Bridging the Knowledge–Vaccination Gap: A Comparative Cross-Sectional Study of Tetanus Toxoid KAP among Female Students in Sindh, Pakistan

Suneel Raja; Pasand Ali Khoso; Hamadullah Kakepoto; Bushra Manzoor

doi:10.36902/rjsser-vol7-iss2-2026(29-34)

Suneel Raja PhD Scholar, Department of Sociology, University of Sindh, Jamshoro, Pakistan
Pasand Ali Khoso Assistant Professor, Department of Sociology, University of Sindh, Jamshoro, Pakistan
Hamadullah Kakepoto PhD Scholar, Department of Sociology, University of Sindh, Jamshoro, Pakistan
Bushra Manzoor PhD Scholar, Department of Sociology, University of Sindh, Jamshoro, Pakistan

DOI: https://doi.org/10.36902/rjsser-vol7-iss2-2026(29-34)

Keywords: Tetanus Toxoid; Vaccination; Knowledge Attitude Practice; Women of Childbearing Age; Pakistan; Health Belief Model.

Abstract

Tetanus still is a preventable cause of maternal and neonatal mortality in Pakistan where tetanus toxoid (TT) vaccination coverage among women of reproductive age is still below the elimination threshold. This study evaluated and compared knowledge, attitude and practices (KAP) about TT vaccination among medical and non-medical female students of child bearing age in Sindh. A comparative cross-sectional study was carried out on 400 female students (200 medical and 200 non-medical) of the age group of 15-49 years at two public universities of Jamshoro, Sindh. Data were collected using a self-administered questionnaire, which was developed based on the Health Belief Model. Categorical variables were compared using the chi-square test. Composite domain scores were compared between groups. Crude odds ratios and adjusted prevalence ratios were used to identify determinants of uptake. The inter-domain relationship was examined using Pearson correlation. Significance was considered at p-value < 0.05. Medical students had significantly better knowledge (mean 7.57±1.42 vs 4.33±3.20), attitude (mean 29.08±2.92 vs 26.59±4.10) and practice (mean 1.96±1.45 vs 0.70±1.03) scores than non-medical students (all p<0.001). No non-medical students had ever received a TT vaccine (0.0%) versus 45.0% of medical students. Reported refusal was uncommon and similar between groups (p = 0.628). We found that rural residence (adjusted PR 0.38, 95% CI 0.21–0.67) and marital status (adjusted PR 0.08, 95% CI 0.01–0.43) were significant barriers to uptake. Knowledge was more related to practice (r = 0.515) than attitude (r = 0.324). TT vaccination coverage among young women of childbearing age was critically low, due to lack of awareness and access rather than refusal.

Further to the elimination for material and neonatal tetanus, it is highly suggested to improve the practical vaccine based knowledge and to design university level vaccination accessible, especially for the students of non-medical.