Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023

Abstract Background Despite vaccination being the most cost-effective means to prevent disease and its adverse consequences, missing opportunities for vaccination remains a critical public health challenge. Many SSA countries still couldn’t reach the target endorsed by the Global Vaccine Action Plan...

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Main Authors: Melak Jejaw, Tesfahun Zemene Tafere, Misganaw Guadie Tiruneh, Asebe Hagos, Getachew Teshale, Mikias Mered Tilahun, Wubshet D. Negash, Kaleb Assegid Demissie
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Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21273-3
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author Melak Jejaw
Tesfahun Zemene Tafere
Misganaw Guadie Tiruneh
Asebe Hagos
Getachew Teshale
Mikias Mered Tilahun
Wubshet D. Negash
Kaleb Assegid Demissie
author_facet Melak Jejaw
Tesfahun Zemene Tafere
Misganaw Guadie Tiruneh
Asebe Hagos
Getachew Teshale
Mikias Mered Tilahun
Wubshet D. Negash
Kaleb Assegid Demissie
author_sort Melak Jejaw
collection DOAJ
description Abstract Background Despite vaccination being the most cost-effective means to prevent disease and its adverse consequences, missing opportunities for vaccination remains a critical public health challenge. Many SSA countries still couldn’t reach the target endorsed by the Global Vaccine Action Plan. Identifying contributing factors helps policymakers and planners to design potential interventions to avert missing opportunities for vaccination. Thus, this study aimed to assess the prevalence and factors associated with missed opportunities for vaccination. Methods This study used nationally representative demographic and health survey data collected from 2016 to 2023 among 44,149 children aged 12 to 23 months in SSA countries. Stata version 14 statistical package was used. Bi-variable and multivariable logistic regression analyses were done to ascertain factors associated with a missed opportunity for vaccination at a p-value less than 0.05 with adjusted odds ratios (AORs) with a 95% confidence interval. Result The overall prevalence of missed opportunity for vaccination (MOV) was 75.46% (95% CI: 75.04, 75.87%). The highest prevalence of MOV occurred in Gambia (93.85%), whereas the lowest was reported in Mauritania (41.59%). Children age: 12 to 15 months (AOR = 1.3, 95%CI:1.22, 1.36) and 16 to 18 months (AOR = 1.1, 95%CI: 1.04, 1.16), maternal age 35 to 49 (AOR = 1.1, 95%CI: 1.02, 1.17), married mother (AOR = 0.85, 95%CI: 0.80, 0.90), education: didn’t attend formal education (AOR = 1.13, 95%CI: 1.10, 1.22) and completed primary education (AOR = 1.1, 95%CI: 1.02, 1.16), ANC: never attend (AOR = 0.76, 95%CI:0.71, 0.82) and having four and above ANC visit (AOR = 0.9, 95%CI:0.85, 0.96), health insurance users (AOR = 1.4, 95%CI: 1.25, 1.49), male headed household (AOR = 1.35, 95%CI: 1.27, 1.43), religion: Muslim (AOR = 1.5, 95%CI:1.38, 1.57), Animist (AOR = 1.5, 95%CI:1.31, 1.64), and Catholic followers (AOR = 1.2, 95%CI:1.13, 1.31) and Protestant (AOR = 0.88, 95%CI:0.82, 0.95), home delivery (AOR = 0.79, 95%CI:0.75, 0.84), rural dwellers (AOR = 1.1, 95%CI: 1.04, 1.17), ever had media exposure (AOR = 0.91, 95%CI:0.86, 0.97), big problem to reach health facility (AOR = 1.1, 95%CI: 1.02, 1.14), high community wealth status (AOR = 0.91, 95%CI: 0.83, 0.99), low community level educational status (AOR = 1.2, 95%CI: 1.14, 1.38) and human development index: middle (AOR = 1.4, 95%CI: 1.21, 1.59) were factors associated with MOV. Conclusion and recommendation The overall pooled prevalence of missed opportunities for vaccination in Sub-Saharan remains high. Children’s age, maternal age, marital status, education, antenatal care visit, health insurance utilization, sex of household head, religion, place of delivery, residence, media exposure, distance to reach health facility, community wealth status, community educational status, and human development index of the countries were significantly associated with MOV. Policymakers have to encourage technology to promote multimedia exposure to increase community awareness about vaccination, encourage engagement of male partner, and religious leaders in child health. Additionally, potential stakeholders should give great emphasis for accessibility of education and health service for rural and remote areas, and poor segments of population through fostering community health workers and outreach programs, and financial support to increase vaccine coverage by averting missed opportunities for vaccinations. Qualitative research is recommended to explore the facilitators and barriers of missed opportunities for vaccinations among children.
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spelling doaj-art-2fd65308c97a4abcbebc0bfa0aed709d2025-01-12T12:43:04ZengBMCBMC Public Health1471-24582025-01-0125111210.1186/s12889-024-21273-3Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023Melak Jejaw0Tesfahun Zemene Tafere1Misganaw Guadie Tiruneh2Asebe Hagos3Getachew Teshale4Mikias Mered Tilahun5Wubshet D. Negash6Kaleb Assegid Demissie7Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Optometry, School of Medicine and Health Science, University of Gondar Comprehensive Specialized HospitalDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarAbstract Background Despite vaccination being the most cost-effective means to prevent disease and its adverse consequences, missing opportunities for vaccination remains a critical public health challenge. Many SSA countries still couldn’t reach the target endorsed by the Global Vaccine Action Plan. Identifying contributing factors helps policymakers and planners to design potential interventions to avert missing opportunities for vaccination. Thus, this study aimed to assess the prevalence and factors associated with missed opportunities for vaccination. Methods This study used nationally representative demographic and health survey data collected from 2016 to 2023 among 44,149 children aged 12 to 23 months in SSA countries. Stata version 14 statistical package was used. Bi-variable and multivariable logistic regression analyses were done to ascertain factors associated with a missed opportunity for vaccination at a p-value less than 0.05 with adjusted odds ratios (AORs) with a 95% confidence interval. Result The overall prevalence of missed opportunity for vaccination (MOV) was 75.46% (95% CI: 75.04, 75.87%). The highest prevalence of MOV occurred in Gambia (93.85%), whereas the lowest was reported in Mauritania (41.59%). Children age: 12 to 15 months (AOR = 1.3, 95%CI:1.22, 1.36) and 16 to 18 months (AOR = 1.1, 95%CI: 1.04, 1.16), maternal age 35 to 49 (AOR = 1.1, 95%CI: 1.02, 1.17), married mother (AOR = 0.85, 95%CI: 0.80, 0.90), education: didn’t attend formal education (AOR = 1.13, 95%CI: 1.10, 1.22) and completed primary education (AOR = 1.1, 95%CI: 1.02, 1.16), ANC: never attend (AOR = 0.76, 95%CI:0.71, 0.82) and having four and above ANC visit (AOR = 0.9, 95%CI:0.85, 0.96), health insurance users (AOR = 1.4, 95%CI: 1.25, 1.49), male headed household (AOR = 1.35, 95%CI: 1.27, 1.43), religion: Muslim (AOR = 1.5, 95%CI:1.38, 1.57), Animist (AOR = 1.5, 95%CI:1.31, 1.64), and Catholic followers (AOR = 1.2, 95%CI:1.13, 1.31) and Protestant (AOR = 0.88, 95%CI:0.82, 0.95), home delivery (AOR = 0.79, 95%CI:0.75, 0.84), rural dwellers (AOR = 1.1, 95%CI: 1.04, 1.17), ever had media exposure (AOR = 0.91, 95%CI:0.86, 0.97), big problem to reach health facility (AOR = 1.1, 95%CI: 1.02, 1.14), high community wealth status (AOR = 0.91, 95%CI: 0.83, 0.99), low community level educational status (AOR = 1.2, 95%CI: 1.14, 1.38) and human development index: middle (AOR = 1.4, 95%CI: 1.21, 1.59) were factors associated with MOV. Conclusion and recommendation The overall pooled prevalence of missed opportunities for vaccination in Sub-Saharan remains high. Children’s age, maternal age, marital status, education, antenatal care visit, health insurance utilization, sex of household head, religion, place of delivery, residence, media exposure, distance to reach health facility, community wealth status, community educational status, and human development index of the countries were significantly associated with MOV. Policymakers have to encourage technology to promote multimedia exposure to increase community awareness about vaccination, encourage engagement of male partner, and religious leaders in child health. Additionally, potential stakeholders should give great emphasis for accessibility of education and health service for rural and remote areas, and poor segments of population through fostering community health workers and outreach programs, and financial support to increase vaccine coverage by averting missed opportunities for vaccinations. Qualitative research is recommended to explore the facilitators and barriers of missed opportunities for vaccinations among children.https://doi.org/10.1186/s12889-024-21273-3A missed opportunity for vaccinationPrevalenceMultilevel analysisSSA countries
spellingShingle Melak Jejaw
Tesfahun Zemene Tafere
Misganaw Guadie Tiruneh
Asebe Hagos
Getachew Teshale
Mikias Mered Tilahun
Wubshet D. Negash
Kaleb Assegid Demissie
Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023
BMC Public Health
A missed opportunity for vaccination
Prevalence
Multilevel analysis
SSA countries
title Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023
title_full Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023
title_fullStr Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023
title_full_unstemmed Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023
title_short Three in four children age 12–23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016–2023
title_sort three in four children age 12 23 months missed opportunities for vaccination in sub saharan african countries a multilevel mixed effect analysis of demographic health and surveys 2016 2023
topic A missed opportunity for vaccination
Prevalence
Multilevel analysis
SSA countries
url https://doi.org/10.1186/s12889-024-21273-3
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