Individual and community level determinants of childhood full immunization in Ethiopia: a multilevel analysis

Abstract

BackgroundExpanded program on immunization is one of the most successful and cost effective public health interventions that protect children against vaccine preventable diseases. The full childhood immunization coverage in many parts of Ethiopia is far from optimal. Hence, the main objective of this study was to assess factors associated with childhood full immunization in Ethiopia.MethodsThe data source for this study was the 2011 Ethiopian Demographic and Health Survey. Multilevel regression analysis techniques were used to conduct the analysis. Accordingly a two level multilevel regression analysis model was built with individuals (level 1) nested with in communities (level 2).ResultsA total of 4983 children aged 12–59 months nested within 520 clusters were included in the analysis. According to the analysis results, in the year 2011, 26 % of children less than 5 years old were fully immunized in Ethiopia. Being born at health institutions, higher level of maternal education, media exposure, region of residence and residing in communities possessing higher maternal antenatal care services utilization were positively associated with childhood full immunization. In contrary to this, the number children aged less than 5 years in the household was negatively associated with childhood full immunization. The random effect results indicated that 21 % of the variation among the communities was due to community level factors.ConclusionsIt was found that various individual and contextual factors were associated with childhood full immunization. In addition, significant community level variation remains after having controlled individual and community level factors which is an indicative of a need for further research on community level factors. Hence, utilizing multilevel modeling in determining the effect of both individual and contextual level factors simultaneously had brought an important output which may help planners, policy and decision makers to emphasize on both individuals and communities in which they live.

Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal and child characteristics

“…Maternal education was associated with improved vaccination coverage in this study and similar findings have been described for Ethiopia, in multi-country assessments of inequities in vaccination coverage, and in systematic reviews of studies from 13 and 51 countries [9,23,26-30]. A higher maternal educational level raises awareness about the importance of vaccination and it has been reported that educated women choose health care services that generate better health [27,31].…”

PRECEDE- PROCEED Model on Determinants of Completeness Immunization Status among Infants in Bangkalan District, Madura

“…Abadura et al (2015) stated that exposure of information media also influences children's complete basic immunization status. Family who is exposed to media (the utilization of television or radio once in a week at the minimum) has higher possibility to complete their children immunization compares to family who are less exposed to media.…”

Measuring childhood vaccination acceptance of mother in Zhejiang province, East China

“…These unpleasant experience definitely affected the mother's intention and the practice of vaccination, leading to the missed opportunities or the drop outs of vaccination. 24,25 We suggested that all vaccination providers adjust the vaccination session and extend the working hours to reduce the vaccine hesitancy among mothers, which had been indicated to be effective among migrant population in Zhejiang province and might be the most beneficial to the working mothers. As in our study, previous reports had shown that the parents' information searches on vaccination were positively associated with their intention to vaccination.…”