Household and Maternal Determinants of Childhood Immunization Uptake in Nigeria: An Econometric Analysis of National Survey Data

Abstract

Childhood immunisation is a cost-effective public health intervention for preventing vaccine-preventable diseases and reducing mortality among children under five years of age. Despite sustained efforts by the Nigerian Government and development partners to improve coverage, national immunisation levels remain below national and international targets, with persistent socioeconomic and geographical disparities. This study evaluated the effects of maternal and household characteristics on childhood immunisation uptake in Nigeria using secondary data from the Nigeria Demographic and Health Survey. A cross-sectional analytical design was adopted, and the study population comprised mothers and their children aged 12–23 months. Descriptive statistics were used to summarise respondents’ characteristics. Associations between the explanatory variables and childhood immunisation were assessed using the survey-adjusted chi-squared test, while survey-weighted binary logistic regression estimated the independent effects of maternal and household characteristics after accounting for the complex survey design. The findings indicated that higher maternal education, greater household wealth, at least four antenatal care visits, delivery in a health facility, urban residence, and exposure to mass media were positively associated with full immunisation. Higher parity was associated with lower odds of full immunisation, while maternal education was the strongest predictor of vaccination uptake. The study recommends strengthening female education and maternal health services, improving rural infrastructure, reducing socioeconomic barriers, reinforcing health promotion, and enhancing intersectoral coordination to support equitable access to childhood immunisation.