Clinical Epidemiology and Global Health (Oct 2021)
Coverage and determinants of protective dose tetanus toxoid vaccine among postnatal women delivered at university of Gondar comprehensive specialized hospital, northwest Ethiopia, 2019
Abstract
Background: Even though there have been tremendous strides globally in reducing the burden of tetanus, neonatal deaths due to tetanus have reported annually, and most deaths occur in sub-Saharan Africa which accounts for nearly half of the global neonatal mortality by tetanus. Immunization of pregnant women or women of childbearing age with at least two doses of tetanus toxoid is estimated to reduce mortality from neonatal tetanus by 94%. Despite its importance, immunization programs are suboptimal in Ethiopia, where more than 85% of the population have resides in rural districts. Therefore, this study has been used to determine the coverage and determinants of protective dose tetanus vaccine among postnatal women and design a strategy to maximize the service. Methods: Institution-based cross-sectional study was conducted from December 20-June 20, 2019. The sample was taken using a systematic random sampling method. To collect data from the study participants, a semi-structured interviewer-administered and pre-tested questionnaire was used. The data were entered into Epi info version 7.0 and then exported to SPSS version 20.0 for analysis. Logistic regressions analysis was conducted and the level of statistical significance was determined by a p-value of less than 0.05. Results: The proportion of immunization with Tetanus toxoid protective dose was 69.8% (95% CI: 65.2–74.0). Urban residence (AOR = 3.626, 95%CI: 1.510–8.707), husband's having secondary education (AOR = 7.397, 95%CI: 1.873–29.211), husband's having tertiary education (AOR = 9.539, 95%CI: 2.277–39.969), women stated that the provision of TT vaccine service was good (AOR = 3.978, 95%CI 1.303–12.146) and mother stated health care workers who provide TT vaccine were good in their behavior (AOR = 4.259, 95%CI: 1.913–9.484) were factors influencing utilization of TT protective dose immunization. Conclusion: The proportion of TT protective dose immunization in the study area was found to be low. Being Urban residence, secondary and tertiary levels of the husband's educational status, women who stated that ‘the provision of TT vaccine service was good’ and “health care workers who provide TT vaccine were good in their behavior were statistically significant factors influencing TT protective dose immunization. Thus, it is better to strengthening education and empowering women to enhance vaccine utilization. Besides, promoting husband's education and creating community awareness particularly rural residents are better options to increase utilization of TT protective dose vaccine.