez (2012) Paternal education status significantly influences infants' measles vaccination uptake, independent of maternal education status. BMC Public Health 12, 336.

C. Wiysonge , O. Uthman , P. Ndumbe & G. Hussey (2012) Individual and contextual factors associated with low childhood immunisation coverage in sub-Saharan Africa: a multilevel analysis. PLoSONE, 7.

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Journal of Biosocial Science
  • ISSN: 0021-9320
  • EISSN: 1469-7599
  • URL: /core/journals/journal-of-biosocial-science
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