Agimas Muluken Chanie, Alemayehu Meron Asmamaw, Tesfie Tigabu Kidie, Tilahun Werkneh Melkie, Asferie Worku Necho, Aweke Mekuriaw Nibret, Abebe Moges Tadesse, Yalew Anteneh Kassa
Epidemiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
Epidemiology, University of Gondar, Gondar, Ethiopia.
BMJ Open. 2025 Jan 7;15(1):e085235. doi: 10.1136/bmjopen-2024-085235.
Zero-dose children refer to a child who has not yet received any childhood vaccines. Globally, zero-dose children are the major public health problem. In sub-Saharan African countries, one among five children do not have access to vaccines. But the efforts to identify the factors contributing to the zero-dose children are not well addressed in Ethiopia.
To assess individual and community-level maternal factors of zero-dose children in Ethiopia using mini-Ethiopian Demographic Health Survey 2019.
A secondary analysis of a cross-sectional study was used among a total of 3208 participants. STATA-14 was used for descriptive and multilevel binary logistic regression (mixed effects model) analysis. Model selection was conducted using Akaike information criteria. To identify significant factors for zero-dose children, a p value of <0.05 with 95% CI was used.
The prevalence of zero-dose children among children aged 12-35 months was 523 (16.3%, 95% CI 15% to 17.6%). Women with no antenatal care follow-up (adjusted OR (AOR)=1.55, 95% CI 1.02 to 2.35), uneducated women (AOR=1.47, 95% CI 1.11 to 1.95), women who gave birth at home (AOR=1.39, 95% CI 1.04 to 1.86), women who had poor wealth index (AOR=2.15, 95% CI 1.62 to 2.85) and women from low proportions of community media exposure (AOR=1.39, 95% CI 1.13 to 1.71) were the risk factors for zero-dose children in Ethiopia.
Compared with previous studies, the prevalence of zero-dose children was low in Ethiopia. Variables like urban residence, no education, home delivery, poor wealth index, no antenatal care(ANC) visit and women from low proportions of community media exposure were the risk factors for zero-dose children in Ethiopia. Therefore, expanding maternal health services and media access for women is highly recommended to reduce zero-dose children mortality.
零剂量儿童是指尚未接种任何儿童疫苗的儿童。在全球范围内，零剂量儿童是主要的公共卫生问题。在撒哈拉以南非洲国家，五分之一的儿童无法获得疫苗。但在埃塞俄比亚，确定导致零剂量儿童的因素的相关工作并未得到充分开展。
利用2019年埃塞俄比亚小型人口与健康调查评估埃塞俄比亚零剂量儿童的个体和社区层面的母亲因素。
对总共3208名参与者进行横断面研究的二次分析。使用STATA-14进行描述性和多水平二元逻辑回归（混合效应模型）分析。使用赤池信息准则进行模型选择。为确定零剂量儿童的显著因素，采用p值<0.05且95%置信区间的标准。
12至35个月大儿童中零剂量儿童的患病率为523例（16.3%，95%置信区间为15%至17.6%）。未接受产前检查随访的妇女（调整后比值比（AOR）=1.55，95%置信区间为1.02至2.35）、未受过教育的妇女（AOR=1.47，95%置信区间为1.11至1.95）、在家分娩的妇女（AOR=1.39，95%置信区间为1.04至1.86）、财富指数较低的妇女（AOR=2.15，95%置信区间为1.62至2.85）以及社区媒体曝光率较低的妇女（AOR=1.39，95%置信区间为1.13至1.71）是埃塞俄比亚零剂量儿童的风险因素。
与以往研究相比，埃塞俄比亚零剂量儿童的患病率较低。城市居住、未受过教育、在家分娩、财富指数较低、未进行产前检查以及社区媒体曝光率较低的妇女等变量是埃塞俄比亚零剂量儿童的风险因素。因此，强烈建议扩大针对妇女的孕产妇保健服务和媒体接触机会，以降低零剂量儿童的死亡率。
