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
; 24(1): 592, 2024 Feb 23.
Article
em En
| MEDLINE
| ID: mdl-38395877
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% CI1.02, 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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
5_ODS3_mortalidade_materna
Base de dados:
MEDLINE
Assunto principal:
Cuidado Pré-Natal
/
Mães
Limite:
Child
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
BMC Public Health
Ano de publicação:
2024
Tipo de documento:
Article