Disparities in full immunization coverage among urban and rural children aged 12-23 months in southwest Ethiopia: A comparative cross-sectional study

ABSTRACT

Vaccination coverage worldwide fell from 86% in 2019 to 83% in 2020. The purpose of this research was to determine the level of full immunization coverage among children aged 12 to 23 months in both urban and rural Southwest Ethiopia. A comparative cross-sectional study of sampled 644 children aged 12 to 23 months was conducted in the community (296 from urban areas and 348 from rural areas). Chi-square testing was used to determine whether there was a significant difference in full immunization coverage between urban and rural children, and binary logistic regression was used to identify predictors of full immunization. This study included 635 caregivers of children aged 12–23 months (292 from urban areas and 343 from rural areas), yielding a 98.4% response rate. The overall, full immunization coverage among the whole children was 66.1%. There was a significant difference in fully immunization coverage between urban 74.3% and rural 59.2% of children (χ2 = 16.126, P = .000). Residence, wealth index, ANC follow up and fear of COVID 19 infection at health institutions were predictor variables for overall full vaccination. Knowledge and place of delivery were predictor variables for full vaccination in the urban area whereas distance and male partner involvement in the rural area. Vaccination coverage was higher in urban compared to rural areas but it is still far below the WHO recommended target. Promoting male involvement, health education, and communication are crucial for alleviating poor knowledge about child immunization.

KEYWORDS:

• Full immunization
• urban-rural disparity
• associated factors
• Ethiopia

Acknowledgment

I want to thank my colleagues for giving suggestions. I am very grateful to the Wolaita Sodo University College of Health Science and Medicine for giving me the ethical clearance. We are also indebted to thank the respective universities and study participants for their cooperation during data collection.

Authors’ contribution

GA, conceived the research idea and developed the proposal, participated in data collection and analysis, and drafted the paper. MM & AS enriched the concept and proposal write-up participated in data analysis and drafting of the manuscript, and critically reviewed the manuscript. All the authors read and approved the final manuscript.

Abbreviations

AOR Adjusted Odds Ratio

ANC Antenatal Care

BCG Bacille Calmette-Guérin

COVID 19 Corona Virus Diseases 2019

COR Crude Odds Ratio

CI Confidence

EDHS Ethiopian Demographic and Health Survey

EPI Expanded Program of Immunization

GVAP Global Vaccine Action Plan

HSDP-IV Health Sector Development Plan IV

IPV Injectable Polio Vaccine

OPV Oral Polio Vaccine

PCV Pneumococcal Conjugate Vaccine

SD Standard Deviation

SPSS Statistical Package for Social Science

SSA Sub Saharan Africa

TT Tetanus Toxoid

WHO World Health Organization

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval and consent from the participant

The Institutional Review Board (IRB) of Wolaita Sodo University approved all experimental protocols. All methods were carried out in accordance with relevant guidelines and regulations. Before the interview, informed written consent was obtained from all mothers or caregivers of children aged 12–23 months. Participants were informed that they could skip any questions that they didn’t want to answer completely or partially and that they could stop at any time. By not recording identifying information, the confidentiality of the individual information was ensured.

Data availability statement

The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.