The relationship between facility delivery and infant immunization in Ethiopia.

ABSTRACT

OBJECTIVE: To determine whether facility delivery is related to compliance with recommended infant immunizations, particularly those that occur weeks or months after delivery. METHODS: In a retrospective analysis, multivariate logistic regression was used to assess data from the 2011 Ethiopia Demographic and Health Survey (EDHS) to determine the strongest correlates of facility delivery. These correlates were then used, along with facility delivery itself, to determine the relationship between facility delivery and infant immunization. RESULTS: In total, 3334 women delivered a newborn 12-24months before the 2011 EDHS 90.2% (3007) delivered at home, and 9.8% (327) delivered in a facility. Education, wealth status, urban residence, and number of children under 5years living in the household were the factors most strongly associated with facility delivery. When facility delivery and its strongest correlates were entered into multivariate logistic regression models with infant immunizations as the outcome, facility delivery was significantly associated with increased likelihood of DPT-HepB-Hib, polio, and measles vaccination, and increased likelihood of being fully immunized (all P<0.01). Facility delivery was the strongest single factor associated with infants being immunized, doubling the odds of full immunization. CONCLUSION: The impact of facility delivery on health outcomes transcends the immediate delivery and postpartum period.