Abstract

This paper develops a conceptual framework for examining the process of immunisation and explores the sociodemographic determinants of vaccination in Zambia. About 300 mothers with children under 3 years of age were interviewed in urban Lusaka. The analyses suggest that sociostructural, as well as cultural, processes influence the attrition process and immunisation programmes should focus on the uniqueness of each stage. In addition, programmes to improve women's education and to reduce male gender preferences are needed.

PIP:

Data from 277 low income mothers in Lusaka, Zambia were analyzed to determine the effect certain biosocial variables had on immunization coverage of 3-year old children. About 90% began the immunization schedule but the % fell consistently up to DPT3. Only about 48% were fully immunized. 70% of infants in each birth cohort received all the vaccinations except for measles. The largest dropout percentage occurred before the measles shot. The 1985 birth cohort represented the largest percentage not immunized against measles (about 35%), but they had the highest overall rates of immunization. The 1986 birth cohort had the lowest immunization rates. Increased educational levels of mothers increased the chances of immunization. In addition, all children of mothers working outside the home were vaccinated against some diseases compared with 12./5% of children of mothers who do not work outside the home who received no vaccinations. Among children with some immunization, boys tended to have received more vaccinations than girls. Girls were 2.32 times more likely to have received the BCG than boys, but were also more likely to stop at this stage this stage than boys. Boys were more likely than girls to stop at the 3rd stage. Other than the 2nd stage, attrition rates for girls were always lower than for boys. Further lower attrition rates were tied in with higher levels of education. Younger mothers were more likely to have their children who had received a BCG vaccination return for the DPT1 vaccination than older mothers, but age did not influence immunization converge at other stages. These results suggest that immunization programs should focus on improving the chance of vaccination at each stage, especially the last stage. They also highlight the need for these programs to improve women's education and reduce son preferences.