Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011-2016: results from a national survey

Authors

August C. Anderson, School of Medicine, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.
Adam Richards, Department of Global Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Washington, DC, NW, 20052, USA.
Kevin Delucchi, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA.
Mandana Khalili, Department of Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Building 5, Suite 3D4, San Francisco, CA, 94110, USA. Mandana.Khalili@ucsf.edu.

Document Type

Journal Article

Publication Date

4-19-2022

Journal

BMC health services research

Volume

22

Issue

1

DOI

10.1186/s12913-022-07902-w

Keywords

Hepatitis B / prevention & control; Hepatitis B Vaccines / therapeutic use; Infectious Disease Transmission, Vertical / prevention & control; Maternal-Child Health Services; Quality of Health Care

Abstract

BACKGROUND: Hepatitis B virus birth dose (HepB-BD) vaccination is recommended to reduce mother to infant transmission. We evaluated the HepB-BD status of women who gave birth between 2011 and 2016 (N = 3,583) using the 2015-2016 Myanmar Demographic and Health Survey. METHODS: Frequency distributions of HepB-BD vaccination across maternal and health system factors, concentration indices, and logistic regression models were used to estimate coverage, inequity, and factors associated with vaccination. RESULTS: The majority of participants were younger than 30 years of age, lived in rural areas, and were multiparous. Almost all received antenatal care (ANC), but only 43% received recommended ANC services, and 60% gave birth at home. The overall HepB-BD coverage rate was 26%. Vaccination coverage was higher in urban areas and was inequitably concentrated among children of more educated and wealthier women. HepB-BD coverage was also positively associated with receipt of ANC at non-governmental facilities, and delivery at a facility, skilled provider at birth and Cesarean delivery. After adjusting for sociodemographic and health system factors, receipt of the HepB-BD was positively associated with weekly media exposure, receipt of recommended ANC, and Cesarean delivery, and inversely associated with home delivery. CONCLUSIONS: Both socioeconomic and health systems factors influenced suboptimal and inequitable vaccination coverage. Improved access to quality ANC and delivery services may increase HepB-BD coverage although targeted approaches to reach home births are likely required to achieve national goals.

APA Citation

Anderson, August C.; Richards, Adam; Delucchi, Kevin; and Khalili, Mandana, "Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011-2016: results from a national survey" (2022). GW Authored Works. Paper 773.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/773

Department

Global Health