Coverage and factors associated with full immunisation among children aged 12-59 months in Bangladesh: insights from the nationwide cross-sectional demographic and health survey

Abstract

Objective: To estimate the coverage and factors associated with full immunisation coverage among children aged 12-59 months in Bangladesh.

Study design: The study is cross sectional in design. Secondary dataset from Bangladesh Demographic and Health Survey was used for this analysis. Immunisation status was categorised as 'fully immunised' if the children had received all the eight recommended vaccine doses otherwise 'partially/unimmunised'.

Settings: Bangladesh.

Participant: Children aged 12-59 months were the study participants. Participants were randomly selected through a two-stage stratified sampling design. A total of 6230 children were eligible for the analysis.

Results: About 86% of the children (5356 out of 6230) were fully immunised. BCG has the highest coverage rate (97.1%) followed by oral polio vaccine 1 (97%) and pentavalent 1 (96.6%), where the coverage rate was the lowest for measles vaccine (88%). Coverage was higher in urban areas (88.5%) when compared with rural ones (85.1%). Full immunisation coverage was significantly higher among children who lived in the Rangpur division (adjusted OR (AOR)=3.46; 95% CI 2.45 to 4.88, p<0.001), were 48-59 months old (AOR=1.32; 95% CI 1.06 to 1.64, p=0.013), lived in a medium size family (AOR=1.56; 95% CI 1.32 to 1.86, p<0.001), had parents with a higher level of education (AOR=1.96; 95% CI 1.21 to 3.17, p=0.006 and AOR=1.55; 95% CI 1.05 to 2.29, p=0.026) and belonged to the richest families (AOR=2.2; 95% CI 1.5 to 3.21, p<0.001). The likelihood of being partially or unimmunised was higher among children who had the father as their sole healthcare decision-maker (AOR=0.69; 95% CI 0.51 to 0.92, p<0.012).

Conclusions: There were significant variations of child immunisation coverage across socioeconomic and demographic factors. These findings will inform innovative approaches for immunisation programmes, and the introduction of relevant policies, including regular monitoring and evaluation of immunisation coverage-particularly for low-performing regions, so that the broader benefit of immunisation programmes can be achieved in all strata of the society.

Keywords: bangladesh; coverage; health policy; public health.

Figure 1

Coverage rate by individual vaccines (BCG, pentavalent, oral polio vaccine (OPV) and measles) across administrative divisions in Bangladesh (map obtained from open access source and edited according to study findings).

Figure 2

Coverage rate by individual vaccines across place of residence of respondents (urban vs rural) in Bangladesh. OPV, oral polio vaccine.