ArticleBMC public health2019
Trends of inequalities in childhood immunization coverage among children aged 12-23 months in Kenya, Ghana, and Côte d'Ivoire.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- To what extent are vulnerability issues included and addressed in Kenya's health and immunization policy documents? A systematic review of documents.NIHR open research · 2025Pooled it
- Progress in reaching zero-dose children: analysis of population-modifiable risk factors and inequity trends in low- and lower-middle-income countries.International journal for equity in health · 2026Article
- Progress and gaps in childhood immunization among two-year-olds in Ghana (1993-2022): A trend and equity analysis.PloS one · 2026Article
- Assessing Postnatal Immunisation Services in a Low-Resource Setting: A Cross-Sectional Survey.Healthcare (Basel, Switzerland) · 2025Article
- Characteristics of Studies Focusing on Vaccine Series Completion Among Children Aged 12-23 Months in Sub-Saharan Africa: A Scoping Review.Children (Basel, Switzerland) · 2025Review
- Trends and inequalities in full immunization coverage among two-year-olds in Sierra Leone, 2008-2019.PloS one · 2025Article
- Inequality in Childhood Immunization Coverage: A Scoping Review of Data Sources, Analyses, and Reporting Methods.Vaccines · 2024Article
- Socioeconomic and residence-based related inequality in childhood vaccination in Sub-Saharan Africa: Evidence from Benin.Health science reports · 2023Article
- Trends, projection and inequalities in full immunization coverage in Ethiopia: in the period 2000-2019.BMC pediatrics · 2022Article
- Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya.BMC infectious diseases · 2021Article
- Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: an explorative ecological study using DHIMSII data from one district in the Volta region of Ghana.BMC pregnancy and childbirth · 2020Article
- The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: analysis from four recent demographic and health surveys in Nepal.BMC public health · 2019Article
- A Decomposition Analysis to Understand the Wealth-Based Inequalities in Child Vaccination in Rural Southern Assam: A Cross-Sectional Study.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
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Authors and funding
3 authors at 2 institutions in 2 countries.
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Abstract
backgroundImmunization is one of the most cost-effective health intervention to halt the spread of childhood diseases, and improve child health. Yet, there is a substantial disparity in childhood immunization coverage. The overall objective of the study is to investigate the trends of within-country inequalities in childhood immunization coverage among children aged 12-23 months in Kenya, Ghana, and Côte d'Ivoire. The three countries included in this study are countries that are on the verge of entering the accelerated phase of the Gavi, the Vaccine Alliance's co-sharing of costs of vaccine and eventually assuming full costs of vaccines. Côte d'Ivoire is in the Gavi preparatory transition phase, entering the accelerated transition phase in 2020, with an expected transition to full self-financing in 2025. Ghana is expected to enter the accelerated transition phase in 2021 and to full self-financing in 2026 while Kenya will enter in 2022 and fully self-finance in 2027. We examine the pattern of inequality in childhood immunization coverage over time through an equity lens by mainly exploring the direction of inequality in coverage.
methodsWe use data from the Demographic Health Surveys and Multiple Indicator Cluster Surveys. The rate difference, rate ratio, and relative concentration index are used as measures of inequality.
resultsResults of the study suggest that in most years inequality in immunization coverage in the three countries persist over time, and it favors the most-advantaged households. However, there is a sharp decrease pattern in inequalities in childhood immunization coverage in Ghana over time.
conclusionPolicymakers could be more strategic in addressing pro-rich inequality in immunization coverage by designing health interventions through an equity lens. Using inequality data and putting disadvantaged households at the center of health intervention designs could increase the efficiency of the primary health care system and reduce the incidence of mortality and morbidity as a result of vaccine-preventable disease.
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