Knowledge, Attitude and Practices Regarding Tetanus Toxoid Vaccination among Medical and Non-Medical Female Students of Childbearing Age in Sindh, Pakistan: A Comparative Cross-Sectional Study

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

doi:10.36902/rjsser-vol7-iss2-2026(29-35)

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 Professor, 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(29-35)

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

Abstract

Background: Tetanus remains a preventable cause of maternal and neonatal mortality in Pakistan, where coverage of tetanus toxoid (TT) vaccination among women of reproductive age remains below the elimination threshold. This study assessed and compared the knowledge, attitude and practices (KAP) regarding TT vaccination between medical and non-medical female students of childbearing age in Sindh.

Methods: A comparative cross-sectional study was conducted among 400 female students (200 medical and 200 non-medical) aged 15–49 years at two public universities in Jamshoro, Sindh. Data were collected through a self-administered questionnaire developed using the Health Belief Model. The chi-square test compared categorical variables, composite domain scores were compared between groups, crude odds ratios and adjusted prevalence ratios identified determinants of uptake, and Pearson correlation examined inter-domain relationships. A p-value < 0.05 was considered significant.

Results: Medical students demonstrated significantly higher knowledge (mean 7.57 ± 1.42 vs 4.33 ± 3.20), attitude (29.08 ± 2.92 vs 26.59 ± 4.10) and practice (1.96 ± 1.45 vs 0.70 ± 1.03) scores than non-medical students (all p < 0.001). No non-medical student had ever received a TT vaccine (0.0%) compared with 45.0% of medical students, yet reported refusal was uncommon and similar between groups (p = 0.628). Rural residence (adjusted PR 0.38, 95% CI 0.21–0.67) and married status (adjusted PR 0.08, 95% CI 0.01–0.43) were significant barriers to uptake. Knowledge correlated more strongly with practice (r = 0.515) than attitude did (r = 0.324).

Conclusion: TT vaccination coverage was critically low among young women of childbearing age, driven by inadequate awareness and access rather than refusal. Strengthening practical, vaccine-specific knowledge and providing accessible, university-based vaccination, particularly for non-medical and rural students, is recommended to advance maternal and neonatal tetanus elimination.