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Zemariam AB, Abebe GK, Kassa MA, Alamaw AW, Molla RW, Abate BB, Tilahun BD, Wondie WT, Shimelash RA, Fentanew M. Immunization coverage and its associated factors among children aged 12-23 months in Ethiopia: An umbrella review of systematic review and meta-analysis studies. PLoS One 2024; 19:e0299384. [PMID: 38451961 PMCID: PMC10919590 DOI: 10.1371/journal.pone.0299384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Immunization estimated to prevent 2 to 3 million children deaths every year from vaccine preventable disease. In Ethiopia, limited and inconclusive studies have been conducted on immunization coverage so far. Therefore, this umbrella review was intended to estimate the pooled national immunization coverage and its associated factors among children age 12-23 months in Ethiopia. METHODS This umbrella review included five systematic reviews and meta-analyses through literature search from PubMed, Science direct, and web of science, CINHALE, and data bases specific to systematic reviews such as the Cochrane Database of Systematic Reviews and Prospero, the International Prospective Register of Systematic Reviews from May 1 to 30/ 2023. Only systematic reviews and meta-analyses published in English from inception to May 1, 2023, were included. The quality of each study was assessed using Assessment of Multiple Systematic Reviews. Data were extracted using Microsoft excel 2016 and analyzed using STATA 17.0 statistical software. Heterogeneity among studies was assessed using the Cochran Q statistics and I2 test. The pooled effect sizes were determined using pooled proportion for the full vaccination coverage and odds ratios for the associated factors with the corresponding 95% confidence interval were used to declare statically significance. RESULTS Five studies with 77,161 children aged 12-23 months were included. The overall pooled full vaccination coverage was 57.72% (95% CI 50.17, 65.28). Institutional delivery (OR: 2.12, 95% CI: 1.78-2.52), travel to vaccination site for <2 hours (OR: 2.43, 95%CI: 1.97-3.00), received at least one antenatal (ANC) visit (OR: 3.2, 95%CI: 2.46-4.1), good maternal knowledge of immunization (OR: 3.63, 95%CI: 2.82-4.67), being informed on immunization schedule (OR: 2.54, 95%CI: 2.02-3.2), living in urban areas (OR: 2, 95% CI: 1.54-2.6), and a household visit by health-care providers (HCP) during the postnatal period (OR: 2.23, 95%CI: 1.22-4.09) were the independent predictors of immunization coverage. CONCLUSION This study showed the full immunization coverage in Ethiopia was lower compared to the WHO-recommended level. Besides, the current umbrella review identifies several factors that contribute to higher immunization coverage. These includes; institutional delivery, near to vaccination site, having ANC visit, being urban residence, household visited by HCP, having good knowledge and informed on immunization schedule. Thus, the government should intensify the growth of immunization services by emphasizing outreach initiatives to reach remote areas and professionals must combine child immunization service with other medical services offered by health institutions.
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Affiliation(s)
- Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Gebremeskel Kibret Abebe
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Addis Wondemagegn Alamaw
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Rediet Woldesenbet Molla
- Department of Midwifery, School of Midwifery, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Biruk Beletew Abate
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Befekad Deresse Tilahun
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Wubet Tazeb Wondie
- Departments of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Rahel Asres Shimelash
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, DebreMarkos University, DebreMarkos, Ethiopia
| | - Molla Fentanew
- Departments of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Metkie KA, Melese GB, W/Silassie BD, Ali FE. Determinants of immunization status among 12-24 months old children in Ethiopia: Using 2019 Ethiopian mini demographic and health survey data. PLoS One 2023; 18:e0283629. [PMID: 36996256 PMCID: PMC10062578 DOI: 10.1371/journal.pone.0283629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/13/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Vaccination is a global success story, one of the most effective and successful health interventions for health and development, saving the lives of millions of children every year. In 2018, nearly 870,000 Ethiopian children did not receive the life-saving measles, diphtheria, and tetanus vaccines. This study aimed to determine what factors influence children's immunization status in Ethiopia. METHODS Immunization status was examined in a sample of 1843 children aged 12-24 months using data from the 2019 Ethiopian Mini Demographic and Health Survey 2019. The study used percentages to show the prevalence of immunization status among children. The marginal likelihood effect was used to determine the impact of each category of the explanatory variable on one response category of immunization status. Ordinal logistic regression models were constructed, and the best-fitting model was selected to identify significant immunization status variables. RESULTS The immunization prevalence among children was 72.2% (34.2% fully immunized and 38.0% partially immunized), while about 27.8% of children were non-immunized. The fitted partial proportional odds model revealed that child immunization status was significantly associated with region afar (OR = 7.90; CI: 4.78-11.92), family planning use (OR = 0.69; CI: 0.54-0.88), residence (OR = 2.22;CI: 1.60-3.09), antenatal visit (OR = 0.73;CI: 0.53-0.99), and delivery place (OR = 0.65;CI: 0.50-0.84). CONCLUSIONS Vaccinating children was a significant step forward in improving and protecting child health in Ethiopia, as the proportion of non-immunized children was about 27.8%. The study showed that the prevalence of non-immunization status among rural children was 33.6% and about 36.6% among children from non-educated mothers. As a result, it is agreeable that treatments are better to focus on targeting essential childhood vaccinations by promoting maternal education about family planning, antenatal visits, and maternal access to health care.
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Affiliation(s)
- Kassahun Animut Metkie
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
| | - Getasew Berhanu Melese
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
| | | | - Fatuma Ebrahim Ali
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
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Asmare G, Madalicho M, Sorsa A. Disparities in full immunization coverage among urban and rural children aged 12-23 months in southwest Ethiopia: A comparative cross-sectional study. Hum Vaccin Immunother 2022; 18:2101316. [PMID: 36054825 DOI: 10.1080/21645515.2022.2101316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccination coverage worldwide fell from 86% in 2019 to 83% in 2020. The purpose of this research was to determine the level of full immunization coverage among children aged 12 to 23 months in both urban and rural Southwest Ethiopia. A comparative cross-sectional study of sampled 644 children aged 12 to 23 months was conducted in the community (296 from urban areas and 348 from rural areas). Chi-square testing was used to determine whether there was a significant difference in full immunization coverage between urban and rural children, and binary logistic regression was used to identify predictors of full immunization. This study included 635 caregivers of children aged 12-23 months (292 from urban areas and 343 from rural areas), yielding a 98.4% response rate. The overall, full immunization coverage among the whole children was 66.1%. There was a significant difference in fully immunization coverage between urban 74.3% and rural 59.2% of children (χ2 = 16.126, P = .000). Residence, wealth index, ANC follow up and fear of COVID 19 infection at health institutions were predictor variables for overall full vaccination. Knowledge and place of delivery were predictor variables for full vaccination in the urban area whereas distance and male partner involvement in the rural area. Vaccination coverage was higher in urban compared to rural areas but it is still far below the WHO recommended target. Promoting male involvement, health education, and communication are crucial for alleviating poor knowledge about child immunization.
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Affiliation(s)
- Getachew Asmare
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Merkine Madalicho
- Department of Expanded Program of Immunization, Wolaita Zone Health Department, Wolaita Sodo, Ethiopia
| | - Abebe Sorsa
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Boke MM, Tenaw G, Berhe NM, Tiruneh WK. Determinants of incomplete childhood immunization among children aged 12-23 months in Dabat district, Northwest Ethiopia: Unmatched case- control study. PLoS One 2022; 17:e0274501. [PMID: 36264780 PMCID: PMC9584397 DOI: 10.1371/journal.pone.0274501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 08/28/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Despite the effort to increase access to routine immunization, majority of children in low-resource countries including Ethiopia are still either unvaccinated or under-vaccinated. In Ethiopia for the past four decades, the completion rate of routine childhood immunization remains low particularly in a rural area. In this study setting, evidence regarding the socio-economic, maternal continuum care, and caregiver characteristics effect on child immunization is limited. Hence, this study aimed to identify the determinants of incomplete vaccination among children aged 12-23 months in Dabat district, Northwest Ethiopia. METHODS A community-based unmatched case-control study design was employed among 132 cases and 262 controls. Multi-stage sampling method was used to recruit eligible study participants. Logistic regression analysis was used to identify the determinants to children's incomplete vaccination. RESULTS Caregivers' attitude towards vaccine (AOR: 6.1, 95% CI 3.4 to 11.1), knowledge on the schedule of vaccination (AOR: 4, 95% CI 2.2 to 7.1), Place of delivery (AOR: 2.7, 95% CI 1.3 to 5.5), and marital status (AOR: 2.36, 95% CI 1.22 to 4.56) were statistically significant association with incomplete childhood vaccination. CONCLUSION Home delivery, caregivers' poor knowledge on the schedule of vaccination, caregivers' negative perception towards vaccine and unmarried marital status were predictors to incomplete vaccination. Therefore, to enhance full vaccination coverage, immunization health education program needs to address vaccine related safety enquiries in a meaningful method to caregivers, in order to improve the perception of caregivers towards vaccine. Moreover, improving maternal continuum care coverage is crucial.
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Affiliation(s)
- Moges Muluneh Boke
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Neamin M. Berhe
- Department of Public Health, ABH Campus, Jimma University, Jimma, Ethiopia
| | - Woynhareg Kassa Tiruneh
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mebrate M, Workicho A, Alemu S, Gelan E. Vaccination Status and Its Determinants Among Children Aged 12 to 23 Months in Mettu and Sinana Districts, Oromia Region, Ethiopia: A Comparative Cross Sectional Study. Pediatric Health Med Ther 2022; 13:335-348. [PMID: 36176346 PMCID: PMC9514263 DOI: 10.2147/phmt.s380303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Globally, more than 19 million children have not received all of their vaccination benefits, resulting in an estimated one million deaths worldwide each year. Vaccine-preventable diseases are becoming more common in Ethiopia, despite the fact that official vaccination coverage is sufficient to develop herd immunity locally for some diseases such as measles. This mistrust of the official report prompted us to conduct a community survey and compare it to other areas where there have been no reports of vaccine-preventable disease. Methods A community-based comparative cross-sectional study was conducted from 20/01–20/02/2021 in Sinana and Mettu districts. Probability proportional to estimate size was used to select 23 clusters. We recruited 228 from Mettu and 436 from Sinana by systematic random sampling. We used a structured questionnaire to collected data from mother–child pair using card and history. We conducted independent t-tests to test coverage differences between districts. We identified determinants of full vaccination status by multivariate logistic regression analysis after bivariate candidate selection. Results Fully vaccinated children accounted for 62.7% in Sinana and 91.6% in Mettu, demonstrating a significant coverage difference (p<0.001). Being a resident of Mettu (AOR: 3.5, 95% CI [1.5, 6.9]), intended pregnancy (AOR 5.9, 95% CI [2.4, 11.3]), 4 or more antenatal care visits (AOR: 2.09, 95% CI [1.4, 3]), having postnatal care (AOR: 3.5, 95% CI [1.6, 7.9]), younger child age (AOR: 0.87, 95% CI [0.8, 0.9]), having up to three children (AOR 3, 95% CI [1.13, 8]) and good knowledge of vaccine schedule (AOR: 2.4, 95% CI [1.4, 4]) were associated positively with full vaccination status. Conclusion Full vaccination status was 91.6% in Mettu and 62.7% in Sinana district. Place of residence, ANC, PNC, pregnancy intention, child number, age of child and knowledge of vaccination schedule were significantly associated with vaccination status of the children.
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Affiliation(s)
| | - Abdulhalik Workicho
- Department of Epidemiology, College of Health Science, Jimma University, Jimma, Ethiopia
| | - Soresa Alemu
- Mettu Health Science College, Mettu, Ethiopia
- Correspondence: Soresa Alemu, Mettu, Oromia, Ethiopia, Tel +251 917273506, Email
| | - Ebsa Gelan
- Departement of Statistics, College of Natural Science, Mettu University, Mettu, Ethiopia
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Hunegnaw A, Mekonnen HS, Techane MA, Agegnehu CD. Prevalence and Associated Factors of Chronic Kidney Disease among Adult Hypertensive Patients at Northwest Amhara Referral Hospitals, Northwest Ethiopia, 2020. Int J Hypertens 2021; 2021:5515832. [PMID: 34484816 PMCID: PMC8416396 DOI: 10.1155/2021/5515832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/02/2021] [Accepted: 08/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a progressive loss of the kidney function which leads to a decreased kidneys' ability to process waste in the blood and it affects the other important functions of the kidney. The disease has different stages that can alter the health status of individuals. During the early stages, patients may present with a normal or slight decrease in glomerular filtration rate (GFR) and albuminuria. Later, it progresses and leads to end-stage renal disease (ESRD) or kidney failure. Hypertension is considered as the major contributing risk factor of CKD. OBJECTIVE This study was aimed to assess the prevalence and associated factors of chronic kidney disease among adult hypertensive patients in referral hospitals of the Northwest Ethiopia. METHODS An institution-based cross-sectional study was conducted among 581 adult hypertensive patients in a chronic follow-up clinic in referral hospitals, Northwest Ethiopia, from July to August 2020. Systematic random sampling was used to select the study participants. Data were collected using the interviewer-administered questionnaire and participants medical records. Both bivariable and multiple logistic regression analyses were performed. Model fitness was assessed using a Hosmer-Lemeshow test. RESULT The total prevalence of CKD among adult hypertensive patients was 17.6% (95% CI: 14.7-20.8). Diastolic blood pressure ≥90 mmHg (AOR = 8.65; 95% CI: 4.77-15.68), duration of hypertension ≥10 years (AOR = 8.81; 95% CI: 2.47-31.45), stage II HTN (AOR = 2.61; 95% CI: 1.04-6.50), comorbid disease (AOR = 7.0; 95% CI: 2.20-22.21), proteinuria (AOR = 4.59; 95% CI: 2.08-10.12), dyslipidemia (AOR = 3.40; 95% CI: 1.56-7.24), and serum creatinine ≥1 mg/dl (AOR = 8.88; 95% CI: 4.40-17.91) were associated with chronic kidney disease among adult hypertensive patients. CONCLUSION In this study, the prevalence of CKD among hypertensive patients found was 17.6%. Regarding associated factors, dyslipidemia, proteinuria, comorbid disease, serum creatinine greater than 0.9 mg/dl, duration of hypertension greater than 10 years, and diastolic blood pressure greater than 90 mmHg are factors associated with the occurrence of chronic kidney disease among hypertensive patients.
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Affiliation(s)
- Anteneh Hunegnaw
- University of Gondar, Comprehensive Specialised Hospital, Gondar, Ethiopia
| | - Habtamu Sewunet Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masresha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chilot Desta Agegnehu
- School of Nursing, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Miretu DG, Asfaw ZA, Addis SG. Impact of COVID-19 pandemic on vaccination coverage among children aged 15 to 23 months at Dessie town, Northeast Ethiopia, 2020. Hum Vaccin Immunother 2021; 17:2427-2436. [PMID: 33721546 DOI: 10.1080/21645515.2021.1883387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Disturbances are occurring in healthcare, trade, and travel, with countries closing off their borders due to the pandemic of coronavirus disease 2019(COVID-19) in the world. The pandemic has its impact on the delivery of important health services, including vaccinations. This study aimed to assess the impact of COVID-19 on vaccination coverage among children aged 15-23 months.Methods: A community-based cross-sectional study was conducted from July 22 to August 7, 2020, in Dessie town, Ethiopia. 633 children with their mother/caregiver were interviewed. Interviewer administered pre-tested structured questioner was used. Data was entered into EPI data and analyzed by using SPSS (Statistical Package for Social Sciences). Both binary and multivariate logistic regression analyses were tested. In multivariate analysis, a significant association was declared at a p-value of < 0.05.Result: Response rate was 96.4%. Based on the vaccination card plus recall, 350 (57.4%) of children finished all recommended vaccines. Age-eligible vaccination coverage during the COVID-19 outbreak was 12.5% lower than before the outbreak. Being a father main caregiver, mother/caregiver who can write and read, and mother/caregiver who educated from grade 1 to 8 mother/caregiver who is divorced, mother/caregiver who spend more than 30 minutes to reach health institution, and mother/caregiver who aware about the benefit of vaccination, about the campaign, and knowledge of COVID-19 each shows statistically significant association with full vaccination status of children.Conclusion: Full vaccination coverage among children aged 15-23 months remains low in Dessie town, which further decreases after the COVID-19 pandemic. Hence, measures should be taken to increase consciousness about vaccination and the COVID-19 pandemic.
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Affiliation(s)
- Debrnesh Goshiye Miretu
- Department of Pediatric and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zinet Abegaz Asfaw
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Gedamu Addis
- Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Agegnehu CD, Alem AZ. Exploring spatial variation in BCG vaccination among children 0-35 months in Ethiopia: spatial analysis of Ethiopian Demographic and Health Survey 2016. BMJ Open 2021; 11:e043565. [PMID: 33910946 PMCID: PMC8094339 DOI: 10.1136/bmjopen-2020-043565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Tuberculosis is a major public health problem and is the second leading cause of death worldwide. BCG vaccination is a life-saving and important part of standard tuberculosis control measures, particularly in Ethiopia where tuberculosis is endemic. The End Tuberculosis Strategy targets of 2020 have not been achieved. Exploring spatial variations in BCG vaccination among children is vital to designing and monitoring effective intervention programmes. Therefore, this study aimed to explore the spatial variation in BCG vaccination among children in Ethiopia. DESIGN Cross-sectional study design. SETTING Ethiopia. PARTICIPANTS Children aged 0-35 months. PRIMARY OUTCOME BCG vaccination coverage. METHODS Data from the 2016 Ethiopian Demographic and Health Survey were used and a total of 4453 children aged 0-35 months were included. Spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographical risk areas for BCG vaccine utilisation. ArcGIS V.10.6 and SaTScan V.9.6 statistical software were employed to explore spatial pattern and significant hotspot areas for BCG vaccination among children. RESULTS BCG vaccination was spatially clustered in Ethiopia at the regional level (Global Moran's I=0.516, p<0.001). A total of 51 most likely clusters of low BCG vaccination were identified in the Somali and Afar regions (log-likelihood ratio=136.58, p<0.001). Significant secondary clusters were also identified in North West Gambela, South Amhara, South West Addis Ababa, North East Southern Nations, Nationalities, and People's Region, and South West Oromia. CONCLUSION A low probability of receiving BCG vaccination was found among children in the Somali and Afar regions. Therefore, these areas should be given attention when designing effective immunisation strategies to improve BCG vaccination among children in order to reduce the burden of tuberculosis in Ethiopia.
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Affiliation(s)
- Chilot Desta Agegnehu
- School of Nursing, College of medicine and health scienes and comprehensive specailized hospital, Unievrsity of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public health, Collge of medicine and health sciences, University of Gondar, Gondar, Ethiopia
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Fenta SM, Fenta HM. Individual and community-level determinants of childhood vaccination in Ethiopia. Arch Public Health 2021; 79:53. [PMID: 33879269 PMCID: PMC8059167 DOI: 10.1186/s13690-021-00581-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe. Most unvaccinated children live in the poorest countries including Ethiopia. Therefore, this study aimed to identify the determinants of vaccination coverage among children aged12-23 months in Ethiopia. METHODS A cross-sectional secondary data were obtained from the 2016 Ethiopian Demographic and Health Survey data (EDHS). A total of 1929 children were included. A Multilevel Proportional Odds Model was used to identify the individual and community-level factors associated with child vaccination. RESULT Among 1, 929 children, only 48.6% (95% CI: 46.3 to 50.8%) were fully vaccinated while 37.8% (95% CI: 35.7 to 40.1%) were partially vaccinated.. The multilevel ordinal logistic regression model reveled that housewife mother (AOR =1.522, 95%CI: 1.139, 2.034), institutional delivery (AOR =2.345, 95%CI: 1.766, 3.114),four or above antenatal care visits (AOR = 2.657; 95% CI: 1.906, 3.704), children of mothers with secondary or higher education (AOR = 2.008; 95% CI: 1.209, 3.334),Children whose fathers primary education (AOR = 1.596; 95% CI: 1.215, 2.096), from the rich households (AOR = 1.679; 95% CI: 1.233, 2.287) were significantly associated with childhood vaccination. CONCLUSION Child vaccination coverage in Ethiopia remains low. Therefore, there is a need to increase child vaccination coverage by promoting institutional delivery and prenatal care visits, as well as maternal tetanus immunization. Besides, public initiatives needed to improve child vaccination coverage, women's and husband's education, poor women, and further advancement of health care services for poor women, housewife women, women living in remote areas should be made to maintain further improvements in child vaccination. Furthermore, policies and programs aimed at addressing cluster variations in child vaccination need to be formulated and their implementation must be strongly pursued.
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Affiliation(s)
- Setegn Muche Fenta
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Haile Mekonnen Fenta
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
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Adamu AA, Essoh TA, Adeyanju GC, Jalo RI, Saleh Y, Aplogan A, Wiysonge CS. Drivers of hesitancy towards recommended childhood vaccines in African settings: a scoping review of literature from Kenya, Malawi and Ethiopia. Expert Rev Vaccines 2021; 20:611-621. [PMID: 33682587 DOI: 10.1080/14760584.2021.1899819] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION There is a dearth of literature on vaccine hesitancy in Africa. In this study, we aimed to explore the drivers of hesitancy toward recommended childhood vaccines in Kenya, Malawi, and Ethiopia. METHODS A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O'Malley's recommendations as modified by Levac. RESULTS A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context. CONCLUSION This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.
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Affiliation(s)
- Abdu A Adamu
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Téné-Alima Essoh
- Agence De Médecine Préventive (AMP) Afrique - Preventive Medicine Agency Africa, Abidjan, Cote d'Ivoire
| | - Gbadebo Collins Adeyanju
- Psychology and Infectious Diseases Lab, Department of Media and Communication Science, Faculty of Philosophy, University of Erfurt, Erfurt, Germany.,Centre for Empirical Research in Economics and Behavioural Science (CEREB), University of ErfurtErfurt, Germany
| | - Rabiu I Jalo
- Department of Community Medicine, Faculty of Clinical Sciences, College of Health Science, Bayero University Kano, Kano State, Nigeria.,Department of Community Medicine, Aminu Kano Teaching Hospital, Kano State, Nigeria
| | - Yusuf Saleh
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano State, Nigeria
| | - Aristide Aplogan
- Agence De Médecine Préventive (AMP) Afrique - Preventive Medicine Agency Africa, Abidjan, Cote d'Ivoire
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
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Wale Tegegne A, Kassie Gidafie A, Girma Mamo D, Tilahun Wassie S, Abita Mengie Z. Immunization Status and Challenges During COVID-19 and Associated Factors Among Children Aged 10-23 Months in South Region, Ethiopia 2020. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:101-109. [PMID: 33727881 PMCID: PMC7954040 DOI: 10.2147/phmt.s294739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/22/2021] [Indexed: 12/23/2022]
Abstract
Background The worldwide COVID-19 pandemic is overstressing health systems and Essential health services and vaccination services are disrupted. Immunization is a confirmed gizmo for governing and even eliminating communicable diseases. Objective This study aims to assess the challenge and status of immunization during COVID-19 and associated factors among children aged 10–23 months south Nation Nationality and People Region Ethiopia. Methods and Materials: community-based mixed quantitative and qualitative cross-sectional study was done in southwest Ethiopia. Data was collected using semi-structured questionnaires and in-depth interviews. After that, the data were edited, coded, and move in into Epi info version 7.2 for data management then transported to SPSS version 25 for analysis. The analyzed data were presented by tables, graphs, figures, and text form. Results According to this study, the prevalence of incomplete immunization was found to be 809 (62.2%) with (95% CI: 59.5, 64.8). In multivariable analysis waiting time at a health facility (AOR=0.04, 95% CI 0.0001,0.004), education (AOR=5.08,95% CI2.31,11.14), place of delivery (AOR=2.34,95% CI 4.96,6.089), fearing of COVID-19 (AOR=3.62,95% CI 1.72,7.64) and do not understand the separation care of COVID-19 and other health services (AOR=2.85,95% CI1.38,5.9) were significantly associated factors. Conclusion The prevalence of incomplete immunization among children aged 10–23 months was very high in this study as compared to the other studies done in a different pocket of Ethiopia. Consecutively, reducing waiting time at a health facility, avoiding unnecessary fear of COVID-19, and promoting immunization in a different area of southwest Ethiopia along with health extension workers are recommended.
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Affiliation(s)
- Alemnew Wale Tegegne
- Department of Midwifery, College of Medicine and Health Science, Mizan Tepi University, Tepi, Ethiopia
| | - Aychew Kassie Gidafie
- Department of Nursing, College of Medicine and Health Science, Mizan Tepi University, Tepi, Ethiopia
| | - Desalegn Girma Mamo
- Department of Midwifery, College of Medicine and Health Science, Mizan Tepi University, Tepi, Ethiopia
| | - Semahegn Tilahun Wassie
- Department of Midwifery, College of Medicine and Health Science, Mizan Tepi University, Tepi, Ethiopia
| | - Zinie Abita Mengie
- Department of Midwifery, College of Medicine and Health Science, Mizan Tepi University, Tepi, Ethiopia
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Nour TY, Farah AM, Ali OM, Osman MO, Aden MA, Abate KH. Predictors of immunization coverage among 12-23 month old children in Ethiopia: systematic review and meta-analysis. BMC Public Health 2020; 20:1803. [PMID: 33243208 PMCID: PMC7689978 DOI: 10.1186/s12889-020-09890-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/15/2020] [Indexed: 12/26/2022] Open
Abstract
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.
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Affiliation(s)
- Tahir Yousuf Nour
- Department of public health, College of Medicine and Health Sciences, Jigjiga University, P.O. BOX 1020, Jigjiga, Ethiopia.
| | - Alinoor Mohamed Farah
- Department of public health, College of Medicine and Health Sciences, Jigjiga University, P.O. BOX 1020, Jigjiga, Ethiopia
| | - Omer Moelin Ali
- Department of public health, College of Medicine and Health Sciences, Jigjiga University, P.O. BOX 1020, Jigjiga, Ethiopia
| | - Mohamed Omar Osman
- Department of public health, College of Medicine and Health Sciences, Jigjiga University, P.O. BOX 1020, Jigjiga, Ethiopia
| | - Mowlid Akil Aden
- Department of public health, College of Medicine and Health Sciences, Jigjiga University, P.O. BOX 1020, Jigjiga, Ethiopia
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Desalew A, Semahegn A, Birhanu S, Tesfaye G. Incomplete Vaccination and Its Predictors among Children in Ethiopia: A Systematic Review and Meta-Analysis. Glob Pediatr Health 2020; 7:2333794X20968681. [PMID: 33241080 PMCID: PMC7675896 DOI: 10.1177/2333794x20968681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/13/2020] [Accepted: 09/30/2020] [Indexed: 12/16/2022] Open
Abstract
Background. Vaccination is an effective public health intervention that has contributed to a substantial reduction in the burden of vaccine-preventable diseases. Abridged evidence on incomplete vaccination is not well established in Ethiopia. Therefore, this meta-analysis aimed to estimate the pooled prevalence of incomplete vaccination and its predictors among children aged 12 to 23 months. Methods. Primary studies conducted in Ethiopia were searched. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) checklist. The analysis was conducted using STATA 14 and RevMan. The presence of statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using I2 statistics. Pooled prevalence and odds ratio (OR) were computed at a 95% confidence interval (CI). Results. The pooled prevalence of incomplete vaccination was 30% (95% CI: 25-35). Maternal illiteracy (OR = 1.96; 95% CI: 1.40, 2.74) and home delivery (OR = 2.78; 95% CI: 2.28, 3.38) were associated factors that increased incomplete vaccination. However, maternal autonomy (OR = 0.54; 95% CI: 0.33, 0.89), maternal knowledge (OR = 0.31; 95% CI: 0.20, 0.47), husband employment (OR = 0.49; 95% CI: 0.35, 0.67), urban residence (OR = 0.61; 95% CI: 0.43, 0.86), ANC visits (OR = 0.30; 95% CI: 0.23, 0.39), postnatal care (OR = 0.39; 95% CI: 0.30, 0.52), and tetanus toxoid vaccine (3+) (OR = 0.42; 95% CI: 0.26, 0.69) were factors that reduced incomplete vaccination. Conclusion. In Ethiopia, 3 out of 10 children have incomplete vaccination. Policies should focus on strengthening and improving women’s education, maternal health knowledge, empowering women, and the utilization of prenatal care can overcome some of the barriers.
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Affiliation(s)
- Assefa Desalew
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Agumasie Semahegn
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Simon Birhanu
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gezahegn Tesfaye
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Individual- and Community-Level Determinants for Complete Vaccination among Children Aged 12-23 Months in Ethiopia: A Multilevel Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6907395. [PMID: 33062691 PMCID: PMC7545462 DOI: 10.1155/2020/6907395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/20/2020] [Accepted: 09/16/2020] [Indexed: 11/25/2022]
Abstract
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.
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Nour TY, Farah AM, Ali OM, Abate KH. Immunization coverage in Ethiopia among 12-23 month old children: systematic review and meta-analysis. BMC Public Health 2020; 20:1134. [PMID: 32689962 PMCID: PMC7370412 DOI: 10.1186/s12889-020-09118-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/15/2020] [Indexed: 01/15/2023] Open
Abstract
Background Immunization is a cost-effective public health strategy. Immunization averts nearly three million deaths annually but immunization coverage is low in some countries and some regions within countries. The aim of this systematic review and meta-analysis is to assess pooled immunization coverage in Ethiopia. Method A systematic search was done from PubMed, Google Scholar, EMBASE, HINARI, and SCOPUS, WHO’s Institutional Repository for Information Sharing (IRIS), African Journals Online databases, grey literature and reviewing reference lists of already identified articles. A checklist from the Joanna Briggs Institute was used for appraisal. The I2 was used to assess heterogeneity among studies. Funnel plot were used to assess publication bias. A random effect model was used to estimate the pooled prevalence of immunization among 12–23 month old children using STATA 13 software. Result Twenty eight articles were included in the meta-analysis with a total sample size of 20,048 children (12–23 months old). The pooled prevalence of immunization among 12–23 month old children in Ethiopia was found to be 47% (95%, CI: 46.0, 47.0). A subgroup analysis by region indicated the lowest proportion of immunized children in the Afar region, 21% (95%, CI: 18.0, 24.0) and the highest in the Amhara region, 89% (95%, CI: 85.0, 92.0). Conclusion Nearly 50% of 12–23 month old children in Ethiopia were fully vaccinated according to this systematic review and meta-analysis this indicates that the coverage, is still low with a clear disparity among regions. Our finding suggests the need for mobile and outreach immunization services for hard to reach areas, especially pastoral and semi-pastoral regions. In addition, more research may be needed to get more representative data for all regions. PROSPERO registration number CRD42020166787.
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Affiliation(s)
- Tahir Yousuf Nour
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia.
| | - Alinoor Mohamed Farah
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Omer Moeline Ali
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Kalkidan Hassen Abate
- Department of Population and Family Health, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
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Eshete A, Shewasinad S, Hailemeskel S. Immunization coverage and its determinant factors among children aged 12-23 months in Ethiopia: a systematic review, and Meta- analysis of cross-sectional studies. BMC Pediatr 2020; 20:283. [PMID: 32513135 PMCID: PMC7278125 DOI: 10.1186/s12887-020-02163-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Immunization is the process by which a person is made immune or resistant to an infectious disease, typically by the administration of vaccine. Vaccination coverage for other single vaccines ranged from 49.1% for PCV to 69.2% for BCG vaccine. The vaccination coverage for basic vaccinations was 39.7% in Ethiopia. There have been epidemiological studies available on immunization in Ethiopia. Yet, these studies revealed a wide variation over time and across geographical areas. This systematic review and Meta-analysis aim to estimate the overall immunization coverage among 12-23 months children in Ethiopia. METHODS Cross-sectional studies that reported on immunization coverage from 2003 to August 2019 were systematically searched. Searches were conducted using PubMed, Google Scholar, Cochrane library, and gray literature. Information was extracted using a standardized form of Joanna Briggs Institute. The search was updated 20 Jan 2020 to decrease time-lag bias. The quality of studies assessed using Joanna Briggs Institute cross-sectional study quality assessment criteria. I-squared statistics applied to check the heterogeneity of studies. A funnel plot, Begg's test, and Egger's regression test was used to check for publication bias. RESULTS Out of 206 studies, 30 studies with 21,672 children with mothers were included in the Meta-analysis. The pooled full immunization coverage using the random-effect model in Ethiopia was 58.92% (95% CI: 51.26-66.58%). The trend of immunization coverage was improved from time to time, but there were great disparities among different regions. Amhara region had the highest pooled fully immunized coverage, 72.48 (95%CI: 62.81-82.16). The I2 statistics was I2 = 99.4% (p = 0.0001). A subgroup meta-analysis showed that region and study years were not the sources of heterogeneity. CONCLUSION This review showed that full immunization coverage in Ethiopia was 58.92% (95% CI: 51.26-66.58%). The study suggests that the child routine immunization program needs to discuss this low immunization coverage and the current practice needs revision.
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Affiliation(s)
- Akine Eshete
- College of Health Sciences, Department of Public Health, Debre Berhan University, Debre Berhan, Ethiopia.
| | - Sisay Shewasinad
- College of Health Sciences, Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
| | - Solomon Hailemeskel
- College of Health Sciences, Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia
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Ketema DB, Assemie MA, Alamneh AA, Alene M, Chane KY, Alamneh YM, Birhanu MY, Alebel A. Full vaccination coverage among children aged 12-23 months in Ethiopia: a systematic review and meta-analysis. BMC Public Health 2020; 20:777. [PMID: 32448220 PMCID: PMC7249262 DOI: 10.1186/s12889-020-08940-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaccination is one of the most cost-effective means of public health interventions to prevent childhood deaths from infectious diseases. Although several fragmented studies have been conducted concerning full vaccination coverage among children aged 12-23 months in Ethiopia, the pooled estimate has not been determined so far. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of full vaccination coverage among children aged 12-23 months in Ethiopian. METHODS To find potentially relevant studies, we systematically searched five major databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, Google Scholar, and Science Direct). This review included community based cross-sectional studies reported in English language; had good quality, and published from the 1st of January 2000 to the 20th of November 2019. Data were analyzed using Stata™ Version 14.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. Higgins and Egger's tests were used to assess heterogeneity and publication bias, respectively. Primary estimates were pooled using a random effects meta-analysis model. RESULTS Of the total of 851 identified articles 21 studies involving 12,094 children met the inclusion criteria and were included in this meta-analysis. The included studies sample size ranged from 173 to 923. The lowest proportion of full vaccination coverage was reported from Afar Region [21% (95% CI: 18, 24%)], whereas the highest proportion of full vaccination coverage was reported from Amhara Region [73% (95% CI: 67, 79%)]. The overall prevalence of full vaccination coverage among children in Ethiopia was 60% (95% CI: 51, 69%). CONCLUSIONS Our finding suggested that six in every 10 children in Ethiopia were fully vaccinated. However, this finding is much lower than the World Health Organization recommended rate. Moreover, high regional variations in terms of full vaccination coverage across the country was observed. Therefore, a special attention should be given to improve the overall childhood vaccination coverage.
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Affiliation(s)
- Daniel Bekele Ketema
- Department of Public Health, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Moges Agazhe Assemie
- Department of Public Health, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Alehegn Aderaw Alamneh
- Department of Human Nutrition and Food Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Muluneh Alene
- Department of Public Health, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Kassahun Yawukal Chane
- School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa,, Ethiopia
| | - Yoseph Merkebe Alamneh
- Deprtment of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | | | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
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Debie A, Lakew AM. Factors associated with the access and continuum of vaccination services among children aged 12-23 months in the emerging regions of Ethiopia: evidence from the 2016 Ethiopian demography and health survey. Ital J Pediatr 2020; 46:28. [PMID: 32131868 PMCID: PMC7057504 DOI: 10.1186/s13052-020-0793-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/25/2020] [Indexed: 11/25/2022] Open
Abstract
Background Child vaccination is an instrument for saving millions of lives. Only one in twenty children has access to childhood vaccination in hard to reach areas in developing countries. Although studies have been done on childhood vaccination, factors associated with access and continuum were not considered in Ethiopia. Therefore, this study aimed to identify the factors associated with the access and continuum of childhood vaccination in the emerging regions of Ethiopia based on the 2016 EDHS datasets. Methods The two-stage stratified sampling technique was used for the survey carried out on 642 mothers of children aged 12–23 months. Access is the provision of services in shorter waiting times and flexibly at all times and alternative methods of communication. Accordingly, continuum of care reflects the extent to which a series of discrete health care events are being experienced by people coherently and interconnected over time. As a result, access and continuum of childhood vaccination are determined using pentavalent-1 and measles vaccination status of children, respectively. A binary logistic regression model was fitted to identify the factors associated with access and continuum of the vaccination. Results Overall, 25.1% of children aged 12–23 months received all of the recommended childhood vaccines. Sixty-two percent of children accessed and 46.9% had continuum of childhood vaccination in the emerging regions of Ethiopia. Pentavalent_1 to 3 and BCG to measles dropout rates were 33.42 and 17.53%, respectively. Mothers’ formal education (AOR = 1.99; 95%CI: 1.20, 3.31), ANC (AOR = 4.13; 95%CI: 2.75,6.19), health facility delivery of last birth (AOR = 1.58; 95%CI: 1.19, 2.82), rich wealth (AOR = 1.57; 95%CI: 1.19, 3.14) and average child birth weight (AOR = 1.67; 95%CI: 1.03, 2.72) were positively associated with childhood access to vaccination. On the other hand, mothers’ ANC attendance (AOR = 3.68; 95%CI: 2.48, 5.47) and rich wealth (AOR = 2.07; 95%CI: 1.15, 3.71) were positively associated with the continuum of the services. On the contrary, children with rural resident mothers (AOR = 0.33; 95%CI: 0.14, 0.76) and small birth weight (AOR = 0.51; 95%CI: 0.33, 0.81) were negatively associated to the access and continuum of childhood vaccination, respectively. Conclusion Childhood vaccination status was low in the emerging regions of Ethiopia. Variables such as maternal education, birth weight of children, ANC, health facility delivery and wealth were associated with the access and continuum of the vaccination. Therefore, empowering women with education and strengthening maternal healthcare services might enhance childhood vaccination. In addition, the government needs to design a compensation mechanism for the cost relating to childhood vaccination to improve the access and continuum of the service.
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Affiliation(s)
- Ayal Debie
- Department of Health Systems and Health Policy, Institute of Public Health, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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