Determinants of Basic Immunization Coverage: The Role of Family Knowledge and Support in Central Sulawesi, Indonesia Open Access

Authors

  • 1 Abustam Community Health Center, Banggai District, Central Sulawesi, Indonesia
  • 2 Tariq Ullah Dow University, Pakistan, Karachi, Pakistan

https://doi.org/10.55018/ihc.v11.6 Published: 2025-06-30

Abstract

Background: Indonesia continues to face challenges in achieving optimal immunization coverage, especially in rural and underserved regions. In Central Sulawesi, incomplete basic immunization among children remains prevalent despite government programs. This study aimed to investigate the role of maternal knowledge and family support in predicting complete basic immunization coverage among children aged 1–5 years in Toili II Community Health Center, Banggai Regency.

Methods: A cross-sectional correlational study was conducted in August 2024 using a non-probability sampling method. A total of 53 mothers participated. Data were collected using validated and reliable questionnaires measuring maternal knowledge (18 items) and family support (15 items). Immunization status was verified using vaccination cards. Data analysis involved descriptive statistics, bivariate Chi-square tests, and multivariate logistic regression.

Result: Results showed that 64.2% of children had complete immunization. Nearly half of the mothers had moderate knowledge (49.1%) and moderate family support (39.6%). Logistic regression revealed that both maternal knowledge (p < 0.001) and family support (p < 0.001) were significant independent predictors of complete immunization. Together, they explained 85.9% of the variance in immunization status.

Conclusion: This study concludes that maternal knowledge and family support significantly and synergistically influence childhood immunization completeness. Health promotion strategies should integrate family-based education and support systems into immunization programs, particularly in rural areas. Frontline health workers are encouraged to assess both knowledge and perceived support during routine visits. Policymakers should consider embedding family-engagement modules in immunization guidelines and leveraging household dynamics to strengthen national immunization coverage.

Keywords:

Immunization, Knowledge, Family Support, Vaccination

References

Alyafei, A. and Easton-Carr, R. (2025) ‘The Health Belief Model of Behavior Change.’, in. Treasure Island (FL).
Anand, S. et al. (2023) ‘Asian American Vaccination, Testing, and Other Healthcare Knowledge & Behaviors during COVID-19, A Systematic Review.’, Pathogens and global health. England, 117(2), pp. 120–133. doi: 10.1080/20477724.2022.2106110.
Cataldi, J. R. and O’Leary, S. T. (2021) ‘Parental vaccine hesitancy: scope, causes, and potential responses.’, Current opinion in infectious diseases. United States, 34(5), pp. 519–526. doi: 10.1097/QCO.0000000000000774.
Davies, C. et al. (2021) ‘School-based HPV vaccination positively impacts parents’ attitudes toward adolescent vaccination.’, Vaccine. Netherlands, 39(30), pp. 4190–4198. doi: 10.1016/j.vaccine.2021.05.051.
Ding, J. et al. (2024) ‘Knowledge about, attitudes toward and acceptance and predictors of intention to receive the mpox vaccine among cancer patients in China: A cross-sectional survey.’, Human vaccines & immunotherapeutics. United States, 20(1), p. 2337157. doi: 10.1080/21645515.2024.2337157.
Elbert, B. et al. (2023) ‘Mothers’ knowledge, attitude, and behavior regarding child immunization, and the association with child immunization status in Medan City during the COVID-19 pandemic.’, IJID regions. England, 8(Suppl), pp. S22-6. doi: 10.1016/j.ijregi.2023.03.014.
Gilbert, J. (2024) ‘Sustainable Development Goals (SDG).’, mSystems. United States, p. e0114023. doi: 10.1128/msystems.01140-23.
Langer, S. et al. (2024) ‘Parental knowledge and attitudes to infant immunization in the context of RSV: All about confidence?’, Vaccine. Netherlands, 42(23), p. 126050. doi: 10.1016/j.vaccine.2024.06.018.
Ma, L. et al. (2023) ‘Nutrition knowledge, attitudes, and dietary practices among parents of children and adolescents in Weifang, China: A cross-sectional study.’, Preventive medicine reports. United States, 35, p. 102396. doi: 10.1016/j.pmedr.2023.102396.
Mehrabizadeh, M. et al. (2024) ‘Narratives of resilience: Understanding Iranian breast cancer survivors through health belief model and stress-coping theory for enhanced interventions.’, BMC women’s health. England, 24(1), p. 552. doi: 10.1186/s12905-024-03383-7.
Parwati, N. M. et al. (2021) ‘A Health Belief Model-Based Motivational Interviewing for Medication Adherence and Treatment Success in Pulmonary Tuberculosis Patients.’, International journal of environmental research and public health. Switzerland, 18(24). doi: 10.3390/ijerph182413238.
Perin, J. et al. (2022) ‘Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals.’, The Lancet. Child & adolescent health. England, 6(2), pp. 106–115. doi: 10.1016/S2352-4642(21)00311-4.
Qin, C. et al. (2022) ‘Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study.’, Frontiers in public health. Switzerland, 10, p. 986916. doi: 10.3389/fpubh.2022.986916.
Rapheal, E. et al. (2023) ‘Using the Health Belief Model to Predict Pre-Travel Health Decisions among U.S.-Based Travelers.’, The American journal of tropical medicine and hygiene. United States, 109(4), pp. 937–944. doi: 10.4269/ajtmh.22-0633.
Regazzi, L. et al. (2022) ‘Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers.’, Human vaccines & immunotherapeutics. United States, 18(6), p. 2116206. doi: 10.1080/21645515.2022.2116206.
Riskesdas (2018) ‘Riset kesehatan dasar. Badan penelitian dan pengembangan kesehatan. Kementrian kesehatan RI’.
Saidu, Y. et al. (2023) ‘The faces behind vaccination: unpacking the attitudes, knowledge, and practices of staff of Cameroon’s Expanded program on Immunization.’, Human resources for health. England, 21(1), p. 88. doi: 10.1186/s12960-023-00869-7.
Yigit, E. et al. (2021) ‘Knowledge, attitudes and behaviors of Inonu University faculty members regarding childhood vaccine refusal.’, Human vaccines & immunotherapeutics. United States, 17(12), pp. 5191–5195. doi: 10.1080/21645515.2021.2008711.
Zambri, F. et al. (2022) ‘Health Belief Model efficacy in explaining and predicting intention or uptake influenza vaccination during pregnancy.’, Annali dell’Istituto superiore di sanita. Italy, 58(4), pp. 285–292. doi: 10.4415/ANN_22_04_09.
Zastawna, B. et al. (2023) ‘Analysis of Parents’ Attitudes and Knowledge toward Immunization and How These Factors Influence Their Decisions to Vaccinate Their Children against Human Papilloma Virus (HPV).’, Medicina (Kaunas, Lithuania). Switzerland, 59(10). doi: 10.3390/medicina59101755.


Permission is granted subject to the terms of the License under which the work was published. Permission will be required if your reuse is not covered by the terms of the License.

How to Cite

Abustam, & Ullah, T. . (2025). Determinants of Basic Immunization Coverage: The Role of Family Knowledge and Support in Central Sulawesi, Indonesia. International Journal of Health Concord, 1(1), 9-17. https://doi.org/10.55018/ihc.v11.6

Downloads

Download data is not yet available.

Share.

Scrollspy Example

Similar Articles

You may also start an advanced similarity search for this article.