Determinants of Maternal Adaptation to Childhood Vaccination in 21st-Century Southernmost Thailand

Abstract

This study investigates maternal behavioral adaptation toward childhood immunization within the sociocultural context of Southernmost Thailand, evaluating how individual capacities and contextual correlates influence vaccination completion. A quantitative cross-sectional survey was conducted among 1,200 mothers of children aged five years or older in Pattani, Yala, and Narathiwat. Using a three-stage, stratified, multi-stage random sampling technique, geographic and demographic representativeness was ensured. Data were collected via structured interviews using a validated instrument (IOC ≥ 0.60), and binary logistic regression was employed to identify significant predictors of immunization adherence. Results indicated a childhood vaccination completion rate of 63.7%. Multivariate analysis revealed that maternal adaptation was strongly driven by socio-economic stability and modern health literacy. Mothers with stable socio-demographic profiles, particularly government officials (OR = 7.98; 95% CI [2.67, 23.81]) and business owners (OR = 6.74; 95% CI [2.54, 17.87]), had significantly higher odds of completing. High service satisfaction (OR = 4.39; 95% CI [3.09, 6.23]) and maternal COVID-19 vaccination history (OR = 3.28; 95% CI [1.53, 4.22]) emerged as robust positive predictors. Conversely, specific contextual determinants, including paternal decision-making authority and vaccine safety anxiety, significantly hindered adherence, reflecting the enduring influence of traditional patriarchal structures. The persistent disparity in Southernmost Thailand is driven by a complex interplay between modern enablers and traditional constraints. Strictly medical or economic approaches are insufficient to address this variation in uptake, as barriers are deeply rooted in the region’s unique sociocultural and structural scaffolding. Future public health interventions should prioritize precision public health and improvements in service design while addressing patriarchal influences and linguistic gaps to bridge the existing coverage deficit.