The relationship between facility delivery and infant immunization in Ethiopia.
OBJECTIVE
To determine whether facility delivery is related to compliance with recommended infant immunizations, particularly those that occur weeks or months after delivery.


METHODS
In a retrospective analysis, multivariate logistic regression was used to assess data from the 2011 Ethiopia Demographic and Health Survey (EDHS) to determine the strongest correlates of facility delivery. These correlates were then used, along with facility delivery itself, to determine the relationship between facility delivery and infant immunization.


RESULTS
In total, 3334 women delivered a newborn 12-24months before the 2011 EDHS: 90.2% (3007) delivered at home, and 9.8% (327) delivered in a facility. Education, wealth status, urban residence, and number of children under 5years living in the household were the factors most strongly associated with facility delivery. When facility delivery and its strongest correlates were entered into multivariate logistic regression models with infant immunizations as the outcome, facility delivery was significantly associated with increased likelihood of DPT-HepB-Hib, polio, and measles vaccination, and increased likelihood of being fully immunized (all P<0.01). Facility delivery was the strongest single factor associated with infants being immunized, doubling the odds of full immunization.


CONCLUSIONS
The impact of facility delivery on health outcomes transcends the immediate delivery and postpartum period.
Global REACH, University of Michigan Medical School, Ann Arbor, USA; Department of Medical Education, University of Michigan Medical School, Ann Arbor, USA. Electronic address: camoyer@umich.edu.
Cheryl A
CA
Moyer
Lia
L
Tadesse
Senait
S
Fisseha
D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005002:Ethiopia; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D016013:Likelihood Functions; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014612:Vaccines / Q000008:administration & dosage
D014612:Vaccines
Africa; Ethiopia; Facility delivery; Immunizations; Maternal health service utilization; Vaccinations