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

Acharya, Pawan; Kismul, Hallgeir; Mapatano, Mala Ali; Hatløy, Anne

doi:10.1371/journal.pone.0202742

Cited by 73 publications

(102 citation statements)

References 41 publications

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“…The PAF value in the 2016 survey showed that if measles immunization coverage in all subgroups were at the same level as household with mothers who have secondary school education or higher, the overall country’s measles immunization coverage could be improved by a staggering 45%. Similar findings were reported by other studies in Ethiopia [ 42 ], Democratic Republic of Congo [ 43 ] and Nigeria [ 44 ]. Educated mothers are more likely to use health care services (i.e.…”

Section: Discussionsupporting

confidence: 92%

Inequalities in measles immunization coverage in Ethiopia: a cross-sectional analysis of demographic and health surveys 2000–2016

Shibre

Zegeye²,

Idriss-Wheeler

et al. 2020

BMC Infect Dis

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Background: Ethiopia has low measles immunization coverage and little is known about the disparities surrounding what coverage is provided. This study assessed disparities in measles immunization and its change over time using the four Ethiopia Demographic and Health Surveys conducted between 2000 and 2016. Methods: This is a cross-sectional analysis of data using Ethiopia Demographic and Health Surveys (EDHS) conducted between 2000 and 2016. We used the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) to present the inequalities. Four measures of inequality were calculated: Difference (D), Ratio (R), Population Attributable Fraction (PAF) and Population Attributable Risk (PAR). The results were disaggregated by wealth, education, residence, sex and sub-national regions and 95% Uncertainty Intervals (UIs) were computed for each point estimate to boost confidence of the findings. Results: Measles immunization coverage was higher among the richest and secondary and above schools' subgroup by nearly 30 to 31 percentage points based on point estimates (D = 31%; 95% CI; 19.48, 42.66) and 29.8 percentage points (D = 29.8%; 95% CI; 16.57, 43.06) as compared to the poorest and no education subgroup respectively in the 2016 survey. Still, in the 2016 survey, substantial economic status (

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Section: Discussionsupporting

confidence: 92%

Inequalities in measles immunization coverage in Ethiopia: a cross-sectional analysis of demographic and health surveys 2000–2016

Shibre

Zegeye²,

Idriss-Wheeler

et al. 2020

BMC Infect Dis

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“…The other finding in this study was that children born at a health facility had higher Odds of being fully immunized compared to children born at home. This finding was in line with the studies done in Zimbabwe (28) and Democratic Republic Congo (20). The reason might be women utilized institutional delivery service, be more confident in utilizing child immunization services.…”

Section: Discussionsupporting

confidence: 89%

“…The reason might be women utilized institutional delivery service, be more confident in utilizing child immunization services. And also administrative of the BCG vaccine soon after childbirth and counseling at a health facility might have contributed to being knowledgeable on children's vaccination (20).…”

Section: Discussionmentioning

confidence: 99%

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Determinants of full immunization among children aged 12-23 months in Ethiopia. Further analysis of the 2016 Ethiopian Demographic and Health Survey Data.

Asresie

Fekadu

Nigatu

et al. 2019

Preprint

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Background: Immunization program has become the most effective public health measure for the controlling of vaccine-preventable disease among children. Globally, immunization coverage is increasing, however, 19.4 million infants not vaccinated in 2015. Ethiopia is one of the Sub-Saharan African countries with a high number of children unimmunized. Although there are studies about immunization among children, there is a dearth of information about factors associated with full immunization. Therefore, this analysis was performed to identify factors associated with full immunization among children aged 12-23 months in Ethiopia. Methods : The analysis was done based on the 2016 Ethiopian Demography and Health Survey data. The 2016 Ethiopian Demography and Health Survey was a community based, cross-sectional study conducted from January 18, 2016, to June 27, 2016. The survey used a two-stage stratified random sampling technique. A total of 2004 children aged 12-23 months were included in the analysis. Both descriptive and logistic regression analyses were performed using STATA. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result: Fully immunization coverage among children was 38.6%. Born at a health facility, living in Dire Dewa city, source of information from the card, mothers’ educational level (primary and secondary plus), and marital status (married and formerly married) were found positively associated with full immunization. On the other hand, smoking history of mothers and living in Afar, Amhara, Somalia, Gambella, and Oromia regions were negatively associated with full immunization. Conclusion: Fully immunization coverage among children was low. Children who were born at a health facility, source of information from the card, living Dire Dewa city, and whose mothers’ literate and married had higher Odds of being fully immunized. On the other hand, children whose mothers’ had a history of smoking and living Afar, Somalia, Gambella, Amhara and Oromia regions were had lower Odds of being fully immunized. Therefore strengthening institutional delivery and keeping immunization cards should be strengthened, and more emphasis should be given to children whose mothers’ illiterate, never married, smoker and living in Afar, Amhara, Somali, Gambella, and Oromia regions.

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“…At the community level, the geographic region and place of residence, communities with high illiteracy rates, socioeconomically disadvantaged communities, communities with a higher rate of institutional delivery, and maternal antenatal care were associated with childhood vaccination status. 26,27 However, a preponderance of these studies focused on either complete vaccination or incomplete vaccination and few studies have examined the predictors of childhood vaccination using a three-way category of full vaccination, under-vaccination, and non-vaccination. Similarly, prior studies conducted in Malawi on childhood vaccination have focused either on coverage of individual vaccines or complete and incomplete, vaccination and no study separated the vaccination status into non-, under, and full e vaccination.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with non- and under-vaccination among children aged 12–23 months in Malawi. A multinomial analysis of the population-based sample

Ntenda

2019

Pediatrics & Neonatology

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Background: Non-and under-vaccination among children in Malawi have received little attention. Between 2010 and 2016, the proportion of children who received full immunization before their first birthday dropped from 81% to 76% in Malawi. This signifies that a certain fraction of children are either non-vaccinated or under-vaccinated. Thus, the present study attempted to examine the predictors of non-and under-vaccination among children aged 12 e23 months in Malawi. Methods: Cross-sectional data obtained from the Malawi Demographic and Health Survey 2015 e16 were utilized. The percentage of children aged 12e23 months who were non-vaccinated, under-vaccinated, or fully vaccinated with 1 dose of Bacillus CalmetteeGuérin, 3 doses of oral polio vaccine, 3 doses of pentavalent, 2 doses of rotavirus vaccine, 3 doses of pneumococcal vaccine and 1 dose of measles-containing vaccine were calculated. The odds of being nonvaccinated and under-vaccinated compared to full vaccination relative to various sociodemographic factors were assessed using a multivariable multinomial logistic regression with logit link function which accounted for survey design. Results: Of 3111 children aged 12e23 months, 72% were fully vaccinated, 26% were undervaccinated, and about 2% were non-vaccinated. The multinomial logistic regression showed that children from the poorest households, and children who did not have postnatal care within two months had increased odds of being under-vaccinated. On the other hand, children who

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

Cited by 73 publications

References 41 publications

Inequalities in measles immunization coverage in Ethiopia: a cross-sectional analysis of demographic and health surveys 2000–2016

Inequalities in measles immunization coverage in Ethiopia: a cross-sectional analysis of demographic and health surveys 2000–2016

Determinants of full immunization among children aged 12-23 months in Ethiopia. Further analysis of the 2016 Ethiopian Demographic and Health Survey Data.

Factors associated with non- and under-vaccination among children aged 12–23 months in Malawi. A multinomial analysis of the population-based sample

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