1
|
Oladapo RK, Obidiro OP, Oyetola AB, Olajide A, Oladapo MO, Lawrence US, Hasan MM, Islam Z, Mustapha AA, Osuagwu-Nwogu E, Ghazanfar S, Olaleye MA, Monisola I, Ibraheem B, Afolayan AA, Barakat A, Adewole MO. COVID-19 vaccination in low and middle-income countries: Creating a sustainable roadmap for promoting public health intervention. Int J Health Plann Manage 2024. [PMID: 39090524 DOI: 10.1002/hpm.3834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 08/04/2024] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic is a global public health threat ravaging the health systems. In low and middle-income countries (LMICs), COVID-19 and several other challenges concurrently worsen the health outcome indicators. Interestingly, vaccines have been identified as the most reliable and cost-effective public health intervention, and the governments in LMICs have instituted an array of plans to ensure every eligible person gets vaccinated. However, there is still considerable apathy around the use of the available COVID-19 vaccines in LMICs which is impeding the fight against the COVID-19 pandemic. In this paper, we explore the multiple interrelated factors behind low COVID-19 vaccination coverage in LMICs. It is therefore recommended that the governments in LMICs embrace multicomponent and wide-ranging strategies. This should involve utilising community-based approaches such as community pharmacy-led vaccination to promote community access to COVID-19 vaccines and to revive trust in national health authorities by offering population-specific, target-driven, transparent, and timely communication to the community who they serve about the safety and efficacy of the COVID-19 vaccine. Communication strategies should be tailored to reflect diverse political orientations as this can enhance vaccine acceptance. Additionally, local political parties and representative should be engaged in broad alliances to facilitate community mobilisation and support for vaccination campaigns. Also, relevant Nongovernmental Organisations and Community-based Organisations should institute programs at the grassroots that incorporate the gatekeepers to the community aimed at influencing population behaviour regarding COVID-19 vaccine hesitancy. Besides, the public health department in the ministry of health in LMICs should create more awareness, through social and mass media, particularly in the rural, semi-urban, and slum communities about the pivotal role of vaccination. Thus, we opined that these strategies will help LMICs achieve the COVID-19 vaccination target and further reposition the healthcare systems, and promote other public health interventions now and in the future.
Collapse
Affiliation(s)
- Rasaq Kayode Oladapo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | | | - Mariam Olaitan Oladapo
- Department of Urban and Regional Planning, Faculty of Environmental Design and Management, Obafemi Awolowo University, Ile Ife, Osun, Nigeria
| | | | - Mohammed Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Sciences, Mawlana Bhashani Science, and Technology University, Tangail, Bangladesh
| | - Zarmina Islam
- Dow University of Health Sciences, Karachi, Pakistan
| | | | | | | | | | | | | | | | | | - Mary Omotola Adewole
- Department of Biochemistry, Faculty of Science, Federal University Oye, Oye, Ekiti, Nigeria
| |
Collapse
|
2
|
Kuuyi A, Kogi R. Factors contributing to immunization coverage among children less than 5 years in Nadowli-Kaleo District of Upper West Region, Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002881. [PMID: 39088462 PMCID: PMC11293730 DOI: 10.1371/journal.pgph.0002881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/12/2024] [Indexed: 08/03/2024]
Abstract
Immunization prevents deaths from diseases such as diphtheria, tetanus, whooping cough and measles in about 2.5 million children each year worldwide. Failure to vaccinate children in the required timeframe could result in disease outbreaks among them and increase costs of living among the populations directly affected. Even though Ghana has set 95% as the target for immunization coverage, the Nadowli-Kaleo district has been below this national target. This study was conducted to identify the factors influencing low immunization coverage among children under five years in the Nadowli-Kaleo district, Ghana. An analytical cross-sectional study design was adopted for this study. Systematic sampling method was used to recruit the respondents. The data was collected using KoboCollect online data collection tool and analyzed using Stata Version 17.0. Chi-square test was used to establish the association between child's immunization status and the independent variables. Logistic regression was used to determine the degree of association. A p-value less than 0.05 was considered statistically significant. Fully immunized status among children under-five was a little above average (55.4%). Mother's or caregiver's age, marital status, occupation, and current child's birth order were significantly associated with children full immunization. Also, number of ANC visits, delivery location, and distance to health facility were significantly associated with children full immunization. A child delivered at the health facility had higher chance of 2.12 times to be fully immunized than giving birth at home [AOR = 2.12, 95%CI = 1.14-3.94, and p-value = 0.017]. The health system related factors which were statistically associated with child full immunization included time spent during immunization service and being informed when to come for the next vaccination visit. Coverage for children with fully immunized status was not very encouraging at our study site. We recommend expansion of access to maternal and child health services, encouraging institutional childbirth, and timely regular antenatal visits.
Collapse
Affiliation(s)
- Alice Kuuyi
- Department of Disease Control, Nadowli-Kaleo District Health Directorate, Ghana Health Service, Nadowli, Ghana
- Department of Health Information, Asunafo South District Health Directorate, Ghana Health Service, Kukuom, Ghana
| | - Robert Kogi
- Department of Health Information, Asunafo South District Health Directorate, Ghana Health Service, Kukuom, Ghana
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana
| |
Collapse
|
3
|
Bantie B, Atnafu Gebeyehu N, Adella GA, Ambaw Kassie G, Mengstie MA, Abebe EC, Abdu Seid M, Gesese MM, Tegegne KD, Zemene MA, Anley DT, Dessie AM, Fenta Feleke S, Dejenie TA, Chanie ES, Kebede SD, Bayih WA, Moges N, Kebede YS. Mapping geographical inequalities of incomplete immunization in Ethiopia: a spatial with multilevel analysis. Front Public Health 2024; 12:1339539. [PMID: 38912271 PMCID: PMC11193363 DOI: 10.3389/fpubh.2024.1339539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Background Immunization is one of the most cost-effective interventions, averting 3.5-5 million deaths every year worldwide. However, incomplete immunization remains a major public health concern, particularly in Ethiopia. The objective of this study is to investigate the geographical inequalities and determinants of incomplete immunization in Ethiopia. Methods A secondary analysis of the mini-Ethiopian Demographic Health Survey (EDHS 2019) was performed, utilizing a weighted sample of 3,865 children aged 12-23 months. A spatial auto-correlation (Global Moran's I) statistic was computed using ArcGIS version 10.7.1 to assess the geographical distribution of incomplete immunization. Hot-spot (areas with a high proportion of incomplete immunization), and cold spot areas were identified through Getis-Ord Gi* hot spot analysis. Additionally, a Bernoulli probability-based spatial scan statistics was conducted in SaTScan version 9.6 software to determine purely statistically significant clusters of incomplete immunization. Finally, a multilevel fixed-effects logistic regression model was employed to identify factors determining the status of incomplete immunization. Results Overall, in Ethiopia, more than half (54%, 95% CI: 48-58%) of children aged 12-23 months were not fully immunized. The spatial analysis revealed that the distribution of incomplete immunization was highly clustered in certain areas of Ethiopia (Z-score value = 8.379419, p-value < 0.001). Hotspot areas of incomplete immunization were observed in the Afar, Somali, and southwestern parts of Ethiopia. The SaTScan spatial analysis detected a total of 55 statistically significant clusters of incomplete immunization, with the primary SaTScan cluster found in the Afar region (zones 1, 3, and 4), and the most likely secondary clusters detected in Jarar, Doola, Korahe, Shabelle, Nogob, and Afdar administrative zones of the Somali region of Ethiopia. Indeed, in the multilevel mixed-effect logistic regression analysis, the respondent's age (AOR: 0.92; 95% CI: 0.86-0.98), residence (AOR: 3.11, 95% CI: 1.36-7.14), living in a pastoralist region (AOR: 3.41; 95% CI: 1.29-9.00), educational status (AOR: 0.26; 95% CI: 0.08-0.88), place of delivery (AOR: 2.44; 95% CI: 1.15-5.16), and having PNC utilization status (AOR: 2.70; 95% CI: 1.4-5.29) were identified as significant predictors of incomplete immunization. Conclusion and recommendation In Ethiopia, incomplete immunization is not randomly distributed. Various factors at both individual and community levels significantly influence childhood immunization status in the country. It is crucial to reduce disparities in socio-demographic status through enhanced collaboration across multiple sectors and by bolstering the utilization of maternal health care services. This requires concerted efforts from stakeholders.
Collapse
Affiliation(s)
- Berihun Bantie
- Department of Comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Sodo, Ethiopia
| | - Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Sodo, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Physiology, Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molalegn Mesele Gesese
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Solomon Demis Kebede
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Moges
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yenealem Solomon Kebede
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
4
|
Tamir TT, Workneh BS, Mekonen EG, Zegeye AF. Coverage, spatial distribution and determinants of childhood inactivated poliovirus vaccine immunization in Ethiopia. PLoS One 2024; 19:e0301933. [PMID: 38820454 PMCID: PMC11142555 DOI: 10.1371/journal.pone.0301933] [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: 01/09/2024] [Accepted: 03/22/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Polio eradication is a current and common strategy throughout the globe. The study of the newly introduced inactivated poliovirus vaccine provides a grasp on the current status of immunization and identifies any disparities in the implementation of the vaccine throughout Ethiopia. Thus, this study aimed to demonstrate the spatial distribution, coverage, and determinants of inactivated poliovirus vaccine immunization in Ethiopia. METHOD Spatial distribution and determinants of inactivated poliovirus vaccine immunization in Ethiopia were conducted using Ethiopian mini-demographic and health survey 2019 data. A total of 2,056 weighted children aged 12 to 35 months were included in the analysis. The association between the outcome and explanatory variables was determined by commuting the adjusted odds ratio at a 95% confidence interval. The p-value of less than 0.05 was used to declare factors as significantly associated with the inactivated poliovirus vaccine immunization. RESULT The weighted national coverage of inactivated poliovirus vaccine immunization in Ethiopia was 51.58% at a 95% confidence interval (49.42, 53.74). While the rates of inactivated poliovirus vaccine immunization were observed to be greater in Addis Ababa, Tigiray, Amahara, and Benishangul Gumuz provinces and lower in the Somali, Afar, and SNNPR provinces of Ethiopia, Antenatal care follow-up, place of delivery, place of residence, and region were significantly associated with inactivated poliovirus immunization in Ethiopia. CONCLUSION The distribution of inactivated poliovirus immunization was spatially variable across Ethiopia. Only about half of the children aged twelve to thirty-five months received the inactivated poliovirus vaccine in the country. The factors, both at the individual and community level, were significantly associated with inactivated poliovirus immunization. Therefore, policies and strategies could benefit from considering antenatal care follow-up, place of delivery, place of residence, and region while implementing inactivated poliovirus vaccine immunization.
Collapse
Affiliation(s)
- Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia
| |
Collapse
|
5
|
Kos IA, Hajar FN, Sarot Pereira da Cunha G, Corte C, Furlan LA, Santa Maria A, Valverde D, Emoingt Furtado B, Morita Fernandes-Silva M, Feijó Azevedo V. Lessons Learned from the COVID-19 Pandemic: Interpreting Vaccination Strategies in a Nationwide Demographic Study. Vaccines (Basel) 2024; 12:581. [PMID: 38932310 PMCID: PMC11209574 DOI: 10.3390/vaccines12060581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE Brazil was strongly affected by the COVID-19 pandemic. Its continental dimension and socio-demographic characteristics pose challenges to distribution and accessibility, making vaccination programs challenging. The objectives of the study were to describe the clinical and demographic characteristics of the general population vaccinated against COVID-19 by October 2021 and analyze the strategies implemented during the vaccination program. STUDY DESIGN AND SETTING A retrospective nationwide study that analyzed data from the OpenDataSUS platform of the Informatics Department of the Brazilian Ministry of Health (DataSUS), which contains information from all individuals in Brazil who have received at least one dose of any vaccine against COVID-19 approved by the National Health Agency (ANVISA) from 17 January to 3 October 2021. RESULTS Until 3 October, a total of 146,254,578 persons (68.6 per 100 inhabitants) received at least one dose of a vaccine in Brazil. The north and northeast regions had the lowest vaccination rates compared with the remaining regions (North: 56.8, Northeast: 62.0, South: 74.4, and Southeast: 73.2 per 100 inhabitants). Elderly individuals had the highest vaccination rates, particularly those above 70 years old. Heterologous dosing regimens were administered to 1,063,079 individuals (0.7% of those receiving the first dose). CONCLUSIONS The COVID-19 vaccination program reached more than two-thirds of the population in Brazil by 9 months after its start, but the vaccination coverage was heterogeneous, reflecting the country's geographic and socio-demographic characteristics. Establishing priority groups for vaccination was a main characteristic of the vaccination strategy. In addition, technology transfer agreements have played an important role in increasing vaccine accessibility.
Collapse
Affiliation(s)
- Igor Age Kos
- Edumed Educação em Saúde, 2495 Bispo Dom José Street, Curitiba 80440-080, Brazil; (I.A.K.)
- Department of Internal Medicine I, Hematology, Oncology and Rheumatology, Saarland University Medical Center, Kirrbergstr. 100, 66424 Homburg, Germany
| | - Faissal Nemer Hajar
- Edumed Educação em Saúde, 2495 Bispo Dom José Street, Curitiba 80440-080, Brazil; (I.A.K.)
| | | | - Claudia Corte
- AstraZeneca Brazil, Raposo Tavares Road, KM 26.9, Cotia 06709-000, Brazil
| | | | - André Santa Maria
- AstraZeneca Brazil, Raposo Tavares Road, KM 26.9, Cotia 06709-000, Brazil
| | - Douglas Valverde
- Techtrials, Dr. Ovídio Pires de Campos Street, São Paulo 05403-010, Brazil
| | | | - Miguel Morita Fernandes-Silva
- Edumed Educação em Saúde, 2495 Bispo Dom José Street, Curitiba 80440-080, Brazil; (I.A.K.)
- Department of Internal Medicine, Federal University of Paraná, Rua General Carneiro, 181, 10° Andar, Alto da Glória, Curitiba 80060-900, Brazil
| | - Valderilio Feijó Azevedo
- Edumed Educação em Saúde, 2495 Bispo Dom José Street, Curitiba 80440-080, Brazil; (I.A.K.)
- Department of Internal Medicine, Federal University of Paraná, Rua General Carneiro, 181, 10° Andar, Alto da Glória, Curitiba 80060-900, Brazil
| |
Collapse
|
6
|
Khanam M, Jahan NA. Determinants of Full Vaccination Coverage among Children Aged 12-23 Months in Bangladesh: A Comparison between High- and Low-Performing Divisions. Int J Pediatr 2024; 2024:7787593. [PMID: 38779618 PMCID: PMC11111301 DOI: 10.1155/2024/7787593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 10/21/2023] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction A better understanding of the significant factors behind childhood vaccination is important for designing strategies to increase vaccination coverage and reduce child mortality and morbidity. The study is aimed at identifying the determinants of full vaccination coverage among children aged 12-23 months in Bangladesh and at comparing the determinants between high- and low-performing areas. Methods This study used the latest available Bangladesh Demographic and Health Survey 2017-18 data. A weighted sample of 1678 children was included in this study. The association between full vaccination coverage and explanatory variables was identified using chi-square test. Multivariable logistic regression analysis was employed to identify associated factors of full vaccination coverage. Results Findings showed that about 88% of the children had full vaccination coverage. The odds of full vaccination coverage was significantly higher among children of mothers with secondary education compared to children of mothers with no formal education (AOR = 2.07, 95%CI = 1.16 to 3.70). Mother's working status was another significant factor behind full vaccination coverage (AOR = 1.53, 95%CI = 1.002 to 2.34). In addition, we identified that higher age of mother (AOR = 2.76, 95%CI = 1.28 to 5.96 for 20-34 years group and AOR = 12.14, 95%CI = 1.21 to 122.41 for 35 and above age group) and being in middle-income household (AOR = 4.66, 95%CI = 1.33 to 16.34) were significantly associated with full vaccination coverage in high-performing areas. On the other hand, children of mothers with secondary education level (AOR = 2.31, 95%CI = 1.86 to 4.49) and exposure to media (AOR = 1.58, 95%CI = 1.001 to 2.50) had higher odds of having full vaccination coverage in low-performing areas. Conclusions This study identified the associated factors of full vaccination coverage among children. The findings indicate the importance of maternal education and mothers' employment for children's vaccination uptake. In low-performing areas, investment in education and awareness raising initiatives may play instrumental role in achieving full vaccination coverage.
Collapse
Affiliation(s)
- Moriam Khanam
- Institute of Health Economics, University of Dhaka, Dhaka 1000, Bangladesh
| | - Nahid Akhter Jahan
- Institute of Health Economics, University of Dhaka, Dhaka 1000, Bangladesh
| |
Collapse
|
7
|
Osman MA, Waits A, Chien LY. Factors Associated with Vaccination Coverage among 0-59-Month-Old Children: A Multilevel Analysis of the 2020 Somaliland Demographic and Health Survey. Vaccines (Basel) 2024; 12:509. [PMID: 38793760 PMCID: PMC11125891 DOI: 10.3390/vaccines12050509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/03/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
Globally, there has been little growth in vaccination coverage, with countries in the Horn of Africa having the lowest vaccination rates. This study investigated factors associated with vaccination status among children under five years old in Somaliland. The 2020 Somaliland Demographic and Health Survey surveyed women aged 15-49 years from randomly selected households. This multilevel analysis included 2673 primary caregivers of children under five. Only 34% of children were ever vaccinated. Childhood vaccination coverage was positively associated with high-budget regions, high healthcare facility density, and children older than 23 months. Vaccination coverage was greater for urban and rural residents than for nomadic people. Children whose mothers could read part of one sentence or one complete sentence were more likely to be vaccinated than illiterate mothers. Children whose mothers received antenatal care (ANC) once, two to three times, or four times or more were more likely to be vaccinated than those whose mothers received no ANC. Childhood vaccination coverage in Somaliland is low. Promoting maternal ANC visits and increasing women's literacy may enhance vaccination coverage. Funds should be allocated to areas with low resources, particularly for nomadic people, to boost vaccination uptake.
Collapse
Affiliation(s)
- Mohamed Abdalle Osman
- International Health Program, Yang-Ming Campus, National Yang Ming Chiao Tung University, Taipei City 112304, Taiwan;
- Faculty of Health Sciences, Sanaag University, Erigavo, Somaliland
| | - Alexander Waits
- Institute of Public Health, Yang-Ming Campus, National Yang Ming Chiao Tung University, Taipei City 112304, Taiwan;
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, Yang-Ming Campus, National Yang Ming Chiao Tung University, Taipei City 112304, Taiwan
| |
Collapse
|
8
|
Bhatt A, Monk V, Bhatti A, Eiden AL, Hermany L, Hansen N, Connolly MP, Baxter L, Vanderslott S, Mitrovich R, Slater R. Identifying factors that can be used to assess a country's readiness to deploy a new vaccine or improve uptake of an underutilised vaccine: a scoping review. BMJ Open 2024; 14:e080370. [PMID: 38719292 PMCID: PMC11086410 DOI: 10.1136/bmjopen-2023-080370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Identifying whether a country is ready to deploy a new vaccine or improve uptake of an existing vaccine requires knowledge of a diverse range of interdependent, context-specific factors. This scoping review aims to identify common themes that emerge across articles, which include tools or guidance that can be used to establish whether a country is ready to deploy a new vaccine or increase uptake of an underutilised vaccine. DESIGN Scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines. DATA SOURCES Embase, CINAHL, Cochrane Library, Google Scholar, MEDLINE, PsycINFO and Web of Science were searched for articles published until 9 September 2023. Relevant articles were also identified through expert opinion. ELIGIBILITY CRITERIA Articles published in any year or language that included tools or guidance to identify factors that influence a country's readiness to deploy a new or underutilised vaccine. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened records and performed data extraction. Findings were synthesised by conducting a thematic analysis. RESULTS 38 articles met our inclusion criteria; these documents were created using methodologies including expert review panels and Delphi surveys and varied in terms of content and context-of-use. 12 common themes were identified relevant to a country's readiness to deploy a new or underutilised vaccine. These themes were as follows: (1) legal, political and professional consensus; (2) sociocultural factors and communication; (3) policy, guidelines and regulations; (4) financing; (5) vaccine characteristics and supply logistics; (6) programme planning; (7) programme monitoring and evaluation; (8) sustainable and integrated healthcare provision; (9) safety surveillance and reporting; (10) disease burden and characteristics; (11) vaccination equity and (12) human resources and training of professionals. CONCLUSIONS This information has the potential to form the basis of a globally applicable evidence-based vaccine readiness assessment tool that can inform policy and immunisation programme decision-makers.
Collapse
Affiliation(s)
- Aomesh Bhatt
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Vaneesha Monk
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Amanda L Eiden
- Center for Observational and Real-World Evidence (CORE), Merck & Co Inc, North Wales, Pennsylvania, USA
| | | | | | | | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | | | | |
Collapse
|
9
|
Biks GA, Shiferie F, Tsegaye DA, Asefa W, Alemayehu L, Wondie T, Zelalem M, Lakew Y, Belete K, Gebremedhin S. High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis. BMC Public Health 2024; 24:592. [PMID: 38395877 PMCID: PMC10893596 DOI: 10.1186/s12889-024-18077-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Globally, according to the World Health Organization (WHO) 2023 report, more than 14.3 million children in low- and middle-income countries, primarily in Africa and South-East Asia, are not receiving any vaccinations. Ethiopia is one of the top ten countries contributing to the global number of zero-dose children. OBJECTIVE To estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia. METHODS A cross-sectional vaccine coverage survey was conducted in June 2022. The study participants were mothers of children aged 12-35 months. Data were collected using the CommCare application system and later analysed using Stata version 17. Vaccination coverage was estimated using a weighted analysis approach. A generalized estimating equation model was fitted to determine the predictors of zero-dose children. An adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of 0.05 or less was considered statistically significant. RESULTS The overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR = 2.78; 95% CI: 1.70, 4.53], poorer [AOR = 1.96; 95% CI: 1.02, 3.77]), single marital status [AOR = 2.4; 95% CI: 1.7, 3.3], and maternal age (15-24 years) [AOR = 1.2; 95% CI: 1.1, 1.3] were identified as key determinant factors of zero-dose children in the study settings. Additional factors included fewer than four Antenatal care visits (ANC) [AOR = 1.3; 95% CI: 1.2, 1.4], not receiving Postnatal Care (PNC) services [AOR = 2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR = 3.7; 95% CI: 2.6, 5.4], women-headed household [AOR = 1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR = 1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR = 1.7; 95% CI: 1.2, 2.5]. CONCLUSION In the study settings, the prevalence of zero-dose children is very high. Poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilizing antenatal or post-natal services are the important predictors. Therefore, it is recommended to target tailored integrated and context-specific service delivery approach. Moreover, extend immunization sessions opening hours during the evening/weekend in the city administrations to meet parents' needs.
Collapse
Affiliation(s)
| | | | | | | | | | - Tamiru Wondie
- Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Meseret Zelalem
- Maternal and Child Health, Minister of Health, Addis Ababa, Ethiopia
| | - Yohannes Lakew
- Maternal and Child Health, Minister of Health, Addis Ababa, Ethiopia
| | | | | |
Collapse
|
10
|
Abdilahi MM, Mohamed AI, Jonah KM, Ismail AS. Prevalence and factors associated with immunization coverage among children under five years in Mohamed Mooge health center, Hargeisa, Somaliland: a cross-sectional study. BMC Pediatr 2023; 23:545. [PMID: 37904092 PMCID: PMC10614313 DOI: 10.1186/s12887-023-04371-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 10/17/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Routine immunization contributes greatly to reduction in mortality from vaccine preventable diseases among children. The Somaliland Demographic and Health survey, 2020 revealed that only 13.7% of children in Marodijeh (Hargeisa) region had received all recommended vaccines, which is far below the World Health Organization (WHO) target of 80%. We therefore, assessed factors associated with immunization coverage among children under five years at Mohamed Mooge Health Center in Hargeisa, Somaliland. METHODS Institutional based cross-sectional study was conducted on 174 systematically sampled, consented mothers that visited Mohamed Mooge Health Center for antenatal care during December 2022 to May 2023. Data was collected using a structured questionnaire. Data was analysed using SPSS and the relationship between dependent and independent variables was checked chi-square test at p ≤ 0.05. Finally, candidate variables were tested by using multivariate logistic regression in order to control potential confounders and the result was presented using AOR and 95% confidence interval. Model fitness was checked using Hosmer-Lemeshaw goodness of fit test with P > 0.05 for fitness. Multicollinearity between variables was checked using correlation coefficients at 0.80 or higher. RESULT: Among 174 study participants, the prevalence of overall vaccine completion in this study was 55.3%. Women who had being aware about childhood immunization on BCG vaccination (AOR = 3.887; 95% CI: 1.275, 6.844), pentavalent (AOR = 11.385; 95% CI: 5.424-14.464), and measles (AOR = 3.074; 95% CI: 1.822-6.130) had higher odds of having immunized their children. Mothers who had employment had higher odds of having their children immunized against measles (AOR = 4.069; 95% CI: 1.822-6.130) compared to those who had not. CONCLUSIONS Full immunization coverage was lower than the target set by the World Health Organization in this study area. The current study revealed that, the mother's awareness of childhood vaccinations on BCG, pentavalent, measles and employment status of mothers were positively associated with immunization coverage. To promote vaccination coverage, the government should implement a national awareness campaign on childhood immunization and increase the number of outreach services.
Collapse
Affiliation(s)
| | - Ahmed Ismail Mohamed
- College of Medicine and Health Science, University of Hargeisa, Hargeisa, Somaliland
| | - Kiruja M Jonah
- College of Medicine and Health Science, University of Hargeisa, Hargeisa, Somaliland
| | | |
Collapse
|
11
|
Lawal TV, Atoloye KA, Adebowale AS, Fagbamigbe AF. Spatio-temporal analysis of childhood vaccine uptake in Nigeria: a hierarchical Bayesian Zero-inflated Poisson approach. BMC Pediatr 2023; 23:493. [PMID: 37773112 PMCID: PMC10540393 DOI: 10.1186/s12887-023-04300-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Globally, child mortality and morbidity remain a serious health challenge and infectious diseases are the leading causes. The use of count models together with spatial analysis of the number of doses of childhood vaccines taken is limited in the literature. We used a Bayesian zero-inflated Poisson regression model with spatio-temporal components to assess the number of doses of childhood vaccines taken among children aged 12-23 months and their associated factors. METHODS Data of 19,564 children from 2003, 2008, 2013 and 2018 population-based cross-sectional Nigeria Demographic and Health Survey were used. The childhood vaccines include one dose of Bacillus-Calmette-Guérin; three doses of Diphtheria-Pertussis-Tetanus; three doses of Polio and one dose of Measles. Uptake of all nine vaccines was regarded as full vaccination. We examined the multilevel factors associated with the number of doses of childhood vaccines taken using descriptive, bivariable and multivariable Bayesian models. Analysis was conducted in Stata version 16 and R statistical packages, and visualization in ArcGIS. RESULTS The prevalence of full vaccination was 6.5% in 2003, 14.8% in 2008, 21.8% in 2013 and 23.3% in 2018. Full vaccination coverage ranged from 1.7% in Sokoto to 51.9% in Anambra. Factors associated with the number of doses of childhood vaccines taken include maternal age (adjusted Incidence "risk" Ratio (aIRR) = 1.05; 95% Credible Interval (CrI) = 1.03-1.07) for 25-34 years and (aIRR = 1.07; 95% CrI = 1.05-1.10) for 35-49 years and education: (aIRR = 1.11, 95% CrI = 1.09-1.14) for primary and (aIRR = 1.16; 95% CrI = 1.13-1.19) for secondary/tertiary education. Other significant factors are wealth status, antenatal care attendance, working status, use of skilled birth attendants, religion, mother's desire for the child, community poverty rate, community illiteracy, and community unemployment. CONCLUSION Although full vaccination has remained low, there have been improvements over the years with wide disparities across the states. Improving the uptake of vaccines by educating women on the benefits of hospital delivery and vaccines through radio jingles and posters should be embraced, and state-specific efforts should be made to address inequality in access to routine vaccination in Nigeria.
Collapse
Affiliation(s)
- Temitayo Victor Lawal
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, FCT Nigeria
| | - Kehinde Adebola Atoloye
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- Viable Knowledge Masters, Abuja, FCT Nigeria
- Viable Helpers Development Organization, Abuja, FCT Nigeria
| | - Ayo Stephen Adebowale
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- Population and Health Research Entity, Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- Division of Population and Behavioural Science, School of Medicine, Health Data Science Unit, University of St Andrews, St Andrews, UK
- Institute of Applied Health Sciences, School of Medicine, Medicinal Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- Research Methods and Evaluation Unit, Institute for Health & Wellbeing, Coventry University, Coventry, UK
| |
Collapse
|
12
|
Frozanfar MK, Hamajima N, Fayaz SH, Rahimzad AD, Stanekzai H, Inthaphatha S, Nishino K, Yamamoto E. Factors associated with pentavalent vaccine coverage among 12-23-month-old children in Afghanistan: A cross-sectional study. PLoS One 2023; 18:e0289744. [PMID: 37552707 PMCID: PMC10409276 DOI: 10.1371/journal.pone.0289744] [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: 11/01/2022] [Accepted: 07/25/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION This study aimed to identify the factors associated with the coverage of the third dose of pentavalent vaccine (Penta3) among children aged 12-23 months in Afghanistan. METHODS The data of 3,040 children aged 12-23 months were taken from the Afghanistan Health Survey 2018, including characteristics of the children and their households, household heads, and mothers/primary care givers. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using a logistic model. Multivariable stepwise logistic regression analysis with forward-selection (Model 1) and backward-selection (Model 2) was performed using variables that showed significant differences by bivariate analysis. RESULTS The coverage of Penta3 among 12-23-month-old children was 82.3%. Factors associated with Penta3 coverage in the two models of multivariable analysis were 18-23 months old compared to 12-17 months old; having no diarrhea in the last two weeks compared to having diarrhea; no bipedal edema compared to having edema; taking vitamin A supplement; 1-2 children under five years in a household compared to three or more; distance from residence to the nearest health facility ≤2 hours on foot; having a radio; having a TV; educated heads of households; non-smoking of heads of households; and literacy of mothers/primary caregivers. CONCLUSIONS Penta3 coverage among 12-23-month-old children improved but was still lower than the target. Primary education should be provided to all children throughout the country. TV and radio are useful tools for providing health information. Mobile outreach programs and the establishment of new health facilities should be promoted to improve access to health service for all people in Afghanistan.
Collapse
Affiliation(s)
- Muhammad Kamel Frozanfar
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Healthcare-Associated Infections and Antimicrobial Resistance Program, Office of Epidemiology, Virginia Department of Health, Richmond, Virginia, United States of America
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Said Hafizullah Fayaz
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland, United States of America
| | - Abdullah Darman Rahimzad
- Department of Ear, Nose and Throat, Balkh University Faculty of Medicine, Mazar-i-Sharif, Balkh, Afghanistan
| | | | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kimihiro Nishino
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| |
Collapse
|
13
|
Fagbamigbe AF, Lawal TV, Atoloye KA. Evaluating the performance of different Bayesian count models in modelling childhood vaccine uptake among children aged 12-23 months in Nigeria. BMC Public Health 2023; 23:1197. [PMID: 37344872 DOI: 10.1186/s12889-023-16155-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/20/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Choosing appropriate models for count health outcomes remains a challenge to public health researchers and the validity of the findings thereof. For count data, the mean-variance relationship and proportion of zeros is a major determinant of model choice. This study aims to compare and identify the best Bayesian count modelling technique for the number of childhood vaccine uptake in Nigeria. METHODS We explored the performances of Poisson, negative binomial and their zero-inflated forms in the Bayesian framework using cross-sectional data pooled from the Nigeria Demographic and Health Survey conducted between 2003 and 2018. In multivariable analysis, these Bayesian models were used to identify factors associated with the number of vaccine uptake among children. Model selection was based on the -2 Log-Likelihood (-2 Log LL), Leave-One-Out Cross-Validation Information Criterion (LOOIC) and Watanabe-Akaike/Widely Applicable Information Criterion (WAIC). RESULTS Exploratory analysis showed the presence of excess zeros and overdispersion with a mean of 4.36 and a variance of 12.86. Observably, there was a significant increase in vaccine uptake over time. Significant factors included the mother's age, level of education, religion, occupation, desire for last-child, place of delivery, exposure to media, birth order of the child, wealth status, number of antenatal care visits, postnatal attendance, healthcare decision maker, community poverty, community illiteracy, community unemployment, rural proportion and number of health facilities per 100,000. The zero-inflated negative binomial model was best fit with -2Log LL of -27171.47, LOOIC of 54464.2, and WAIC of 54588.0. CONCLUSION The Bayesian zero-inflated negative binomial model was most appropriate to identify factors associated with the number of childhood vaccines received in Nigeria due to the presence of excess zeros and overdispersion. Improving vaccine uptake by addressing the associated risk factors should be promptly embraced.
Collapse
Affiliation(s)
- A F Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - T V Lawal
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.
| | - K A Atoloye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
14
|
Atteraya MS, Song IH, Ebrahim NB, Gnawali S, Kim E, Dhakal T. Inequalities in Childhood Immunisation in South Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1755. [PMID: 36767118 PMCID: PMC9914161 DOI: 10.3390/ijerph20031755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Identifying the inequalities associated with immunisation coverage among children is crucial. We investigated the factors associated with complete immunisation among 12- to 23-month-old children in five South Asian countries: Afghanistan, Bangladesh, India, Nepal, and Pakistan, using nationally representative data sets from the Demographic and Health Survey (DHS). Descriptive statistics, bivariate association, and logistic regression analyses were employed to identify the prevalence and the factors in each country that affect the likelihood of full childhood immunisation coverage. The complete childhood immunisation coverage varied significantly within each country in South Asia. Afghanistan had the lowest immunisation rates (42.6%), whereas Bangladesh ranked the highest in complete childhood immunisation rates, at 88.2%. Similarly, 77.1% of Indian children, 79.2% of Nepali children, and 62.2% of Pakistani children were completely immunised. Household wealth status strongly correlated with full childhood immunisation in Afghanistan, India, and Pakistan at the bivariate level. The results from the logistic regression showed that a higher maternal educational level had a statistically significant association with complete childhood immunisation in all countries compared to mothers who did not attend any school. In conclusion, the study revealed the inequalities of complete childhood immunisation within South Asia. Governments must be proactive in their endeavours to address universal and equitable vaccine coverage in collaboration with national and international stakeholders and in line with the relevant Sustainable Development Goals.
Collapse
Affiliation(s)
| | - In Han Song
- Department of Social Welfare, Yonsei University, Seoul 03722, Republic of Korea
| | - Nasser B. Ebrahim
- Department of Public Health, Keimyung University, Daegu 42601, Republic of Korea
| | - Shreejana Gnawali
- International Affairs Team, Keimyung University, Daegu 42601, Republic of Korea
| | - Eungi Kim
- Department of Library and Information Science, Keimyung University, Daegu 42601, Republic of Korea
| | - Thakur Dhakal
- Department of Life Science, Yeungnam University, Gyeongsan 38541, Republic of Korea
| |
Collapse
|
15
|
Tesfa GA, Yehualashet DE, Getnet A, Bimer KB, Seboka BT. Spatial distribution of complete basic childhood vaccination and associated factors among children aged 12-23 months in Ethiopia. A spatial and multilevel analysis. PLoS One 2023; 18:e0279399. [PMID: 36608032 PMCID: PMC9821487 DOI: 10.1371/journal.pone.0279399] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/07/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Complete childhood vaccination considerably aids in the reduction of morbidity and mortality from vaccine-preventable childhood diseases. Understanding the geographical disparity of complete basic childhood vaccination and Identifying associated factors is vital to designing appropriate interventions. This study aimed to assess the spatial distribution and associated factors of complete basic childhood vaccination among children aged 12-23 months in Ethiopia. METHODS A two-stage stratified sampling technique was used based on the 2019 Ethiopian mini demographic and health survey data. A total weighted sample of 1,028 children was included in the analysis. ArcGIS version 10.8 software was used to visualize the spatial distribution of complete basic childhood vaccination. The Bernoulli-based model was used to detect significant clusters of areas using SaTScan version 9.6 software. To identify associated factors, multilevel logistic regression analyses were used, and all variables with a p-value less than 0.05 were reported as statistically significant predictors. RESULTS Complete basic childhood vaccination among children aged 12-23 months had a significant variation in Ethiopia (Moran's I = 0.276, p<0.001). The spatial scan analysis identified the most likely significant primary clusters with low complete basic childhood vaccination coverage in the Somali region's Afder, Liben, Shabelle, and Nogobe zones; the Southern Nation Nationality and Peoples Region's (SNNPR) Gedeo and Sidama zones; and the Oromia region's Bale and Guji zones. The second significant cluster was found in the Afar region's zones 1, 4, and 5, as well as the northern Somali region's Siti zone. In the multivariable multilevel analysis, maternal age 20-24, 25-29, 35-39, and 40-44 years, delivery at a health facility, four or more antenatal care (ANC) visits, orthodox religion fellowship, maternal primary education, Muslim religion fellowship, living in the Afar, Somalia, and Oromia regions, and living in rural areas were all found to be significantly associated with complete basic childhood vaccination. CONCLUSION A geographically significant variation of complete basic childhood vaccination was observed. Maternal age, maternal education, religion, place of delivery, ANC visit, region, and residence were significantly associated with complete basic childhood vaccination. Developing immunization campaigns targeting areas that had low basic vaccination coverage and designing healthcare programs that can motivate facility-based delivery and ANC follow-up is recommended.
Collapse
Affiliation(s)
- Getanew Aschalew Tesfa
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
- * E-mail:
| | | | - Addisu Getnet
- Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Kirubel Biweta Bimer
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Binyam Tariku Seboka
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| |
Collapse
|
16
|
Nchinjoh SC, Saidu Y, Agbor VN, Mbanga CM, Jude Muteh N, Njoh AA, Ndoula ST, Nsah B, Edwige NN, Roberman S, Zamir CS. Factors Associated with Zero-Dose Childhood Vaccination Status in a Remote Fishing Community in Cameroon: A Cross-Sectional Analytical Study. Vaccines (Basel) 2022; 10:vaccines10122052. [PMID: 36560465 PMCID: PMC9784537 DOI: 10.3390/vaccines10122052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Cameroon's suboptimal access to childhood vaccinations poses a significant challenge to achieving the Immunization Agenda 2030 goal-ranking among the top 15 countries with a high proportion of zero-dose (unvaccinated) children worldwide. There are clusters of zero-dose children in pockets of communities that traditionally miss essential healthcare services, including vaccination. The Manoka Health District (MHD) is home to such settlements with consistently low vaccination coverages (DPT-HepB-Hib-1: 19.8% in 2021) and frequent outbreaks of vaccine-preventable diseases (VPD). Therefore, the absence of literature on zero-dose children in this context was a clarion call to characterize zero-dose children in fragile settings to inform policy and intervention design. Methodology: This cross-sectional analytical study involved 278 children, 0-24 months of age, selected from a 2020 door-to-door survey conducted in the two most populous health areas in an archipelago rural district, MHD (Cap-Cameroon and Toube). We used R Statistical Software (v4.1.2; R Core Team 2021) to run a multivariable logistic regression to determine zero-dose associated factors. Results: The survey revealed a zero-dose proportion of 91.7% (255) in MHD. Children who were delivered in health facilities were less likely to be zero-dose than those born at home (AOR: 0.07, 95% CI: 0.02-0.30, p = 0.0003). Compared to children born of Christian mothers, children born to minority non-Christian mothers had higher odds of being zero-dose (AOR: 6.55, 95% CI: 1.04-41.25, p = 0.0453). Children born to fathers who are immigrants were more likely to be zero-dose children than Cameroonians (AOR: 2.60, 95% CI = 0.65-10.35, p = 0.0016). Younger children were likely to be unvaccinated compared to older peers (AOR: 0.90, 95% CI: 0.82-1.00, p = 0.0401). Conclusions: In the spirit of "leaving no child behind," the study highlights the need to develop context-specific approaches that consider minority religious groups, immigrants, and younger children, including newborns, often missed during vaccination campaigns and outreaches.
Collapse
Affiliation(s)
- Sangwe Clovis Nchinjoh
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +237-678-687-939
| | - Yauba Saidu
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Institute for Global Health, University of Siena, 53100 Siena, Italy
| | - Valirie Ndip Agbor
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | | | | | - Andreas Ateke Njoh
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé P.O. Box 2084, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui BP 157, Central African Republic
| | - Shalom Tchofke Ndoula
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé P.O. Box 2084, Cameroon
| | - Bernard Nsah
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
| | | | - Sveta Roberman
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
- The Gordon Academic College of Education, Haifa 3570503, Israel
| | - Chen Stein Zamir
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
| |
Collapse
|
17
|
Fenta SM, Ayenew GM, Fenta HM, Biresaw HB, Fentaw KD. Community and individual level determinants of infant mortality in rural Ethiopia using data from 2016 Ethiopian demographic and health survey. Sci Rep 2022; 12:16879. [PMID: 36207579 PMCID: PMC9546827 DOI: 10.1038/s41598-022-21438-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
The infant mortality rate remains unacceptably high in sub-Saharan African countries. Ethiopia has one of the highest rates of infant death. This study aimed to identify individual-and community-level factors associated with infant death in the rural part of Ethiopia. The data for the study was obtained from the 2016 Ethiopian Demographic and Health Survey. A total of 8667 newborn children were included in the analysis. The multilevel logistic regression model was considered to identify the individual and community-level factors associated with new born mortality. The random effect model found that 87.68% of the variation in infant mortality was accounted for by individual and community level variables. Multiple births (AOR = 4.35; 95%CI: 2.18, 8.69), small birth size (AOR = 1.29; 95%CI: 1.10, 1.52), unvaccinated infants (AOR = 2.03; 95%CI: 1.75, 2.37), unprotected source of water (AOR = 1.40; 95%CI: 1.09, 1.80), and non-latrine facilities (AOR = 1.62; 95%CI: 1.20) were associated with a higher risk of infant mortality. While delivery in a health facility (AOR = 0.25; 95%CI: 0.19, 0.32), maternal age 35–49 years (AOR = 0.65; 95%CI: 0.49, 0.86), mothers receiving four or more TT injections during pregnancy (AOR = 0.043, 95% CI: 0.026, 0.071), and current breast feeders (AOR = 0.33; 95% CI: 0.26, 0.42) were associated with a lower risk of infant mortality. Furthermore, Infant mortality rates were also higher in Afar, Amhara, Oromia, Somalia, and Harari than in Tigray. Infant mortality in rural Ethiopia is higher than the national average. The government and other concerned bodies should mainly focus on multiple births, unimproved breastfeeding culture, and the spacing between the orders of birth to reduce infant mortality. Furthermore, community-based outreach activities and public health interventions focused on improving the latrine facility and source of drinking water as well as the importance of health facility delivery and received TT injections during the pregnancy.
Collapse
Affiliation(s)
- Setegn Muche Fenta
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Girum Meseret Ayenew
- Research and Technology Transfer Directorate, Amhara Public Health Institute, P.O. Box 477, Bahir Dar, Ethiopia
| | - Haile Mekonnen Fenta
- Department of Statistics, College of Science, Bahir DarUniversity, Bahir Dar, Ethiopia
| | - Hailegebrael Birhan Biresaw
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kenaw Derebe Fentaw
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
18
|
High rates of COVID-19 vaccine refusal among Afghan pregnant women: a cross sectional study. Sci Rep 2022; 12:14057. [PMID: 35982167 PMCID: PMC9387420 DOI: 10.1038/s41598-022-18497-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 08/12/2022] [Indexed: 11/11/2022] Open
Abstract
Severe Acute Respiratory Syndrome Corona Virus Type-2 (SARS-COV-2) was first detected in China and created a global pandemic rapidly. Subsequently after serious efforts different types of vaccines produced against the virus and recommended for all people including pregnant women. The aim of this study was to realize the willingness of pregnant women to accept the COVID-19 vaccine in Kabul Afghanistan. For this purpose, a cross-sectional study was conducted in gynecology wards of several hospitals in Kabul, Afghanistan from 10th of July to 20th of August 2021 through direct interview with the pregnant women who had come for prenatal care to the healthcare centers. The collected data were analyzed through Statistical Package for Social Studies (SPSS) version 25. Simple descriptive analysis computed for demographic characteristics and bi-variable (Chi-square) analysis was carried out to find out the associations of taking vaccine with demographic variables. A p-value of < 0.05 was considered significant at 95% confidence interval. A total of 491 who were completed the inclusion criteria included in the analysis. A small portion of pregnant women (8.6%) illustrated the intent to get the COVID-19 vaccine if it is recommended by the health authorities in Afghanistan. Our study found a high rate of COVID-19 vaccine refusal among pregnant women in Kabul, Afghanistan. They showed the concern on adverse effects of the vaccine as the main reason for refusal, emphasizing the need to reduce the misconception on vaccine efficacy and campaigns to enhance awareness on the vaccine safety and benefits for mothers and babies.
Collapse
|
19
|
Muluye M, Oljira L, Eyeberu A, Getachew T, Debella A, Deressa A, Dheresa M. Partial vaccination and associated factors among children aged 12-23 months in eastern Ethiopia. BMC Pediatr 2022; 22:268. [PMID: 35550040 PMCID: PMC9097114 DOI: 10.1186/s12887-022-03320-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Vaccine prevents about 2–3 million deaths from vaccine-preventable diseases each year. However, immunization coverage in Ethiopia is lower than the herd immunity level required to prevent the spread of all vaccine-preventable diseases. Thus, this study aimed to assess the partial immunization and associated factors among 12–23-month-old children in Eastern Ethiopia. Method A community-based cross-sectional study design was carried out among 874 randomly selected mothers/caregivers of children aged 12–23 months. A structured questionnaire was adapted and data were collected through face-to-face interviews and review of vaccination cards. Data were coded and analyzed using the Stata version 14 software. A binary logistic regression model was utilized to identify the determinant factors. The predictor of partial immunization was presented by an adjusted odds ratio with a 95% confidence interval. A p-value of < 0.05 was used to establish statistical significance. Result The prevalence of partial immunization was 31.4% (95% CI: 28–35). The dropout rate between the first and third pentavalent vaccine was 17%. Being female child [AOR = 0.73, 95% CI: 0.52–0.95], 18–20 month child [AOR = 1.6, 95% CI: 1.1- 2.4], the child born to mothers who heard about vaccination [AOR = 3.9, 95%CI: 1.92- 8.01], a child born to mother who did not receive immunization counselling [AOR = 1.65, 95%CI: 1.15–2.36], and child whose mother walk 15–30 min, 31–60 min, and > 60 min to reach nearby health facilities [AOR = 1.94, 95% CI: 1.1–3.45], [AOR = 4.5, 95% CI: 2.47–8.15], and [AOR = 3.45, 95% CI: 1.59- 7.48] respectively were factors significantly associated with partial vaccination. Conclusions The prevalence of partial immunization is high compared to other studies. As a result, to decrease the proportion of defaulters and to increase immunization coverage, maternal health care utilization like antenatal care follow-up and mother knowledge about the importance of the vaccine need to be sought cautiously.
Collapse
Affiliation(s)
- Menberu Muluye
- Haramaya Health Office in Haramaya, East Hararge Zone, Oromia region, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
20
|
Vaccination status and factors associated among children age 12–23 months in Ethiopia, based on 2016 EDHS: Logit based multinomial logistic regression analysis. PLoS One 2022; 17:e0264004. [PMID: 35213589 PMCID: PMC8880646 DOI: 10.1371/journal.pone.0264004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Childhood immunization is one of the most cost-effective prevention measures for children’s mortality and morbidity, saving 2–3 million lives per year. In Ethiopia, under-five mortality rates, about 190,000 children die each year. Different research conducted in Ethiopia on childhood vaccination have focused on either vaccination coverage of individual vaccine or complete and incomplete vaccination. As far as my literature searching, studies separated the vaccination status into non-vaccinated, partially vaccinated and full vaccinated and assorted factors among children age 12–23 month in Ethiopia were limited. Therefore, the aim of this study was to identify factors associated with vaccination status among children 12–23 months of age in Ethiopia.
Method
A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1911 children age 12–23 months of age were included in the study. Logit based Multinomial logistic regression analysis was computed to distinguish factors associated with routine vaccination of children aged 12–23 months. P-value less than 0.05 was used to declare statistical significance of each independent variables, and adjusted odd ratio (AOR) with 95% confidence interval were used to present the result and STATA 14 was utilized for data management and analysis.
Result
Overall the prevalence of full vaccinated children was 35%, while 49% of children were partially vaccinated and 16% were non-vaccinated. In multinomial analysis, having focused ANC (at least four visits) contrasted to no ANC visits at all had 9.7 higher odd of being fully vaccinated than not vaccinated [AOR = 9.74, 95% CI = 3.52–26.94], and 5 times higher odd of being partially vaccinated than not vaccinated [AOR = 4.97, 95% CI = 2.00–12.33].
Conclusion
The present study found that childhood full vaccination status was low compared with the World Health Organization targets. Frequency of ANC visit and visited by field worker were significantly associated both partially and full vaccination whereas, visited health facility last 12 months and wealth status were significantly associated with childhood full vaccination.
Collapse
|
21
|
Faradita I, Sitaresmi MN, Wahab A. Association between Maternal Health Care and Basic Immunization Completeness in Children Aged 12–23 Months: Analysis of 2017 Indonesian Demographic and Health Survey. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The coverage of complete basic immunization in Indonesia is still lower than the target stated in the 2015-2019 Ministry of Health Strategic Plan. It may be caused by several factors, one of the essential factors is maternal health services.
AIM: The study aims to assess the association between maternal health services and immunization completeness in Indonesian children aged 12–23 months.
METHODS: A cross-sectional design was conducted using the 2017 Indonesian Demographic Health Survey. Two-stage stratified random sampling was used to obtain representative samples from all provinces in Indonesia. The subjects of this study were mothers who had children aged 12–23 months. A total of 3,398 samples were obtained after considering the inclusion and exclusion criteria. The data were analyzed using chi-square and logistic regression.
RESULTS: The prevalence of complete immunization of Indonesian children aged 12–23 months was 61.4%. From multivariate analysis, we found that mothers who attend more than four antenatal care (ANC) (Adjusted odds ratio [AOR] 3.23 95% Confidence interval [CI] [2.31–4.52]), delivery by health-professionals (AOR 3.32 95%CI [2.26–4.88]), and attended postnatal care (PNC) (AOR 1.31 95% CI [1.07–1.59]) were predictors of complete child immunization. In addition, children whose mothers had a higher educational level and who live in Java-Bali were more likely to be completely vaccinated.
CONCLUSION: Maternal health services, which consist of ANC services, delivery by health workers, and PNC services, were associated with the completeness of basic immunization in Indonesian children aged 12–23 months. Strategies to improve immunization coverage must be carried out by increasing the continuity of maternal health services since pregnancy, childbirth, and postpartum.
Collapse
|
22
|
Tesfa GA, Demeke AD, Hailegebreal S, Amede ES, Ngusie HS, Kasie MN, Seboka BT. Spatial distribution and associated factors of measles vaccination among children aged 12-23 months in Ethiopia. A spatial and multilevel analysis. Hum Vaccin Immunother 2022; 18:2035558. [PMID: 35148252 PMCID: PMC9009933 DOI: 10.1080/21645515.2022.2035558] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION In Ethiopia, measles continues to be the cause of a significant number of vaccine-preventable infant morbidity and mortality due to the low vaccination rate. However, understanding the geographical distribution of the measles-containing vaccine first dose (MCV1) and identifying associated factors is crucial to setting up appropriate interventions. This study aimed to explore the spatial distribution and associated factors of MCV1 coverage among children aged 12-23 months in Ethiopia using national representative data. METHODS A cross-sectional study design using a two-stage stratified sampling technique was used. The analysis was performed using STATA 14.2, ArcGIS 10.8, and SaTScan version 9.6 software. To find significant related factors with measles vaccination, researchers used multilevel logistic regression. RESULTS The prevalence of MCV1 in Ethiopia was 58.5%. A spatial variation of MCV1 coverage was observed across the study area. The most likely significant primary clusters with low MCV1 coverage were observed in Liben, Afder, Shebelle, Korahe, and Nogob zones of the Somali region; Bale and Guji zones of the Oromia region, and Gedeo and Sidama zones of the SNNPR. Rural areas, maternal primary education, secondary and above school education, Orthodox religion, Muslim religion, health facility delivery, and Afar region were significantly associated with MCV1 vaccination. CONCLUSION The overall MCV1 coverage in Ethiopia was low. Aside from the inadequate coverage, there was a geographical variation across the country. Low MCV1 coverage areas should be prioritized to improve vaccination efforts to control measles across the country.
Collapse
Affiliation(s)
- Getanew Aschalew Tesfa
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Abel Desalegn Demeke
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Samuel Hailegebreal
- Department of Health Informatics, College of Health Science and Medicine, Arba Minch University, Arba Minch, Ethiopia
| | - Endris Seid Amede
- Department of Psychiatry, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Habtamu Setegn Ngusie
- Department of Health Informatics, College of Health Science and Medicine, Mettu University, Mettu, Ethiopia
| | - Mequanint Nakachew Kasie
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Binyam Tariku Seboka
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| |
Collapse
|
23
|
Olakunde BO, Adeyinka DA, Olakunde OA, Ogundipe T, Oladunni F, Ezeanolue EE. The coverage of hepatitis B birth dose vaccination in Nigeria: Does the place of delivery matter? Trans R Soc Trop Med Hyg 2021; 116:359-368. [PMID: 34453162 DOI: 10.1093/trstmh/trab129] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/09/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hepatitis B birth dose (HepB-BD) vaccination coverage remains suboptimal in Nigeria. While evidence suggests that institutional delivery is associated with the uptake of HepB-BD vaccine, little is known about how the uptake differs by facility ownership (public or private). This study examined the HepB-BD vaccination coverage by place of delivery in Nigeria. METHODS This study is a secondary analysis of data on 6143 children aged 12-23 mo obtained from the 2018 Nigeria Demographic and Health Survey. We assessed the association between HepB-BD vaccination and the place of delivery using logistic regression models. RESULTS About 53% of the children received the HepB-BD vaccine. Approximately 77, 83 and 33% of those delivered at a public health facility, private health facility and at home received the HepB-BD vaccine, respectively. After controlling for child- and maternal-level factors, the odds of receiving HepB-BD vaccine were significantly lower in children delivered at a private health facility (adjusted OR [aOR]=0.77, 95% CI 0.59 to 0.99) or at home (aOR=0.48, 95% CI 0.36 to 0.63). Wealth index and region of residence were significantly associated with the receipt of HepB-BD vaccination in all three places of delivery. CONCLUSIONS Children are less likely to receive the HepB-BD vaccine if they are delivered at a private health facility or at home. There is a need for private health sector engagement for immunization service delivery and innovative community-based interventions to reach the children delivered at home.
Collapse
Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja 900284, Nigeria.,Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu 410101, Nigeria
| | - Daniel A Adeyinka
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon SK S7B 5E5, Canada.,Department of Public Health, National AIDS and STI Control Programme, Federal Ministry of Health, Abuja 900211, Nigeria
| | - Olubunmi A Olakunde
- Department of Disease Control and Immunization, Ondo State Primary Health Care Development Agency, Akure, Ondo 340222, Nigeria
| | - Temitayo Ogundipe
- Department of Hospital Medicine, Sentara Williamsburg Regional Medical Center, VA 23188, USA
| | - Filani Oladunni
- Department of Community and Family Medicine, Howard University Hospital, Washington, DC 20060, USA
| | - Echezona E Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu 410101, Nigeria.,Healthy Sunrise Foundation, NV 89107, USA
| |
Collapse
|
24
|
Nemat A, Bahez A, Salih M, Raufi N, Noor NAS, Essar MY, Ehsan E, Asady A. Public Willingness and Hesitancy to Take the COVID-19 Vaccine in Afghanistan. Am J Trop Med Hyg 2021; 105:713-717. [PMID: 34237016 PMCID: PMC8592316 DOI: 10.4269/ajtmh.21-0231] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/29/2021] [Indexed: 11/23/2022] Open
Abstract
COVID-19 has been causing a global threat to almost all countries for more than one year. Vaccination of the majority of any country's population is considered to be an effective way of controlling the spread and mortality of this infection. Therefore, it is important to assess the public's willingness to be vaccinated against COVID-19. In this study, we evaluated the public willingness and hesitancy to take the vaccine in Afghanistan, during December 2020 and January 2021. Sociodemographic data, awareness on vaccine production, vaccine availability, willingness and hesitancy to take the COVID-19 vaccine were collected. The Statistical Package for Social Studies (SPSS) version 25 was used for data analysis. A total of 806 complete responses were received. Majority of the respondents were ≤ 40 years old (89.8%) and male (72.7%). Less than two-thirds (509; 63%) of the participants reported willingness to take the vaccine when it becomes available, whereas almost one-third (297; 37%) of them were hesitant to take the COVID-19 vaccine. More female than male respondents were willing to take the vaccine (χ2 = 13.176, P value = 0.001). A significant portion of the public were not willing to take the COVID-19 vaccine. In a country like Afghanistan, which already has a low coverage of vaccination, this could pose a challenge for the vaccination program against COVID-19 to be effective. The Ministry of Public Health should work on public trust and change people's mindset about vaccine reality and efficacy to prevent the rejection of this health intervention.
Collapse
Affiliation(s)
- Arash Nemat
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ayesha Bahez
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Mohibullah Salih
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Nahid Raufi
- Department of Dermatology, Kabul University of Medical Sciences, Kabul, Afghanistan
- Department of Dermatology, Guangdong Provincial Dermatology Hospital, Southern Medical University, Guangzhou, China
| | | | - Mohammad Yasir Essar
- Faculty of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Ehsanullah Ehsan
- Department of Dermatology, Alberoni University, Kapisa, Afghanistan
| | - Abdullah Asady
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Fenta SM, Biresaw HB, Fentaw KD, Gebremichael SG. Determinants of full childhood immunization among children aged 12-23 months in sub-Saharan Africa: a multilevel analysis using Demographic and Health Survey Data. Trop Med Health 2021; 49:29. [PMID: 33795028 PMCID: PMC8017626 DOI: 10.1186/s41182-021-00319-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/23/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa is one of the highest under-five mortality and low childhood immunization region in the world. Children in Sub-Saharan Africa are 15 times more likely to die than children from high-income countries. In sub-Saharan Africa, more than half of under-five deaths are preventable through immunization. Therefore, this study aimed to identify the determinant factors of full childhood immunization among children aged 12-23 months in sub-Saharan Africa. METHODS Data for the study was drawn from the Demographic and Health Survey of nine sub-Saharan African countries. A total of 21,448 children were included. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with full childhood immunization RESULT: The prevalence of full childhood immunization coverage in sub-Saharan Africa countries was 59.40% (95% CI: 58.70, 60.02). The multilevel logistic regression model revealed that secondary and above maternal education (AOR = 1.38; 95% CI: 1.25, 1.53), health facility delivery (AOR = 1.51; 95% CI: 1.41, 1.63), fathers secondary education and above (AOR = 1.28, 95% CI: 1.11, 1.48), four and above ANC visits (AOR = 2.01; 95% CI: 1.17, 2.30), PNC visit(AOR = 1.55; 95% CI: 1.46, 1.65), rich wealth index (AOR = 1.26; 95% CI: 1.18, 1.40), media exposure (AOR = 1.11; 95% CI: 1.04, 1.18), and distance to health facility is not a big problem (AOR = 1.42; 95% CI: 1.28, 1.47) were significantly associated with full childhood immunization. CONCLUSION The full childhood immunization coverage in sub-Saharan Africa was poor with high inequalities. There is a significant variation between SSA countries in full childhood immunization. Therefore, public health programs targeting uneducated mothers and fathers, rural mothers, poor households, and those who have not used maternal health care services to promote full childhood immunization to improve child health. By enhancing institutional delivery, antenatal care visits and maternal tetanus immunization, the government and other stakeholders should work properly to increase child immunization coverage. Furthermore, policies and programs aimed at addressing cluster variations in childhood immunization need to be formulated and their implementation must be strongly pursued.
Collapse
Affiliation(s)
- Setegn Muche Fenta
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Hailegebrael Birhan Biresaw
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kenaw Derebe Fentaw
- Department of Statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | |
Collapse
|