Factors associated with non- and under-vaccination among children aged 12–23 months in Malawi. A multinomial analysis of the population-based sample

Abstract

Background: Non-and under-vaccination among children in Malawi have received little attention. Between 2010 and 2016, the proportion of children who received full immunization before their first birthday dropped from 81% to 76% in Malawi. This signifies that a certain fraction of children are either non-vaccinated or under-vaccinated. Thus, the present study attempted to examine the predictors of non-and under-vaccination among children aged 12 e23 months in Malawi. Methods: Cross-sectional data obtained from the Malawi Demographic and Health Survey 2015 e16 were utilized. The percentage of children aged 12e23 months who were non-vaccinated, under-vaccinated, or fully vaccinated with 1 dose of Bacillus CalmetteeGuérin, 3 doses of oral polio vaccine, 3 doses of pentavalent, 2 doses of rotavirus vaccine, 3 doses of pneumococcal vaccine and 1 dose of measles-containing vaccine were calculated. The odds of being nonvaccinated and under-vaccinated compared to full vaccination relative to various sociodemographic factors were assessed using a multivariable multinomial logistic regression with logit link function which accounted for survey design. Results: Of 3111 children aged 12e23 months, 72% were fully vaccinated, 26% were undervaccinated, and about 2% were non-vaccinated. The multinomial logistic regression showed that children from the poorest households, and children who did not have postnatal care within two months had increased odds of being under-vaccinated. On the other hand, children who

Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review

“…Family size was associated with the probability of a child being fully immunized. It was revealed that children from large families have low vaccine uptakes, considering the burden of other children at home in taking up immunization services [11,13,25,46,50]. Migration was also cited as a hindrance to childhood immunization coverage [30,35,44,48].…”

Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review

“…Forty-eight articles met all inclusion criteria for this study; 28 articles were excluded for various reasons. [See supplementary materials 3] Nine articles employed second-hand data analysis [7,12,18,27,37,40,41,47,42]; thirty-six used crosssectional design [1][2][3]11,[13][14][15][16][17]19,[21][22][23][24][25][26][28][29][30][31][32][33][34][35][36][38][39]42,[45][46][48][49][50][51]53,54] and three used case-control study [20,[43][44]. All described studies were conducted on Africa populations (103,655 adults and 76,327 children).…”

“…One critically examined barriers speci c to vaccination doses at birth 0 -1day [18] in the Gambia. Thirty articles reported national immunization coverage [1][2]7,[11][12][13][14][15][16][20][21][22][23][24][25][28][29]32,[34][35][38][39][40][43][44][45][46]49,50,[52][53][54], eighteen did not [3,[17][18][19]22,24,[26][27][30][31]33,[36][37][41][42]47,48,…”

“…Financial limitation was a major barrier cited that hinder childhood immunization. [7,11,13,15,17,24,27,34,36,38,40,42,45,47,50,52]. The place of residence of the mother was reported as determinants of full immunization of a child [39,41,37].…”

“…We describe health system barriers as inherent factors that obstruct the process of delivering vaccine and vaccine related services to it bene ciaries. These includes broken cold chain, irregular supplies and distribution of vaccines; limited human resource and infrastructures, and long distances separating health facilities from families [1][2][3]11,13,[14][15][16]19,22,23,25,29,32,35,43,44,[47][48][49][50][51][52]. Vaccine shortages at health facility level and di culties of transporting vaccines were commonly reported to signi cantly hinder immunization services [1-174 3,11,14,16,19,22,23,25,33,43,47,48,52,51].…”