Department Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
BMC Pediatr. 2022 Apr 11;22(1):193. doi: 10.1186/s12887-022-03250-0.
Immunization is among the most cost-effective health interventions to improve child survival. However, many countries in sub-Saharan Africa failed to achieve their national and international coverage targets repeatedly. The present study investigated trends of coverage and inequalities in coverage in Ethiopia.
This study used data from five rounds of the Demographic and Health Surveys conducted in Ethiopia in 2000, 2005, 2011, 2016, and 2019. The surveys used a multistage cluster sampling procedure to obtain a nationally and sub-nationally representative data. The outcome variables included in the study were full immunization coverage and inequality. The World Health Organization's Health Equity Assessment Toolkit was used to conduct the inequality analysis. Projections for 2025 were based on smoothed averages generated using the demographic and health survey data from 2000 to 2019.
The full (basic) immunization coverage in Ethiopia has increased steadily from 14.3% in 2000 to 44.1% in 2019. Based on the average past performance, the immunization coverage is projected to reach 53.6% by 2025, which will be short of the 75% national full (basic) immunization coverage target for the year 2025. Mothers with higher levels of education are more likely to get their children all basic vaccinations than those with lower levels of education. Similarly, the inequality gaps due to wealth and residency are significant; where children in the lowest wealth strata and those living in rural areas remained disadvantaged.
Despite a steady increase in immunization coverage in the past two decades the country is yet to achieve its immunization target. Thus, more efforts are needed to achieve the current and future national immunization targets. A more focused intervention targeting the disadvantaged groups could be an effective strategy to achieve coverage and minimize the inequality gaps in immunization.
免疫接种是提高儿童生存最具成本效益的健康干预措施之一。然而，撒哈拉以南非洲的许多国家一再未能实现其国家和国际覆盖目标。本研究调查了埃塞俄比亚覆盖范围和覆盖范围不平等的趋势。
本研究使用了 2000 年、2005 年、2011 年、2016 年和 2019 年在埃塞俄比亚进行的五次人口与健康调查的数据。调查采用多阶段聚类抽样程序，获得国家和次国家代表性数据。本研究包括的结果变量为完全免疫接种覆盖率和不平等。使用世界卫生组织的卫生公平评估工具包进行不平等分析。2025 年的预测是基于使用 2000 年至 2019 年人口与健康调查数据生成的平滑平均值。
埃塞俄比亚的完全（基本）免疫接种覆盖率从 2000 年的 14.3%稳步上升到 2019 年的 44.1%。根据过去的平均表现，预计到 2025 年，免疫接种覆盖率将达到 53.6%，这将低于 2025 年全国 75%的完全（基本）免疫接种覆盖率目标。受教育程度较高的母亲比受教育程度较低的母亲更有可能让孩子接受所有基本疫苗接种。同样，由于财富和居住地造成的不平等差距也很大；在最贫穷的阶层和生活在农村地区的儿童仍然处于不利地位。
尽管过去二十年来免疫接种覆盖率稳步上升，但该国仍未实现其免疫接种目标。因此，需要做出更多努力来实现当前和未来的国家免疫接种目标。针对弱势群体的更有针对性的干预措施可能是实现覆盖范围和最大限度缩小免疫接种不平等差距的有效策略。
