Association between the continuum of maternal healthcare services and child immunisation in East Africa: a propensity score matching analysis

Abstract

OBJECTIVE: To assess the association between the maternal continuum of healthcare and child immunisation in East Africa using propensity score matching (PSM). DESIGN: Cross-sectional study using Demographic and Health Survey data. SETTING: This study was conducted in East African countries. PARTICIPANTS: This study included a weighted sample of 13 488 women with children aged 12-23 months. OUTCOME MEASURE: Child immunisation was the outcome variable of this study. RESULTS: The PSM estimates indicate that the average treatment effect on the treated for complete child immunisation was 0.0583, meaning that children of mothers who received a complete maternal continuum of care had a 5.83% higher probability of being fully immunised compared with children of mothers with incomplete care. Expressed relative to the treated group's mean, this corresponds to a 7.48% increase. Additionally, our results indicated that the population average treatment effect was 0.0629. This means that, on average, a complete continuum of maternal healthcare increases the probability of full child immunisation by approximately 6.29% across the entire population. CONCLUSION: The study highlights that children whose mothers receive comprehensive maternal healthcare are more likely to complete their childhood immunisations. This finding underscores the need to integrate immunisation services into maternal healthcare programmes to enhance vaccination coverage and promote better child health. To maximise this connection, improving access to maternal healthcare, especially in underserved regions, is crucial, along with ensuring that immunisation is a regular part of maternal care.