title: Gender inequities, relationship power, and childhood immunization uptake in Nigeria: a population-based cross-sectional study.
abstract: BACKGROUND
  This study aimed to simultaneously examine the association between multiple dimensions of gender inequities and full childhood immunization.
  
  
  METHODS
  A multilevel logistic regression analysis was performed on nationally representative sample data from the 2008 Nigeria Demographic and Health Survey, which included 33,385 women aged 15-49 years who had a total of 28,647 live-born children; 24,910 of these children were included in this study.
  
  
  RESULTS
  A total of 4283 (17%) children had received full immunization. Children of women whose spouse did not contribute to household earnings had a higher likelihood of receiving full childhood immunization (odds ratio (OR) 1.96, 95% confidence interval (95% CI) 1.02-3.77), and children of women who lacked decision-making autonomy had a lower likelihood of receiving full childhood immunization (OR 0.74, 95% CI 0.60-0.91). The likelihood of receiving full childhood immunization was higher among female children (OR 1.28, 95% CI 1.06-1.54), Yoruba children (OR 2.45, 95% CI 1.19-4.26), and children resident in communities with low illiteracy (OR 1.82, 95% CI 1.06-3.12), but lower for children of birth order 5 or above (OR 0.64, 95% CI 0.45-0.96), children of women aged ≤ 24 years (OR 0.66, 95% CI 0.50-0.87) and 25-34 years (OR 0.79, 95% CI 0.63-0.99), children of women with no education (OR 0.33, 95% CI 0.21-0.54) and primary education (OR 0.66, 95% CI 0.45-0.97), as well as children of women resident in communities with high unemployment (OR 0.34, 95% CI 0.20-0.57).
  
  
  CONCLUSIONS
  The woman being the sole provider for her family (i.e., having a spouse who did not contribute to household earnings) was associated with a higher likelihood of fully immunizing the child, and the woman lacking decision-making autonomy was associated with a lower likelihood of fully immunizing the child. These findings draw attention to the need for interventions aimed at promoting women's employment and earning possibilities, whilst changing gender-discriminatory attitudes within relationships, communities, and society in general.
authors.affiliation: Department of Public Health, Division of Social Medicine, Karolinska Institutet, 171 76 Stockholm, Sweden. Diddy.Antai@ki.se
authors.forename: Diddy
authors.initials: D
authors.lastname: Antai
mesh_terms: D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis / Q000379:methods; D009549:Nigeria; D016017:Odds Ratio; D011287:Prejudice; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult