Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2019 Jul 30;19(1):1019. doi: 10.1186/s12889-019-7356-2.
Vaccination is one of the cost effective strategies reducing childhood morbidity and mortality. Further improvement of immunization coverage would halt about 1.5 million additional deaths globally. Understanding the level of immunization among children is vital to design appropriate interventions. Therefore, this study aimed to assess full immunization coverage and its determinants among children aged 12-23 months in Ethiopia.
The study was based on secondary data analysis from the 2016 Ethiopia Demographic and Health Survey (EDHS). Information about 1,909 babies aged 12-23 months was extracted from children dataset. Both bivariate and multivariable logistic regression models were utilized to assess the status and factors associated with full immunization. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed. Variables with less than 0.05 p-values in the multivariable logistic regression model were considered as statistically and significantly associated with the outcome variable.
The overall full immunization coverage was 38.3% (95% CI: 36.7, 41.2). Rural residence (AOR = 0.60, 95% CI: 0.43, 0.84), employed (AOR = 1.62, 95% CI: 1.31, 2.0), female household head (AOR = 0.58, 95% CI: 0.44, 0.76), wealth index [middle (AOR = 1.44, 95% CI: 1.07, 1.94) and richness (AOR = 1.65, 95% CI: 1.25,2.19)], primary school maternal education (AOR = 1.38,95% CI: 1.07, 1.78), secondary school maternal education (AOR = 2.19, 95% CI: 1.43, 3.36), diploma graduated mothers (AOR = 1.99, 95% CI: 1.09, 3.61), ANC follow ups (AOR = 2.79, 95% CI:2.17 3.59), and delivery at health facilities (AOR = 1.76, 95% CI: 1.36, 2.24) were significantly associated factors with full immunization.
Full immunization coverage in Ethiopia was significantly lower than the global target. Female household head and rural dwellings were negatively associated with full immunization. In contrast higher maternal education, employment, middle and rich economic status, ANC follow up, and delivery at health facility were positively associated with full immunization among 12-23 months old children. This suggests that improved health education and service expansion to remote areas are necessary to step immunization access.
接种疫苗是降低儿童发病率和死亡率的具有成本效益的策略之一。进一步提高免疫覆盖率将使全球额外死亡人数减少约 150 万。了解儿童的免疫水平对于设计适当的干预措施至关重要。因此,本研究旨在评估埃塞俄比亚 12-23 个月儿童的完全免疫覆盖率及其决定因素。
本研究基于 2016 年埃塞俄比亚人口与健康调查(EDHS)的二次数据分析。从儿童数据集提取了 1909 名 12-23 个月大的婴儿的信息。利用双变量和多变量逻辑回归模型评估完全免疫状况及其相关因素。使用具有 95%置信区间(CI)的调整优势比(AOR)进行计算。多变量逻辑回归模型中 p 值小于 0.05 的变量被认为与结局变量具有统计学意义和显著相关性。
总体完全免疫覆盖率为 38.3%(95%CI:36.7,41.2)。农村居住(AOR=0.60,95%CI:0.43,0.84)、就业(AOR=1.62,95%CI:1.31,2.0)、女性户主(AOR=0.58,95%CI:0.44,0.76)、财富指数[中等(AOR=1.44,95%CI:1.07,1.94)和富裕(AOR=1.65,95%CI:1.25,2.19)]、母亲接受小学教育(AOR=1.38,95%CI:1.07,1.78)、中学教育(AOR=2.19,95%CI:1.43,3.36)、母亲获得文凭(AOR=1.99,95%CI:1.09,3.61)、接受 ANC 随访(AOR=2.79,95%CI:2.17,3.59)和在卫生机构分娩(AOR=1.76,95%CI:1.36,2.24)与完全免疫呈显著正相关。
埃塞俄比亚的完全免疫覆盖率明显低于全球目标。女性户主和农村居民与完全免疫呈负相关。相比之下,母亲接受更高的教育、就业、中等和富裕的经济地位、ANC 随访和在卫生机构分娩与 12-23 个月大儿童的完全免疫呈正相关。这表明,需要加强对偏远地区的健康教育和服务扩展,以提高免疫接种的可及性。