Determinants of default to fully completion of immunization among children aged 12 to 23 months in south Ethiopia: unmatched case-control study

Asfaw, Abiyot; Koye, Digsu N.; Demssie, Amsalu Feleke; Zeleke, Ejigu Gebeye; Gelaw, Yalemzewod Assefa

doi:10.11604/pamj.2016.23.100.7879

Cited by 30 publications

(36 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies have shown that maternal education, socioeconomic status, and maternal service utilization during antenatal care (ANC), during delivery, and postnatal care associated with child immunization [ 10 – 14 ]. Additionally, factors such as media exposure, perceptions of vaccination, child’s place of birth (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, factors such as media exposure, perceptions of vaccination, child’s place of birth (e.g. health facility), and region of residence also influence the immunization coverage among children [ 10 – 13 ]. Furthermore, the application of multilevel modeling has shown that community/contextual characteristics such as region or province of residence [ 12 , 15 , 16 ], community maternal education [ 15 , 16 ], level of ANC utilization [ 12 ], level of the institutional delivery [ 15 ], and community poverty level [ 12 ] are important determinants of immunization service utilization.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Individual- and community-level determinants of child immunization in the Democratic Republic of Congo: A multilevel analysis

Acharya¹,

Kismul

Mapatano

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

Understanding modifiable determinants of full immunization of children provide a valuable contribution to immunization programs and help reduce disease, disability, and death. This study is aimed to assess the individual and community-level determinants of full immunization coverage among children in the Democratic Republic of Congo. This study used data from the Demographic and Health Survey 2013–14 from the Democratic Republic of Congo. Data regarding total 3,366 children between 12 and 23 months of age were used in this study. Children who were immunized with one dose of BCG, three doses of polio, three doses of DPT, and a dose of measles vaccine was considered fully immunized. Descriptive statistics were calculated for the prevalence and distribution of full immunization coverage. Two-level multilevel logistic regression analysis, with individual-level (level 1) characteristics nested within community-level (level 2) characteristics, was used to assess the individual- and community-level determinants of full immunization coverage. This study found that about 45.3% [95%CI: 42.02, 48.52] of children aged 12–23 months were fully immunized in the DRC. The results confirmed immunization coverage varied and ranged between 5.8% in Mongala province to 70.6% in Nord-Kivu province. Results from multilevel analysis revealed that, four Antenatal Care (ANC) visits [AOR: 1.64; 95%CI: 1.23, 2.18], institutional delivery [AOR: 2.37; 95%CI: 1.52, 3.72], and Postnatal Care (PNC) service utilization [AOR: 1.43; 95%CI: 1.04, 1.95] were statistically significantly associated with the full immunization coverage. Similarly, children of mothers with secondary or higher education [AOR: 1.32; 95%CI: 1.00, 1.81] and from the richest wealth quintile [AOR: 1.96; 95%CI: 1.18, 3.27] had significantly higher odds of being fully immunized compared to their counterparts whose mothers were relatively poorer and less educated. Among the community-level characteristics, residents of the community with a higher rate of institutional delivery [AOR: 2.36; 95%CI: 1.59, 3.51] were found to be positively associated with the full immunization coverage. Also, the random effect result found about 35% of the variation in immunization coverage among the communities was attributed to community-level factors.The Democratic Republic of Congo has a noteworthy gap in full immunization coverage. Modifiable factors–particularly health service utilization including four ANC visits, institutional delivery, and postnatal visits–had a strong positive effect on full immunization coverage. The study underlines the importance of promoting immunization programs tailored to the poor and women with little education.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Individual- and community-level determinants of child immunization in the Democratic Republic of Congo: A multilevel analysis

Acharya¹,

Kismul

Mapatano

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Although some studies reported determinants of immunization coverage in Ethiopia, they are not consistent and varied across the country. The reported determinants include ANC and PNC coverage, knowledge on age of a child to be vaccinated, parents formal education, place of delivery, residence, traveling time to health facilities, TT vaccination, family size, household wealth status, and marital status [19][20][21][22][23]. Thus, the current work aims at identifying relevant studies and summarizing major predictors of immunization coverage in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Predictors of immunization coverage among 12–23 month old children in Ethiopia: systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background Immunization is one of modern medicine’s greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12–23 months in Ethiopia. Method Electronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I2, Funnel plot and Egger’s test was used to check for publication bias. Results We identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62–3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27–3.77), residence, (OR = 2.11; 95% CI: 1.00–4.45), birth at health facility (OR = 1.86; 95% CI: 0.99–3.49), family size less than four, (OR = 1.81; 95% CI: 1.16–2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07–12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35–4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62–4.89), antennal care, (OR = 3.11; 95% CI: 1.64–5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99–7.75). Conclusion Our findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to “hard to reach areas” to improve immunization coverage for children aged 12–23 months.

show abstract

“…The 2016 EDHS report indicated that vaccination coverage in Ethiopia was low that only 39% of children received all the basic childhood vaccinations [ 6 ]. Studies have shown that maternal education, socioeconomic status, antenatal care, delivery, postnatal care, media exposure, perceptions of vaccination, child's place of birth, and region of residence also influence childhood vaccination status [ 7 – 11 ]. Furthermore, the application of multilevel modeling has helped to assess the community/contextual characteristics, such as the region or province of residence [ 9 , 12 , 13 ], community maternal education [ 12 , 13 ], level of ANC [ 9 ], institutional delivery service utilization [ 12 ], and community poverty level [ 9 ], on childhood vaccination service utilization.…”

Section: Introductionmentioning

confidence: 99%

Individual- and Community-Level Determinants for Complete Vaccination among Children Aged 12-23 Months in Ethiopia: A Multilevel Analysis

Debie

Amare

Handebo

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

Background. Childhood vaccination continues to increase dramatically. In spite of the success of immunization programs to date, millions of children continued to die each year, and sub-Saharan Africa (SSA) accounted for the world’s highest neonatal deaths. Childhood vaccination was designed as one of the most effective ways to reduce child mortalities from fatal vaccine-preventable diseases. Therefore, this study is aimed at investigating the individual- and community-level determinants of childhood complete vaccination in Ethiopia. Methods. A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1,984 children aged 12-23 months was included for analysis. Considering the hierarchical nature of EDHS data, a two-level multilevel analysis for assessing individual- and community-level determinants of childhood complete vaccination was done. The intraclass correlation coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (-2LL) were used for model comparison and for checking model fitness. Variables with p value < 0.2 in the bivariable multilevel analysis were considered for the multivariable multilevel analysis. In the multivariable multilevel logistic regression analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to declare significant determinants of complete childhood vaccination. Results. Overall complete vaccination status among children aged 12-23 months was 39% (95% CI: 36.8, 41.2). In the multilevel analysis, secondary or above educated mothers (AOR=2.48; 95% CI: 1.41, 4.36), richest wealth status (AOR=2.24; 95% CI: 1.16, 4.32), ≥four ANC visits (AOR=2.77; 95% CI: 1.90-4.02), employed mothers (AOR=1.66; 95% CI: 1.26, 2.18), urban residence (AOR=1.84; 95% CI: 1.00, 3.51), and children in city administration (AOR=2.66; 9% CI: 1.53, 4.62) were positively associated with vaccination status. On the other hand, children with a female household head (AOR=0.68; 95% CI: 0.48, 0.96) were negatively associated. Conclusion. Overall, childhood full vaccination status was low compared with the WHO targets. Maternal education, wealth status, ANC visit, maternal occupation, residence, region, and sex of household head were significant predictors of childhood complete vaccination. As a result, it is better to design a compensation mechanism to the costs associated with childhood vaccination for the poor households and strengthen awareness creation for rural residents to improve the access, utilization, and continuum of vaccination service.

show abstract

Determinants of default to fully completion of immunization among children aged 12 to 23 months in south Ethiopia: unmatched case-control study

Cited by 30 publications

References 12 publications

Individual- and community-level determinants of child immunization in the Democratic Republic of Congo: A multilevel analysis

Individual- and community-level determinants of child immunization in the Democratic Republic of Congo: A multilevel analysis

Predictors of immunization coverage among 12–23 month old children in Ethiopia: systematic review and meta-analysis

Individual- and Community-Level Determinants for Complete Vaccination among Children Aged 12-23 Months in Ethiopia: A Multilevel Analysis

Contact Info

Product

Resources

About