Determinants of BCG vaccination coverage in Ethiopia: a cross-sectional survey

Tsehay, Asmamaw Ketemaw; Worku, Getasew Tadesse; Alemu, Yihun Mulugeta

doi:10.1136/bmjopen-2018-023634

Cited by 11 publications

(13 citation statements)

References 14 publications

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“…Information on childhood vaccination is urgently needed in Sub-Saharan African countries where coverage remains inadequate [1,2,4,14,15]. Building public trust and confidence in vaccine safety and effectiveness is crucial.…”

Section: Resultsmentioning

confidence: 99%

“…System-related factors contributing to sub-optimal childhood immunization include poorly arranged and coordinated services, supply stock-outs, inadequate tracking systems, under-trained vaccinators and lack of suitable venues [8][9][10][11]. Distance to services and travel costs are challenges for vaccination in rural and remote areas [7,[12][13][14][15]. Traversing rivers and mountainous landscapes in difficult climatic conditions can inhibit access for both clients and providers [4,8,9,15].…”

Section: Introductionmentioning

confidence: 99%

“…Households with low maternal education [ 15 , 16 ] and poor income are less likely to have their children vaccinated [ 4 , 11 , 14 , 17 ]. Negative parental attitudes such as lack of trust in services and the technical competence of vaccinators [ 8 ] impact on vaccination decisions [ 4 , 7 , 10 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…“Vaccine hesitancy” in both parents and communities refers to behaviour influenced by factors such as low trust in the vaccine and/or the provider, negative perceptions about the need for the vaccine and poor vaccine access [ 18 ]. Media exposure can influence parents’ knowledge of vaccination [ 7 , 11 , 13 , 14 ]. Social media research suggests that online information flows more freely between people who share similar sentiments and that social networks dominated by either positive or negative attitudes toward vaccination can impact on vaccination uptake [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors contributing to the uptake of childhood vaccination in Galkayo District, Puntland, Somalia

Abdullahi

Williams

Sahlén

et al. 2020

Global Health Action

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Background: As in many Sub-Saharan African countries, the health system in Somalia is not operating at the capacity needed to lift childhood vaccination coverage to ninety percent or above, as recommended by United Nations Children's Fund. Current national estimates of coverage for the six major vaccine preventable childhood diseases range from thirty to sixty percent. Infectious disease outbreaks continue to pose significant challenges for the country's health authorities. Objective: This important qualitative study, conducted in Galkayo District, Somalia, investigates limiting factors associated with childhood vaccination uptake from the perspective of both communities and health care workers. Methods: Qualitative information was collected through six focus group discussions with parents (n = 48) and five one-to-one interviews with health workers (n = 15) between March and May 2017, in three settings in the Galkayo District-Galkayo city, Bayra and Bacadwayn. Results: From a health system perspective, the factors are: awareness raising, hard to reach areas, negative attitudes and perceived knowledge of health workers, inadequate supplies and infrastructure, and missed vaccination opportunities. From the perspective of individuals and communities the factors are: low trust in vaccines, misinterpretation of religious beliefs, vaccine refusals, Somalia's patriarchal system and rumours and misinformation. Parents mostly received immunization information from social mobilizers and health facilities. Fathers, who are typically family decision-makers, were poorly informed. The findings highlight the need for in-service training to enable health workers to improve communication with parents, particularly fathers, peripheral communities and local religious leaders. Conclusions: Enhancing knowledge and awareness of vaccination among parents is crucial. Fathers' involvement is lacking. This may be boosted by highlighting fathers' obligation to protect their children's health through vaccination. It is also important that men engage with the wider community in decision-making and advance towards the global vaccination targets.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors contributing to the uptake of childhood vaccination in Galkayo District, Puntland, Somalia

Abdullahi

Williams

Sahlén

et al. 2020

Global Health Action

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“…In Ethiopia, studies that were conducted to identify factors associated with immunization coverage among children commonly focused on full immunization coverage [17–19]. Few studies have also investigated determinants of coverage for specific vaccines included in the national expanded programme on immunization (EPI) [20, 21]. So far, however, very little attention has been paid to newly introduced vaccines such as RVV and PCV.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the uptake of newly introduced childhood vaccinations in Ethiopia: the cases of rotavirus and pneumococcal conjugate vaccines

et al. 2019

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BackgroundChildhood immunization programmes have made substantial contributions to lowering the burden of disease among children in developing countries, however a large proportion of children still remain unimmunized. This study aimed to explore the determinants of rotavirus vaccine (RVV) and pneumococcal conjugate vaccine (PCV) uptake in Ethiopia.MethodsThe 2016 Ethiopian demographic and health survey dataset was used in this analysis. A total of 2004 children aged 12–23 months were included in the analysis. A multivariable logistic regression model was employed to identify the determinants of uptake of the complete schedules of RVV (two doses) and PCV (three doses). Crude and adjusted odds ratios with 95% confidence intervals (CIs) were calculated.ResultsThe uptakes of the complete schedules of RVV and PCV among children aged 12–23 months were 56 and 49.1%, respectively. The likelihood of immunization with the complete schedule of RVV was significantly lower among children from the relatively poor Afar region in Ethiopia (AOR 0.16; 95%-CI 0.04–0.61). Similarly, children living in not only the Afar region (AOR 0.10; 95%-CI 0.03–0.38), but also the Gambela region (AOR 0.25; 95%-CI 0.08–0.83), were less likely to be vaccinated with PCV. On the other hand, children from more wealthy households had higher odds of vaccination with RVV (AOR 1.69; 95%-CI 1.04–2.75). Also attending antenatal care (ANC) was found to be significantly associated with uptake of the complete schedule of RVV and PCV.ConclusionsThe uptake of RVV and PCV is suboptimal in Ethiopia. The uptake of the vaccines were found to be associated with region, ANC use and wealth status.

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