The data from the Demographic and Health Survey conducted in Ghana in 1988 are used to identify determinants of immunisation uptake for children under 5 years. The logistic binomial analysis shows that socioeconomic factors are significant, especially women's education and region, and that the type of prenatal care received by the mother is also important. There is a strong familial correlation of vaccination behaviours, and there is also clustering of data within enumeration areas.

PIP:

This article presents a study of the socioeconomic determinants of use of immunization in Ghana. Data were obtained from the 1988 Ghana Demographic and Health Survey. The sample was self-weighting and included 4488 females aged 15-49 years and a subsample of 943 coresident spouses. The sample included 3690 children aged under 5 years, of whom 21.2% were 1 year olds. Immunization was determined by the child's health card record or maternal recall. Many young infants and older children had no health card. Over 60% of children without a health card did not receive vaccinations. Over 50% of children aged over 11 months who had a health card were not vaccinated. There were many dropouts from receipt of the triple vaccine and oral polio series and measles vaccinations. Unimmunized children tended to come from rural families in the northern region in which fathers were agricultural workers and mothers were illiterate. In the 150 enumeration areas (EAs), an average of 23 children were vaccinated. The number of vaccinated children ranged from 5 to 69 children per EA. 42% of children in the sample had no siblings. Logistic analysis included fixed effects and random effects models. Significant factors related to immunization were the child's age, place of residence, maternal education, father's occupation, region, and type of prenatal care. Vaccination was unrelated to maternal age, radio listening, and deaths of siblings. Findings indicate that familial correlation was present in the sibling analysis. After controlling for age, maternal education had the strongest effect. The random effects model that accounted for familial correlation showed that the most important predictors were maternal education, region, and prenatal care. Findings indicate that the probability of being immunized among "unfavorable background" families varied by unknown factors.