Factors associated with incomplete child immunization in Pakistan: findings from Demographic and Health Survey 2017-18

Objective: The objective of this analysis was to explore the determinants of incomplete immunization in children aged 12-23 months. Study design: A secondary analysis was conducted on cross-sectional survey data from Pakistan Demographic and Health survey 2017-2018. Methods: The present study was confined to children aged 12-23 months at the time of survey giving a sample size of 2048. Complete immunization was described as having received a dose of BCG (Bacille Calmette Guerin), four doses of oral polio vaccine (OPV0, OPV1, OPV2, and OPV3), three doses of pentavalent and pneumococcal vaccine, and one dose of measles vaccine. Multivariable logistic regression was used to explore the association between outcome and predictor variables. Results: The findings showed that the likelihood of being incompletely immunized was higher for the children of Baluchistan (adjusted odds ratio [aOR] = 6.38; 95% confidence interval [CI] = 4.18-9.71), Federally Administered Tribal Areas (aOR = 6.2; 95% CI = 3.97-9.71), Sindh (aOR = 3.24; 95% CI = 2.33 -4.49), Khyber Pakhtunkhwa (aOR = 2.13; 95% CI = 1.54-2.97), Islamabad (aOR = 3.656; 95% CI = 2.34 -5.69), and Gilgit Baltistan (aOR = 2.320; 95% CI = 1.50-3.57) relative to those of Punjabi children. Lower odds of partial vaccination were seen among the children of educated mothers (primary or higher) and those who were born at a health facility. Conclusion: Improving maternal literacy rate, providing easy access to health facilities, and minimizing regional disparities can improve the immunization status of children in Pakistan. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.