Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan; A secondary analysis of cross-sectional survey data

PLoS One. 2018 Oct 31;13(10):e0206766. doi: 10.1371/journal.pone.0206766. eCollection 2018.


Background: Pakistan has a high burden of newborn mortality, which would be significantly preventable through appropriate routine immunization. The purpose of this study was to measure the basic timely childhood immunization coverage and to identify determinants of factors influencing childhood immunization coverage in Sindh, Pakistan.

Methods: Data from Maternal and Child Health Program Indicator Survey 2013-2014 which was conducted in Sindh province of Pakistan was used. Outcome measure was full coverage of the basic immunization schedule from child's vaccination card. The association of receiving basic immunization with demographic factors, socioeconomic status, mother and child health information sources, and perinatal care factors were tested by binary logistic regression.

Results: Among 2,253 children, 1,156 (51.3%) received age-based full basic immunization. The basic immunization rates were 69.1% for under five weeks old, 38.3% for six to nine weeks, 18.8% for 10-13 weeks, 44.0% for 14 weeks-eight months, 60.4% for nine to 11 months, and 59.1% for over one year. Child's age, number of living children, parents' education level, wealth, the source of mother and child health information, number of antenatal care, and assistance during delivery were associated with completing basic immunization.

Conclusions: The overall full basic immunization coverage in Pakistan was still low. Policy makers should identify children at risk of low immunization coverage and obstacles of receiving antenatal care, implement educational interventions targeting on less educated parents, and conduct mass immunization campaigns for timely and complete immunization.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Child Health
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Immunization Schedule
  • Infant
  • Infant, Newborn
  • Male
  • Mass Vaccination*
  • Pakistan
  • Pregnancy
  • Prenatal Care
  • Socioeconomic Factors
  • Vaccination
  • Vaccination Coverage*

Grant support

This publication was made possible through support provided by the US Agency for International Development (USAID), under the terms of Associate Cooperative Agreement No. AID-391-LA-13-00001; Maternal, Newborn and Child Health Services Project. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.