title: Do Maternal Living Arrangements Influence the Vaccination Status of Children Age 12-23 Months? A Data Analysis of Demographic Health Surveys 2010-11 from Zimbabwe.
abstract: BACKGROUND
  Although vaccination is an effective intervention to reduce childhood mortality and morbidity, reasons for incomplete vaccination, including maternal living arrangements, have been marginally explored. This study aims at assessing whether maternal living arrangements are associated with vaccination status of children aged 12-23 months in Zimbabwe. It also explores other variables that may be associated with having children not fully vaccinated.
  
  
  METHODS
  A cross-sectional analysis was performed on the DHS-VI done in Zimbabwe in 2010-2011 (response rate 93%). Incomplete vaccination of children (outcome), was defined as not having received one dose of BCG and measles, 3 doses of polio and DPT/Pentavalent. Maternal living arrangements (main exposure), and other exposure variables were analysed. Survey logistic regression was used to calculate crude and adjusted OR for exposures against the outcome.
  
  
  RESULTS
  The dataset included 1,031 children aged 12-23 months. 65.8% of children were fully vaccinated. 65.7% of the mothers were married and cohabitating with a partner, 20.3% were married/partnered but living separately and 14% were not married. Maternal living arrangements were not associated with the vaccination status of children both in crude and adjusted analysis. Factors associated with poorer vaccination status of the children included: no tetanus vaccination for mothers during pregnancy (adjusted OR = 2.1, 95%CI 1.5;3.0), child living away from mother (adjusted OR = 1.5, 95%CI 1.2;1.8), mother's education (adjusted OR = 0.6, 95%CI 0.4;0.9), high number of children living in the household (adjusted OR = 1.5, 95%CI 1.1;2.2), child age (adjusted OR = 0.7, 95%CI 0.5;0.9).
  
  
  CONCLUSIONS
  Maternal living arrangements were not associated with vaccination status of Zimbabwean children. Other factors, such as the mother's health-seeking behaviour and education were major factors associated with the children's vaccination status. Given the results of this study, it is strongly recommended that the vaccination coverage is increased by improving access to antenatal care and education for the parents.
authors.affiliation: London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Rossi
mesh_terms: D000328:Adult; D001500:BCG Vaccine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000627:therapeutic use; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008458:Measles Vaccine / Q000627:therapeutic use; D009035:Mothers / Q000706:statistics & numerical data*; D023321:Poliovirus Vaccines / Q000627:therapeutic use; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D001500:BCG Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D008458:Measles Vaccine; D023321:Poliovirus Vaccines