Predictive factors for childhood immunization in timor-leste

Objectives: Ten years after independence, child vaccination rates remain low in Timor-Leste. In 2009, only 52.6% of children ages 12-23 months completed all recommended vaccines; 22.7% received no vaccinations. Women with greater decision-making power may be more likely to immunize their children if they have improved access to care. It is critical to increase coverage to reduce child mortality due to vaccine-preventable diseases and meet MDG4 by identifying predictive factors and points for intervention. Methods: I analyzed data from the 2009-10 Timor-Leste Demographic and Health Survey, a nationally representative sample of 13,137 women aged 15-49. Logistic regression was performed to assess the predictive value of women's decision-making power on vaccination status among a subset of 7,392 respondents with children ages 1-4. Literacy, household wealth, access to media, and urbanity were assessed as covariates. Outcomes: 25.6% of children in this sample received no vaccines; 64.1 of children did not complete the full series. Women with higher decision-making power had 1.2 times the odds of completing vaccination for their children. After adjusting for covariates, decision-making power was not significantly associated with vaccination, though literacy, urbanity, and household wealth were significantly and positively associated with vaccination. Literate women were 1.33 times as likely to complete vaccination. Conclusions: Literacy, poverty and living in a rural are key predictors of incomplete vaccination status in Timor-Leste. Low-literacy interventions targeted in rural areas may be critical to meet MDG targets of 90% vaccination coverage by 2015. Further studies should identify mothers' perceived barriers to vaccination.