CORRELATES OF COMPLETE CHILDHOOD VACCINATION IN EAST AFRICAN COUNTRIES.

Sunday, 3rd of August 2014

[source]PLoS One[|source]

Despite the known health and economic benefits of childhood vaccinations, vaccination coverage in low-income countries vary widely. Increasing coverage of vaccines in the poorest countries to 90% in the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Lower parental education, lower maternal age, lower income, female gender of the child, traditional or Muslim religion, and larger family size have been documented as major drivers to the low vaccination rates.

 In this report, the authors provide a comprehensive examination of complete vaccination status in East Africa. The authors use nationally representative data from the DHS for six East African countries to identify common and country-specific barriers to complete childhood vaccination status as recommended by the WHO vaccination schedule. The report documents that in East Africa, complete vaccination status according to the WHO vaccination schedule, was well below the 90% target for reducing the burden of childhood illness and death and varied considerably by country. More details on how to use DHIS data for measuring complete immunization are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994083/

 

 ABSTRACT

BACKGROUND: Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs) vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination.

METHODS: Using data from the Demographic and Health Surveys (DHS) for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette–Guérin (BCG) and DTwPHibHep (DTP) as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression.

RESULTS: Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries.

CONCLUSIONS: Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a critical step towards reaching the Millennium Development Goal of reducing under-five mortality by two-thirds by 2015 and thus should be a global priority.