Timely completion of vaccination and its determinants among children in Northwest, Ethiopia:  A multilevel analysis

Abstract

Background: Timely vaccination is key to prevent unnecessary childhood mortality from vaccinepreventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar city administration, north-west, Ethiopia.Method: This study employed a community-based cross sectional study design. A sample size of 821 children aged 12 to 23 months were considered. Two stages random sampling technique was used to select study subjects. To account the effect of clustering, bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95 % confidence intervals (CIs). Results:Of the 774 children included for analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers aged above 35 years (AOR= 0.469; 95 % CI: 0.253-0.869], who had secondary education and above (AOR = 2.391; 95 % CI: 1.317-4.343), from richest households (AOR = 2.381; 95 % CI: 1.502-3.773), children whose mother attended four or more ante natal care visits (AOR = 2.844; 95 % CI: 1.310-6.174) and whose mother had two or more post natal care visits (AOR =2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination.In contrary, being vaccinated at health post (AOR=0.144; 95%CI: 0.048-0.428) and travelling more than 30 minutes to the vaccination site (AOR= 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities. Conclusion:In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as important indicator of the Abbreviations

Spatial variations and determinants of timely completion of vaccination in Ethiopia using further analysis of EDHS 2019 data: Spatial and multilevel analysis

“…The prevalence of timely completion of vaccinations in Ethiopia is lower than in studies conducted in Gondar city (31.9%) [27], Toke Kutaye district of central Ethiopia 23.9% [20], in Afar, Ethiopia 43.7% [28], Uganda 45.6% [29], china 43.72%-59.25% [25], Tanzania 82.7% -88.5% [30], Saudi Arabia 73% [31], Ghana 87.3% [32], Cameroon 73.3% [33], Kenya 71%-91% [34], Gambia 36.7% [35], Senegal 78.4% [36] and in South Africa 58%-88% [37]. The…”

Age-appropriate Vaccination and Associated Factors among Children Aged 12- 35 Months in Ethiopia: A Multi-Level Analysis

“…This could be because older mothers can have valuable experience in child caring they have likely raised children before, and they can have more exposure to health facilities and health information that can be delivered there (36,37). On the other hand, mothers aged above 35 years were less likely to vaccinate their children on time (38). Scientific research established that both extremities mother's age affects child caring (37).…”