Kebede Sofiya Ayalew, Tsega Yawkal, Cherie Niguss, Molla Asressie, Stecher Chad
Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Health Systems and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
PLoS One. 2025 Apr 29;20(4):e0321947. doi: 10.1371/journal.pone.0321947. eCollection 2025.
Vaccinations saved over 37 million lives between 2000 and 2019. Despite this, Ethiopia's Expanded Program of Immunization has struggled to meet its goals, and little has been studied on the community and individual level determinants of incomplete immunization. Therefore, this study aimed to assess the predictors of incomplete immunization among Ethiopian children aged 12-23 months using Ethiopian Mini Demographic Health Survey 2019 (EMDHS 2019).
The study used data from EMDHS 2019 and about 1029 children aged 12-23 months were included in the study. STATA version 17.0 statistical software was used to manage and analyze data. Multilevel binary logistic regression analysis was conducted. An AOR with 95%CI, and P < 0.05 were used to determine strength of association and declare significance level, respectively.
The factors maternal age ranges of 15-24 (AOR: 4.23; 95%CI: 2.17-8.26) and 25-34 (AOR: 2.68; 95%CI: 1.56-4.61), family size ≥5 (AOR: 2.03; 95%CI: 1.24-3.30), ≤3 antenatal care visits (AOR: 2.32; 95%CI: 1.43-3.75), no postnatal care (AOR: 2.20; 95%CI: 1.23-3.95), rural residence (AOR: 2.54; 95%CI: 1.08-6.25), low (AOR=3.55; 95% CI: 1.32-9.55) and moderate (AOR: 3.29; 95% CI: 1.55-7.00) community-level antenatal care services utilization, and low community-level institutional delivery (AOR: 3.93; 95%CI: 1.35-11.50) were the significant determinant factors of incomplete immunization in Ethiopia.
Young maternal age, family size, inadequate ANC, rural residence, not utilizing PNC services, and poor wealth status were the individual level determinants of incomplete immunization. Low and moderate level of ANC services utilization, and low community level institutional delivery service utilization were the factors determining incomplete immunization at the community level. Therefore, the health decision makers better to be committed to design strategies to enhance complete immunization coverage and maternal and child health services.
2000年至2019年间，疫苗接种挽救了超过3700万人的生命。尽管如此，埃塞俄比亚的扩大免疫规划仍难以实现其目标，而且关于社区和个体层面未完成免疫接种的决定因素的研究很少。因此，本研究旨在利用2019年埃塞俄比亚微型人口健康调查（EMDHS 2019）评估12至23个月大的埃塞俄比亚儿童未完成免疫接种的预测因素。
本研究使用了EMDHS 2019的数据，约1029名12至23个月大的儿童被纳入研究。使用STATA 17.0版统计软件来管理和分析数据。进行了多水平二元逻辑回归分析。分别使用带有95%置信区间的调整后比值比（AOR）和P<0.05来确定关联强度并声明显著性水平。
母亲年龄在15至24岁（AOR：4.23；95%置信区间：2.17 - 8.26）和25至34岁（AOR：2.68；95%置信区间：1.56 - 4.61）、家庭规模≥5（AOR：2.03；95%置信区间：1.24 - 3.30）、产前检查次数≤3次（AOR：2.32；95%置信区间：1.43 - 3.75）、未进行产后护理（AOR：2.20；95%置信区间：1.23 - 3.95）、农村居住（AOR：2.54；95%置信区间：1.08 - 6.25）、社区层面产前护理服务利用率低（AOR = 3.55；95%置信区间：1.32 - 9.55）和中等（AOR：3.29；95%置信区间：1.55 - 7.00）以及社区层面机构分娩率低（AOR：3.93；95%置信区间：1.35 - 11.50）是埃塞俄比亚未完成免疫接种的重要决定因素。
母亲年龄小、家庭规模、产前护理不足、农村居住、未利用产后护理服务以及财富状况差是未完成免疫接种的个体层面决定因素。产前护理服务利用率低和中等以及社区层面机构分娩服务利用率低是社区层面决定未完成免疫接种的因素。因此，卫生决策者最好致力于制定策略，以提高全程免疫接种覆盖率以及母婴健康服务水平。
