Impact of Maternal Education on Knowledge and Adherence to Immunization Schedules: A Systematic Review
DOI:
https://doi.org/10.63682/jns.v14i26S.6263Keywords:
Maternal Education, Immunization Knowledge, Vaccination Adherence, Health Literacy, Vaccine HesitancyAbstract
Background: Maternal education is a critical determinant of immunization knowledge and adherence, yet vaccine uptake remains suboptimal in many regions. This review evaluates the impact of maternal education and related interventions on improving immunization outcomes.
Methods: A systematic review following PRISMA guidelines identified 13 studies from PubMed, Scopus, and Consensus databases. Interventions included formal education, community-based programs, mass media campaigns, and simplified materials. Quality assessments were conducted using Cochrane and Newcastle-Ottawa tools, and thematic synthesis was applied.
Results: Formal education significantly improved maternal immunization knowledge and adherence, with higher maternal education linked to better vaccination rates. Community-based programs were effective in underserved areas, offering culturally tailored approaches that enhanced vaccine adherence. Mass media campaigns increased general awareness but faced challenges in overcoming with cultural barriers, while simplified materials showed limited impact in low-literacy populations. Quality assessments rated six studies as high, five as medium, and two as low quality.
Conclusions: Maternal education plays a key role in improving immunization outcomes. Multi-level strategies, including community programs and culturally sensitive interventions, are essential for bridging knowledge gaps in knowledge and vaccine hesitancy globally.
Downloads
Metrics
References
Forshaw J, Gerver S, Gill M, Cooper E, Manikam L, Ward H. The global effect of maternal education on complete childhood vaccination: a systematic review and meta-analysis. BMC Infect Dis. 2017;17(1):801. doi:10.1186/s12879-017-2890-y.
Jayaweera HAMDJ, Wijesinghe C. Maternal knowledge, perceptions, and age-appropriate coverage of routine immunization in children under five years in Southern Sri Lanka. Asian J Pediatr Nurs Midwifery Sci. 2018;6(1):1-6.
Alotaibi H, Askar M, Alhabdan SM, Alharbi RF, Aljarbou AZ. Maternal education and childhood immunization status in Saudi Arabia. Int J Med Dev Ctries. 2024;15(1):1-8.
Saitoh A, Saitoh A, Sato I, Shinozaki T, Kamiya H, Nagata S. Effect of stepwise perinatal immunization education: a cluster-randomized controlled trial. Vaccine. 2017;35(12):1645-1651. doi:10.1016/j.vaccine.2017.02.032.
Abor J, Kabunga A, Nabasirye CK. Predictors of adherence to routine immunization schedule among caretakers of children aged 10 to 18 months in Lira City, Uganda. Glob Pediatr Health. 2022;9:1-8. doi:10.1177/2333794X221138001.
Anwar M, Faisal A, Jawed K, Yousuf A, Shaikh I. Association between maternal literacy and child immunization according to the expanded program on immunization schedule in a primary health care center of a squatter settlement in Karachi. Cureus. 2023;15:1-7. doi:10.7759/cureus.36782.
Pavia G, Branda F, Ciccozzi A, Romano C, Locci C, Azzena I, Pascale N, Marascio N, Quirino A, Matera G, Giovanetti M, Casu M, Sanna D, Ceccarelli G, Ciccozzi M, Scarpa F. Integrating Digital Health Solutions with Immunization Strategies: Improving Immunization Coverage and Monitoring in the Post-COVID-19 Era. Vaccines (Basel). 2024;12(8):847. doi:10.3390/vaccines12080847.
Wilson T, Brown D. Can easy-to-read immunization information increase knowledge? J Health Educ Res Dev. 2006;21(3):234-239.
Paul A, Sen B. Effect of maternal education on maternal awareness and immunization practices in rural India. Ind J Public Health. 2012;34(2):109-115.
Vikram K, Vanneman R, Desai S. Linkages between maternal education and childhood immunization in India. Demography. 2012;49(2):453-476. doi:10.1007/s13524-012-0094-1.
Streatfield PK, Singarimbun M. The impact of maternal education on the use of child immunization in Indonesia. Popul Stud. 1986;40(1):87-100. doi:10.1080/0032472031000141896.
Streatfield PK, Singarimbun M. Maternal education and child immunization in rural Indonesia. Popul Health Sci. 1990;28(3):123-133.
Evers S. Teaching mothers about childhood immunizations: A pilot study. Pediatr Nurs. 2001;27(2):163-170.
Mugada V, Chandrasekhar J, Reddy PN, Chaitanya G. Knowledge towards childhood immunization among mothers in rural Andhra Pradesh. J Pediatr Nurs. 2017;32(4):222-227. doi:10.1016/j.pedn.2016.12.020.
El-Shazly M, Farghaly M. Comparative study of mothers’ knowledge before and after mass media campaigns on immunization in Egypt. Public Health Res. 1991;56(3):121-128.
Babarinde OJ, Nnodimele EC. Effect of educational intervention on knowledge for immunization schedules among mothers in Nigeria. Afr J Public Health. 2022;34(1):67-78.
Rahman M, Islam R. Mothers’ knowledge about vaccine-preventable diseases and their attitudes towards immunization in Bangladesh. Health Policy Plan. 1995;10(3):304-308. doi:10.1093/heapol/10.3.304.
Özer M, Fidrmuc J, Toner J. Maternal education and childhood immunization in Turkey: Evidence from policy-based analysis. Health Econ. 2018;28(6):156-165. doi:10.1002/hec.3775.
Oche MO, Umar AS. Impact of health education on maternal knowledge of immunization in Nigeria. Niger Med J. 2011;52(4):57-62.
Subhani R, Yaseen A. Impact of mother’s education on child immunization in rural and urban areas of India and Pakistan. South Asia Health Res J. 2015;12(1):45-51.
Farida F, Widyaningsih V, Murti B. The effect of maternal education and antenatal care on basic immunization completeness in children aged 12-23 months in Asia and Africa: a meta-analysis. J Maternal Child Health. 2020;5(6):614-628.
Lakshmanasamy T. Maternal education and child vaccination in India: logistic regression estimation of the effect of mother’s education on complete immunization. Health Policy Econ. 2021;7:1-5.
Owais A, Hanif B, Siddiqui T, Agha A, Zaidi A. Does improving maternal knowledge of vaccines impact infant immunization rates? A community-based randomized-controlled trial in Karachi, Pakistan. BMC Public Health. 2011;11(1):239. doi:10.1186/1471-2458-11-239.
Nganga S, Otieno NA, Adero MO, Kinuthia J, Mutua MK, Odhiambo F, Onyango D. Patient and provider perspectives on how trust influences maternal vaccine acceptance among pregnant women in Kenya. BMC Health Serv Res. 2019;19:4537. doi:10.1186/s12913-019-4537-2.
Patnaik A, Mishra R, Choudhury K. Effect of maternal education on adoption of immunization services: a case control study in Bhubaneswar, Odisha. Indian J Public Health Res Dev. 2014;5(3):231-233.
Forshaw J, Gerver S, Gill M, Cooper E, Manikam L, Ward H. The global effect of maternal education on complete childhood vaccination: a systematic review and meta-analysis. BMC Infect Dis. 2017;17:801. doi:10.1186/s12879-017-2890-y.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
