Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)

Abstract Background Children in sub-Saharan Africa, particularly in Ethiopia, continue to suffer from vaccine-preventable diseases (VPDs), contributing to child mortality. One of the key challenges is vaccination dropout, where children fail to receive subsequent doses after the initial vaccine, lea...

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Main Authors: Eyasu Bamlaku Golla, Habtamu Geremew, Alegntaw Abate, Mohammed Ahmed Ali, Mulat Belay Simegn, Werkneh Melkie Tilahun, Samuel Abdisa Kuse, Smegnew Gichew Wondie
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Language:English
Published: BMC 2025-05-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05786-3
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author Eyasu Bamlaku Golla
Habtamu Geremew
Alegntaw Abate
Mohammed Ahmed Ali
Mulat Belay Simegn
Werkneh Melkie Tilahun
Samuel Abdisa Kuse
Smegnew Gichew Wondie
author_facet Eyasu Bamlaku Golla
Habtamu Geremew
Alegntaw Abate
Mohammed Ahmed Ali
Mulat Belay Simegn
Werkneh Melkie Tilahun
Samuel Abdisa Kuse
Smegnew Gichew Wondie
author_sort Eyasu Bamlaku Golla
collection DOAJ
description Abstract Background Children in sub-Saharan Africa, particularly in Ethiopia, continue to suffer from vaccine-preventable diseases (VPDs), contributing to child mortality. One of the key challenges is vaccination dropout, where children fail to receive subsequent doses after the initial vaccine, leading to incomplete immunization coverage. Hence, our review aimed to determine the pooled magnitude of vaccination dropout and the factors associated with it among children in Ethiopia. Method A comprehensive search of relevant studies was conducted through electronic web-based international databases and the institutional repository of Ethiopian universities. Data were extracted via a Microsoft Excel spreadsheet and then exported to STATA 17 for statistical analysis. A checklist from the Joanna Briggs Institute was utilized to assess the quality of the studies. A random-effects model was employed to estimate the pooled magnitude of vaccination dropout. Heterogeneity between studies was evaluated via the I-square test. Funnel plots and Egger’s regression test were utilized to assess publication bias. Results Seventeen articles with a total sample size of 9152 children (12–23 months old) were included in this meta-analysis. Consequently, the pooled magnitude of vaccination dropout from BCG to measles and Penta-1 to Penta-3 among children aged 12–23 months in Ethiopia was 16.93% (95% CI: 12.43, 21.44) and 13.16% (95% CI: 8.37, 17.96) respectively. Mothers who did not attend ANC (AOR = 3.58, 95% CI = 1.99, 6.44), postponed immunization schedule (AOR = 2.73, 95% CI = 1.53, 4.87), distance from the health care facility (AOR = 2.46, 95% CI = 2.01, 17.18), and home delivery (AOR = 2.78, 95% CI = 2.28, 3.38) were identified as significant factors associated with vaccine dropout. Conclusion The overall pooled magnitude of vaccination dropout among children in Ethiopia is greater than the WHO recommendation of less than 10%. Therefore, our findings suggest the necessity of counseling and educating women to attend antenatal care (ANC) follow-ups, give birth at healthcare facilities, and provide mobile and outreach immunization services for remote areas.
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spelling doaj-art-55e7a3ec5bbe48d2b66e8d3769af70852025-08-20T03:16:51ZengBMCBMC Pediatrics1471-24312025-05-0125111310.1186/s12887-025-05786-3Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)Eyasu Bamlaku Golla0Habtamu Geremew1Alegntaw Abate2Mohammed Ahmed Ali3Mulat Belay Simegn4Werkneh Melkie Tilahun5Samuel Abdisa Kuse6Smegnew Gichew Wondie7College of Health Sciences, Oda Bultum UniversityCollege of Health Sciences, Oda Bultum UniversityDepartment of Medical Laboratory Sciences, College of Health Science, Oda Bultum UniversityDepartment of Midwifery, College of Health Sciences, Oda Bultum UniversityDepartment of Public Health, College of Medicine and Health Sciences, Debre Markos UniversityDepartment of Public Health, College of Medicine and Health Sciences, Debre Markos UniversityDepartment of Medical Laboratory Sciences, College of Health Science, Oda Bultum UniversityDepartment of Human Nutrition, College of Medicine and Health Sciences, Mizan Tepi UniversityAbstract Background Children in sub-Saharan Africa, particularly in Ethiopia, continue to suffer from vaccine-preventable diseases (VPDs), contributing to child mortality. One of the key challenges is vaccination dropout, where children fail to receive subsequent doses after the initial vaccine, leading to incomplete immunization coverage. Hence, our review aimed to determine the pooled magnitude of vaccination dropout and the factors associated with it among children in Ethiopia. Method A comprehensive search of relevant studies was conducted through electronic web-based international databases and the institutional repository of Ethiopian universities. Data were extracted via a Microsoft Excel spreadsheet and then exported to STATA 17 for statistical analysis. A checklist from the Joanna Briggs Institute was utilized to assess the quality of the studies. A random-effects model was employed to estimate the pooled magnitude of vaccination dropout. Heterogeneity between studies was evaluated via the I-square test. Funnel plots and Egger’s regression test were utilized to assess publication bias. Results Seventeen articles with a total sample size of 9152 children (12–23 months old) were included in this meta-analysis. Consequently, the pooled magnitude of vaccination dropout from BCG to measles and Penta-1 to Penta-3 among children aged 12–23 months in Ethiopia was 16.93% (95% CI: 12.43, 21.44) and 13.16% (95% CI: 8.37, 17.96) respectively. Mothers who did not attend ANC (AOR = 3.58, 95% CI = 1.99, 6.44), postponed immunization schedule (AOR = 2.73, 95% CI = 1.53, 4.87), distance from the health care facility (AOR = 2.46, 95% CI = 2.01, 17.18), and home delivery (AOR = 2.78, 95% CI = 2.28, 3.38) were identified as significant factors associated with vaccine dropout. Conclusion The overall pooled magnitude of vaccination dropout among children in Ethiopia is greater than the WHO recommendation of less than 10%. Therefore, our findings suggest the necessity of counseling and educating women to attend antenatal care (ANC) follow-ups, give birth at healthcare facilities, and provide mobile and outreach immunization services for remote areas.https://doi.org/10.1186/s12887-025-05786-3Vaccine dropoutAssociated factorsEthiopiaSystematic reviewMeta analysis
spellingShingle Eyasu Bamlaku Golla
Habtamu Geremew
Alegntaw Abate
Mohammed Ahmed Ali
Mulat Belay Simegn
Werkneh Melkie Tilahun
Samuel Abdisa Kuse
Smegnew Gichew Wondie
Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)
BMC Pediatrics
Vaccine dropout
Associated factors
Ethiopia
Systematic review
Meta analysis
title Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)
title_full Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)
title_fullStr Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)
title_full_unstemmed Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)
title_short Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014–2024)
title_sort vaccination dropout and associated factors among children in ethiopia a systematic review and meta analysis 2014 2024
topic Vaccine dropout
Associated factors
Ethiopia
Systematic review
Meta analysis
url https://doi.org/10.1186/s12887-025-05786-3
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