A COMPARATIVE STUDY OF RURAL VERSUS URBAN UPTAKE OF TETANUS TOXOID VACCINATION AMONG MARRIED WOMEN OF REPRODUCTIVE AGE

Abstract

Perspective Of Background

Maternal and neonatal tetanus remains a major public health issue in developing countries despite the availability of effective tetanus toxoid (TT) vaccines. In Pakistan, particularly in rural areas, factors such as low awareness, poor healthcare accessibility, myths regarding vaccination, poverty, and limited maternal healthcare services continue to affect TT vaccination uptake among women of reproductive age. Differences between rural and urban communities also influence healthcare utilization and immunization practices. Therefore, assessing TT vaccination uptake and its associated factors is essential for improving maternal and neonatal health outcomes.

Objective

The objective of this study was to assess tetanus toxoid vaccination uptake among married women of reproductive age (18–49 years) and to determine its association with socio-demographic factors in rural and urban areas of District Hyderabad, Sindh, Pakistan.

Methodology

A descriptive cross-sectional study was conducted among married women attending Taluka Headquarter Hospital Qasimabad Hyderabad and Rural Health Centre Tando Jam. A total of 328 respondents were selected through simple random sampling technique using Zindagi Mehfooz (ZM) software. Data were collected through a structured questionnaire, interviews, immunization cards, and Lady Health Worker verification. Statistical analysis was performed using SPSS version 27. Descriptive statistics including frequencies and percentages were used, while Chi-square test was applied to determine associations between socio-demographic variables and TT vaccination-related factors. A p-value less than 0.05 was considered statistically significant.

Results

The findings showed that 164 (50%) respondents belonged to rural areas and 164 (50%) belonged to urban areas. The majority of respondents were aged 18–25 years. Inferential analysis revealed significant associations between socio-demographic variables and TT vaccination-related practices. Urban respondents demonstrated comparatively better awareness regarding TT vaccination, improved healthcare accessibility, and greater utilization of maternal healthcare services compared to rural respondents. In contrast, rural women experienced more barriers including transportation difficulties, limited healthcare facilities, lower awareness, and greater misconceptions regarding vaccination. Educational status, occupation, monthly income, and husband’s educational status significantly influenced TT vaccination uptake and maternal healthcare practices. Fear regarding vaccination, myths, and family influence were also identified as important barriers affecting complete immunization.

Conclusion

The study concluded that socio-demographic factors significantly influence TT vaccination uptake among women of reproductive age in rural and urban areas of District Hyderabad. Urban women showed better healthcare accessibility and awareness, whereas rural women faced greater healthcare barriers and limited immunization-related knowledge. Strengthening awareness campaigns, improving healthcare accessibility, enhancing maternal healthcare services, and promoting community-based immunization programs are necessary to improve TT vaccination coverage and reduce maternal and neonatal tetanus in Pakistan.