Across the world, a child’s chance of being protected from preventable diseases often depends on what their parents know, believe, and do. A 2025 global review published in Discover Public Health examined how parental knowledge, attitudes, and practices—collectively known as KAP—shape immunisation outcomes. Covering studies from 22 countries, the review found that parents’ understanding and trust play a decisive role in vaccine uptake, especially for life-saving vaccines such as BCG, DPT, and Pentavalent.

Globally, the World Health Organization (WHO) and UNICEF report that the first dose of the DTP vaccine (DTP1) reached 85% coverage in 2022. Yet, about 19 million children still missed their third dose. This gap, the study reveals, is not simply a supply issue—it’s about perception. Parents’ fears about side effects, lack of understanding of schedules, and misinformation from non-medical sources often lead to under-immunisation or delayed vaccinations.

In Tamil Nadu, India, nearly 95% of parents agreed vaccination prevents epidemics, but 17% still doubted vaccine safety. In Indonesia, only 28% of parents had accurate vaccine knowledge, and 70% were unaware of their purpose. Education and trust emerged as critical factors: mothers with better knowledge and positive attitudes were five to eight times more likely to complete their child’s vaccine schedule. Similarly, parents with higher education and better access to healthcare showed stronger immunisation adherence.

The review emphasised that effective communication by healthcare workers, social trust, and community engagement make the biggest difference. Parents who received clear explanations from doctors and nurses were more confident and punctual about their child’s vaccination appointments. On the other hand, misinformation and cultural myths—such as “healthy children don’t need vaccines”—remained common barriers.

Bangladesh has made remarkable progress in child immunisation through the Expanded Programme on Immunization (EPI), reaching around 92% full immunisation coverage in 2023. However, zero-dose (ZD) and under-immunised (UI) children still exist, especially in hard-to-reach rural and urban slum areas. Here, parental KAP becomes vital.

Mothers are traditionally the caregivers, but the review also reminds that fathers’ knowledge, attitudes, and practices are equally essential. In many Bangladeshi families, fathers make financial and health-related decisions. When fathers are well-informed and supportive, vaccination rates rise, and hesitation drops. As one health expert remarked, “When fathers ask questions, not avoid them, the community listens.” Engaging both parents equally can significantly reduce ZD and UI cases, aligning with the Country Learning Hub’s mission to achieve immunisation equity across Bangladesh.

The study concludes that raising awareness alone isn’t enough; attitudes and trust must evolve hand in hand. Community-based education, clear communication from health workers, and inclusion of fathers in immunisation dialogues can make vaccines not just a public health agenda, but a family commitment.

Bangladesh’s steady progress shows what’s possible when knowledge leads to confidence—and confidence leads to protection. Every parent, informed and motivated, brings the nation one step closer to a generation free from vaccine-preventable diseases.

Reference: 

Ayo-Farai O, Adaramola B, Ernest-Okonofua EO, Alfakeer H, Alnemr L, Ali A, et al. Assessing the role of parental knowledge, attitudes, and practices in childhood immunization: a global review of determinants and health outcomes. Discov Public Health [Internet]. 2025;22(1). Available from: http://dx.doi.org/10.1186/s12982-025-00905-y