Original Paper

Journal of Community Health

, Volume 38, Issue 3, pp 492-499

Determinants of Utilization of Sufficient Tetanus Toxoid Immunization During Pregnancy: Evidence from the Kenya Demographic and Health Survey, 2008–2009

  • Zelalem T. HaileAffiliated withRobert C. Byrd Health Sciences Center, School of Public Health, West Virginia University Email author 
  • , Ilana R. Azulay ChertokAffiliated withSchool of Nursing, West Virginia University
  • , Asli K. TeweldeberhanAffiliated withDepartment of Social and Public Health, Ohio University

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Although the effectiveness of tetanus toxoid (TT) immunization during pregnancy in preventing maternal and neonatal tetanus is well established, in many developing countries, TT immunization programs are underutilized. The objective of this study was to examine factors associated with sufficient TT immunization among postpartum women in Kenya. Population based secondary data analysis was conducted using de-identified data from the 2008–2009 Kenyan Demographic and Health Survey (KDHS) for 1,370 female participants who had a live birth during or within 12 months of the cross-sectional survey. Chi-square test and independent sample t test were conducted to assess bivariate associations and a multivariable logistic regression analysis was conducted to examine associations before and after adjustment for demographic, socioeconomic, cultural, and access to care factors. The main factors contributing to having been sufficiently immunized against tetanus were lower birth order, higher household wealth index, women’s employment, making joint health-related decisions with a partner, and higher number of antenatal care visits. Implications for health care providers and other professionals involved in development of strategies and interventions aimed at improving immunization rates are discussed.


Tetanus toxoid Immunization Pregnancy Demographic and Health Survey Kenya