Persistent socioeconomic disparities in childhood vaccination coverage in Tanzania: Insights from multiple rounds of demographic and health surveys.

OBJECTIVES

This study examined the trends, disparities, and factors associated with childhood vaccination coverage in Tanzania between 2010 and 2022.

METHODS

We used data from three recent Tanzania Demographic and Health Surveys. We included a total of 5637 children aged 12-23 months and their mothers. Socioeconomic disparities in childhood vaccination coverage were evaluated using concentration curves and indices, and decomposition analysis was performed to identify the contributing factors. Poisson regression analysis was conducted to determine the factors associated with childhood vaccination uptake in Tanzania.

RESULTS

Full vaccination coverage remained stable at approximately 75.6 % from 2010 to 2015 but declined to 70.5 % by 2022. Throughout all three survey rounds, children from households with a lower socioeconomic position consistently had lower full vaccination coverage than those from families with a higher socioeconomic position. The concentration index for full vaccination coverage was 0.1531 in 2010 (p < 0.001), 0.1466 in 2015 (p < 0.001), and 0.1314 in 2022 (p < 0.001), indicating persistent but slightly decreasing inequality favoring upper-class children (F-stat = 3.27, p = 0.038). The key contributors to these inequalities were maternal illiteracy, poverty, and lack of exposure to mass media. Factors that increased childhood vaccination uptake included higher socioeconomic position, facility-based childbirth, antenatal care utilization, proximity to healthcare facilities, and having fewer children under the age of five in the household.

CONCLUSION

Despite Tanzania's considerable overall childhood vaccination coverage, the findings indicated significant socioeconomic disparities. Urgent action is needed to close these gaps and ensure that every child in Tanzania receives life-saving protection regardless of their background or circumstances.