Two decades of regional trends in vaccination completion and coverage among children aged 12-23 months: an analysis of the Uganda Demographic Health Survey data from 1995 to 2016

Okello, Gerald; Izudi, Jonathan; Ampeire, Immaculate; Nghania, Frehd; Dochez, Carine; Hens, Niel

doi:10.1186/s12913-021-07443-8

Cited by 15 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From 2000 to 2016, improvements in vaccine delivery increased equity and shifted the dominant contribution to inequity from largely supply-side constraints to demand-side constraints, where the households' behaviour, whether guided by nancial and social constraints, awareness, or beliefs, seems to play a stronger role in immunization. Our ndings are consistent with the ndings from two other studies conducted in Uganda and Ethiopia that reported that maternal education, wealth status, region of residence, and the household head's sex were strongly associated with full vaccination coverage (Geweniger & Abbas, 2020;Okello et al, 2022).…”

Section: Discussionsupporting

confidence: 91%

“…Table 1 summarizes the e ciency (coverage) and equity metrics (concentration indices and absolute equity gap) for 2000and 2016. Additional data for 2000, 2006, and 2016 is featured in Tables 1 to 4 in the supplementary material, and subnational data in tables 5 to 16. Figure 1 shows the coverage and equity by region.…”

Section: Methodsmentioning

confidence: 99%

“…Based upon this backdrop, this paper focuses on analysing vaccine coverage and equity among children under ve years of age in Uganda based on data from the 2000, 2006, 2011, and 2016 Uganda Demographic and Health Surveys (UDHS). It will expand on the results from Okello et al (Okello et al, 2022), which focused on the completion rate for children aged 12-23 months old. Strengthening equitable access to vaccines has potential to not only save lives, but also reduce morbidity, in addition to subsequently advancing economic development at…”

Section: Introductionmentioning

confidence: 95%

See 2 more Smart Citations

Equity in vaccine coverage in Uganda from 2000 to 2016: Revealing the multifaceted nature of inequity.

Ssebagereka

Broucker

Ekirapa-Kiracho

et al. 2022

Preprint

View full text Add to dashboard Cite

Background This study analyses vaccine coverage and equity among children under five years of age in Uganda based on the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Understanding equity in vaccine access and the determinants is crucial for the redress of emerging as well as persistent inequities. Methods Applied to the UDHS for 2000, 2006, 2011, and 2016, the Vaccine Economics Research for Sustainability and Equity (VERSE) Equity Toolkit provides a multivariate assessment of immunization coverage and equity by (1) ranking the sample population with a composite direct unfairness index, (2) generating quantitative measure of efficiency (coverage) and equity, and (3) decomposing inequity into its contributing factors. The direct unfairness ranking variable is the predicted vaccination coverage from a logistic model based upon fair and unfair sources of variation in vaccination coverage. Our fair source of variation is defined as the child’s age – children too young to receive routine immunization are not expected to be vaccinated. Unfair sources of variation are the child’s region of residence, and whether they live in an urban or rural area, the mother’s education level, the household’s socioeconomic status, the child’s sex, and their insurance coverage status. For each unfair source of variation, we identify a “more privileged” situation. Results DPT3 and MCV1 coverage and equity – two vaccines indicative of performance – improved significantly since 2000, from 49.7–76.8% and 67.8–82.7%, respectively, and there are fewer zero-dose children: from 8.4–2.2%. Improvements in retaining children in the program so that they complete the immunization schedule are more modest (from 38.1–40.8%). Except for MCV1, the main drivers for the lack of vaccination shifted from supply-side factors (e.g., availability of vaccines at clinics, disparities between regions) to more demand-side factors – primarily maternal education. Conclusion The past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing SIA such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Equity in vaccine coverage in Uganda from 2000 to 2016: Revealing the multifaceted nature of inequity.

Ssebagereka

Broucker

Ekirapa-Kiracho

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“… 9 In 2020, a report in Lango sub-region in northern Uganda indicated low vaccination coverage (close to 50% of children immunized which is lower than the national average of 55%). 10 In the same year, a study in Lira showed that 49%, 3%, and 48.7% of children had received a pentavalent and measles-containing vaccine respectively by 1 year which was lower than the national target of 90%. 11 However, there is scarce information on the predictors of adherence to routine immunization schedules among caretakers in Lira city, thus the present study.…”

Section: Introductionmentioning

confidence: 97%

Predictors of Adherence to Routine Immunization Schedule Among Caretakers of Children Aged 10 to 18 Months in Lira City, Uganda

Abor

Kabunga

Nabasirye

2022

Global Pediatric Health

View full text Add to dashboard Cite

Background Although the majority of nations have routine immunization programs in place as a public health strategy, more than 1.5 million children under the age of 5 die yearly worldwide due to inadequate vaccination coverage. This study investigated the predictors of adherence to routine immunization schedules in Lira city. Methods This was a cross-sectional study among 420 caretakers of children aged 10 to 18 months. Bivariate and multiple regression analyses were conducted to assess the predictors of adherence to the full immunization schedule. A P-value > .05 was considered statistically significant at 95% CI. Results The study result indicated that the majority, 237 (56.4%) of caretakers were aged 25 to 34 years, 205 (48.8%) had attained primary level education, and 284 (67.6%) were married. The results showed that 365 (87.0%) had their children fully immunized. The predictors of adherence to full immunization schedule were knowledge on when to start vaccination (AOR:5.65; 95% CI:1.82-17.55; P = .003), maternal outcome expectations (AOR:3.45; 95% CI:1.16-10.29; P = .03) and maternal knowledge (AOR:2.15; 95% CI:1.18-3.90; P = .01). Conclusion The study findings show that 9 in 10 of the caregivers adhered to the immunization schedule. The significant predictors of adherence to full immunization were flexible clinical hours, maternal outcome expectations and maternal knowledge. Based on the conclusions we recommend that government and service providers be flexible in clinic hours and continue health education to women of childbearing age at an early stage, especially during antenatal care visits, delivery and the postnatal period on childhood vaccination to maintain adherence to the routine immunization schedule.

show abstract

“…Despite the importance of these cards, they are sometimes not retained until the recommended age, or they are lost or damaged [ 21 ]. In previous studies in Uganda, the possession of a UCHC was associated with childhood vaccination completion [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Does mothers’ and caregivers' access to information on their child’s vaccination card impact the timing of their child’s measles vaccination in Uganda?

et al. 2022

View full text Add to dashboard Cite

Introduction On-time measles vaccination is essential for preventing measles infection among children as early in life as possible, especially in areas where measles outbreaks occur frequently. Characterizing the timing of routine measles vaccination (MCV1) among children and identifying risk factors for delayed measles vaccination is important for addressing barriers to recommended childhood vaccination and increasing on-time MCV1 coverage. We aim to assess the timing of children's MCV1 vaccination and to investigate the association between demographic and healthcare factors, mothers'/caregivers' ability to identify information on their child’s vaccination card, and achieving on-time (vs. delayed) MCV1 vaccination. Methods We conducted a population-based, door-to-door survey in Kampala, Uganda, from June–August of 2019. We surveyed mothers/caregivers of children aged one to five years to determine how familiar they were with their child’s vaccination card and to determine their child’s MCV1 vaccination status and timing. We assessed the proportion of children vaccinated for MCV1 on-time and delayed, and we evaluated the association between mothers'/caregivers' ability to identify key pieces of information (child’s birth date, sex, and MCV1 date) on their child’s vaccination card and achieving on-time MCV1 vaccination. Results Of the 999 mothers/caregivers enrolled, the median age was 27 years (17–50), and median child age was 29 months (12–72). Information on vaccination status was available for 66.0% (n = 659) of children. Of those who had documentation of MCV1 vaccination (n = 475), less than half (46.5%; n = 221) achieved on-time MCV1 vaccination and 53.5% (n = 254) were delayed. We found that only 47.9% (n = 264) of the 551 mothers/caregivers who were asked to identify key pieces of information on their child's vaccination card were able to identify the information, but ability to identify the key pieces of information on the card was not independently associated with achieving on-time MCV1 vaccination. Conclusion Mothers'/caregivers' ability to identify key pieces of information on their child’s vaccination card was not associated with achieving on-time MCV1 vaccination. Further research can shed light on interventions that may prompt or remind mothers/caregivers of the time and age when their child is due for measles vaccine to increase the chance of the child receiving it at the recommended time.

show abstract

Two decades of regional trends in vaccination completion and coverage among children aged 12-23 months: an analysis of the Uganda Demographic Health Survey data from 1995 to 2016

Cited by 15 publications

References 17 publications

Equity in vaccine coverage in Uganda from 2000 to 2016: Revealing the multifaceted nature of inequity.

Equity in vaccine coverage in Uganda from 2000 to 2016: Revealing the multifaceted nature of inequity.

Predictors of Adherence to Routine Immunization Schedule Among Caretakers of Children Aged 10 to 18 Months in Lira City, Uganda

Does mothers’ and caregivers' access to information on their child’s vaccination card impact the timing of their child’s measles vaccination in Uganda?

Contact Info

Product

Resources

About