{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T17:18:38Z","timestamp":1767633518474,"version":"3.48.0"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Women\u2019s empowerment has been significantly associated with improved child health outcomes. Cambodia, amid a rapid socioeconomic transition, offers a critical setting to examine how advancements in women\u2019s empowerment over the past decade have influenced child immunization completion within the first two years of life. Methods: Data from the Cambodia Demographic and Health Surveys conducted in 2010, 2014, and 2021\u201322, encompassing 9222 women with recent births, were analyzed. Empowerment was measured across literacy and information access, employment, and decision-making domains. Multinomial logistic regression assessed associations between empowerment factors and completion of oral polio (OPV), diphtheria\u2013tetanus\u2013pertussis (DTP), pneumococcal conjugate (PCV), and measles\u2013rubella (MR) vaccines, adjusting for demographic and socioeconomic variables. Results: Between 2010 and 2022, women\u2019s empowerment in Cambodia improved significantly, marked by higher literacy rates, nearly half of women completing primary education, and expanded digital access, with 82.4% owning mobile phones and approximately 50% using the internet daily. While non-working women slightly increased, agricultural employment declined by 20%, and cash earnings rose from 48.7% to 82.5%. Most women participated in major household decision-making, either independently or jointly. Completion rates for OPV, DTP, and PCV ranged from 79% to 83%, while just over half of children were fully vaccinated against measles. Higher maternal education and cash earnings were positively associated with OPV, DTP, and PCV completion but negatively associated with measles vaccination. Women in agricultural work were less likely to complete measles vaccination for their children than non-working women. Joint decision-making regarding the use of respondents\u2019 income was associated with a higher likelihood of measles non-completion (OR = 2.26, 95% CI: 1.13\u20134.51), whereas joint decision-making about respondents\u2019 health care was associated with a higher likelihood of measles completion (OR = 0.42, 95% CI: 0.21\u20130.83). Conclusions: Women\u2019s empowerment remains a key determinant of vaccination outcomes in Cambodia. The distinct pattern observed for measles suggests that vaccines scheduled for older ages encounter greater structural and behavioral barriers. To overcome these challenges, strategies should focus on enhancing defaulter tracking, implementing reminder systems, expanding outreach and catch-up programs, and improving the convenience of vaccination services.<\/jats:p>","DOI":"10.3390\/vaccines14010048","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:08:00Z","timestamp":1767197280000},"page":"48","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in Women\u2019s Empowerment and Their Association with Childhood Vaccination in Cambodia: Evidence from Demographic and Health Surveys (2010\u20132022)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8396-5728","authenticated-orcid":false,"given":"Haizhu","family":"Song","sequence":"first","affiliation":[{"name":"Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan 215316, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7869-8398","authenticated-orcid":false,"given":"Yanqin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan 215316, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1444-6815","authenticated-orcid":false,"given":"Qian","family":"Long","sequence":"additional","affiliation":[{"name":"Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan 215316, China"},{"name":"Duke Global Health Institute, Duke University, Durham NC 27708, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lu, X., Fu, C., Wang, Q., He, Q., Hee, J., Takesue, R., and Tang, K. 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