Association Between Vaccination Awareness Program Exposure and Full Immunization Coverage Among Mothers in Rural Bangladesh: A Comparative Cross-Sectional Study in Jashore District.
- 1International School Capital Medical University Beijing China.
- 2Department of Physical Education and Sports Science Jashore University of Science and Technology Jashore Bangladesh.
- 3Department of Nutrition and Food Technology Jashore University of Science and Technology Jashore Bangladesh.
Abstract
Background and aims
Childhood immunization is a cost-effective public health intervention, and Bangladesh has achieved South Asia's highest complete immunization rate, yet village-level effectiveness of local awareness programs remains poorly evaluated. This study evaluated whether exposure to a village-level vaccination awareness program was independently associated with full immunization coverage among mothers in Jashore District, Bangladesh, alongside other maternal determinants.Methods
A community-based, comparative cross-sectional study surveyed 1,000 mothers of children aged 0-5 years, sampled by convenience from villages with and without an implemented awareness program, between June and August 2025. Bivariate associations with full immunization status were tested using Chi-square tests and 95% confidence intervals; multivariable logistic regression estimated adjusted odds ratios (AOR) for all predictors simultaneously.Results
Of 886 mothers with recorded status, 62.1% (95% CI 58.8%-65.2%) were fully immunized. Maternal education showed the strongest association, rising from 53.6% among mothers with no education to 80.9% among graduates (χ² = 52.60, p < 0.001); after adjustment, higher secondary (AOR = 3.42) and graduate education (AOR = 3.64) remained significant, and a supplementary linear-trend model confirmed a significant dose-response gradient across education levels (AOR = 1.50 per level, 95% CI 1.31-1.72, p < 0.001). Awareness-program exposure showed no association with full immunization, either before (61.9% vs. 62.2%, p = 0.98) or after adjustment (AOR = 0.98, p = 0.90). Distance to health facilities (43.2%), fear of side effects (30.9%), and husband disapproval (25.9%) were the leading reported barriers. Mothers with unrecorded EPI status were more often less-educated than those with recorded status (p = 0.004), a missingness pattern addressed explicitly in the Discussion.Conclusion
Maternal education, not awareness-program exposure, independently predicted full immunization. Program investment should shift from generic exposure toward literacy-sensitive content, husband-inclusive counseling, and outreach-site expansion to help close Bangladesh's remaining immunization gap.
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BibTeX
@article{khatun2026association,
title = {{Association Between Vaccination Awareness Program Exposure and Full Immunization Coverage Among Mothers in Rural Bangladesh: A Comparative Cross-Sectional Study in Jashore District.}},
author = {Halima Khatun and Rezwan Hossain and Md Sohel Mia},
journal = {Health science reports},
year = {2026},
month = oct,
doi = {10.1002/hsr2.73445},
url = {https://europepmc.org/article/MED/42948573},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association Between Vaccination Awareness Program Exposure and Full Immunization Coverage Among Mothers in Rural Bangladesh: A Comparative Cross-Sectional Study in Jashore District.
AU - Halima Khatun
AU - Rezwan Hossain
AU - Md Sohel Mia
PY - 2026
DA - 2026/10/27
JO - Health science reports
DO - 10.1002/hsr2.73445
UR - https://europepmc.org/article/MED/42948573
AB - Background and aims Childhood immunization is a cost-effective public health intervention, and Bangladesh has achieved South Asia's highest complete immunization rate, yet village-level effectiveness of local awareness programs remains poorly evaluated. This study evaluated whether exposure to a village-level vaccination awareness program was independently associated with full immunization coverage among mothers in Jashore District, Bangladesh, alongside other maternal determinants.Methods A community-based, comparative cross-sectional study surveyed 1,000 mothers of children aged 0-5 years, sampled by convenience from villages with and without an implemented awareness program, between June and August 2025. Bivariate associations with full immunization status were tested using Chi-square tests and 95% confidence intervals; multivariable logistic regression estimated adjusted odds ratios (AOR) for all predictors simultaneously.Results Of 886 mothers with recorded status, 62.1% (95% CI 58.8%-65.2%) were fully immunized. Maternal education showed the strongest association, rising from 53.6% among mothers with no education to 80.9% among graduates (χ² = 52.60, p < 0.001); after adjustment, higher secondary (AOR = 3.42) and graduate education (AOR = 3.64) remained significant, and a supplementary linear-trend model confirmed a significant dose-response gradient across education levels (AOR = 1.50 per level, 95% CI 1.31-1.72, p < 0.001). Awareness-program exposure showed no association with full immunization, either before (61.9% vs. 62.2%, p = 0.98) or after adjustment (AOR = 0.98, p = 0.90). Distance to health facilities (43.2%), fear of side effects (30.9%), and husband disapproval (25.9%) were the leading reported barriers. Mothers with unrecorded EPI status were more often less-educated than those with recorded status (p = 0.004), a missingness pattern addressed explicitly in the Discussion.Conclusion Maternal education, not awareness-program exposure, independently predicted full immunization. Program investment should shift from generic exposure toward literacy-sensitive content, husband-inclusive counseling, and outreach-site expansion to help close Bangladesh's remaining immunization gap.
SN - 2398-8835
ER -