ArticleBMJ global health2019
Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000-2017.
Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Vaccination dropout and associated factors among children in Ethiopia: a systematic review and meta-analysis (2014-2024).BMC pediatrics · 2025Pooled it
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- Vaccine equity in low and middle income countries: a systematic review and meta-analysis.International journal for equity in health · 2022Pooled it
- Estimating time-varying cholera transmission and oral cholera vaccine effectiveness in Haiti and Cameroon, 2021-2023.BMJ open · 2026Article
- Estimating population immunity against serotype-two poliomyelitis from the inactivated polio vaccine in routine immunization across 112 countries: A modelling study.PLoS medicine · 2026Article
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- Social Listening in Infodemic Management: Insights from Preparatory Work on Ethical Guidance.Asian bioethics review · 2025Article
- Regional, subregional and country-level full vaccination coverage in children aged 12-23 months for 34 countries in sub-Saharan Africa: a global analysis using Demographic and Health Survey data.BMJ global health · 2025Article
- Epidemiology of Yellow Fever in Nigeria: Analysis of Climatic, Ecological, Socio-Demographic, and Clinical Factors Associated with Viral Positivity Among Suspected Cases Using National Surveillance Data, 2017-2023.Journal of epidemiology and global health · 2025Article
- The association between routine immunisation and COVID-19 vaccination in small Island developing states.PloS one · 2025Article
- Addressing the re-emergence and resurgence of vaccine-preventable diseases in Africa: A health equity perspective.Human vaccines & immunotherapeutics · 2024Review
- Inequality in Childhood Immunization Coverage: A Scoping Review of Data Sources, Analyses, and Reporting Methods.Vaccines · 2024Article
- Decomposition Analysis of Socioeconomic Inequalities in Vaccination Dropout in Remote and Underserved Settings in Ethiopia.The American journal of tropical medicine and hygiene · 2024Article
- Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015-2021.BMJ global health · 2023Article
- Vaccination coverage in rural Burkina Faso under the effects of COVID-19: evidence from a panel study in eight districts.BMC health services research · 2023Article
- Multivariate assessment of vaccine equity in Nigeria: A VERSE tool case study using demographic and health survey 2018.Vaccine: X · 2023Article
- Improving the timeliness and completeness of childhood vaccination through color-coded bracelets: a pilot study among Fulani tribe populations in Nigeria.Journal of public health in Africa · 2023Article
- Exploring the Pattern of Immunization Dropout among Children in India: A District-Level Comparative Analysis.Vaccines · 2023Article
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Authors and funding
9 authors at 4 institutions in 6 countries.
Funding
Abstract
backgroundSeveral West African countries are unlikely to achieve the recommended Global Vaccine Action Plan (GVAP) immunisation coverage and dropout targets in a landscape beset with entrenched intra-country equity gaps in immunisation. Our aim was to assess and compare the immunisation coverage, dropout and equity gaps across 15 West African countries between 2000 and 2017.
methodsWe compared Bacille Calmette Guerin (BCG) and the third dose of diphtheria-tetanus-pertussis (DTP3) containing vaccine coverage between 2000 and 2017 using the WHO and Unicef Estimates of National Immunisation Coverage for 15 West African countries. Estimated subregional median and weighted average coverages, and dropout (DTP1-DTP3) were tracked against the GVAP targets of ≥90% coverage (BCG and DTP3), and ≤10% dropouts. Equity gaps in immunisation were assessed using the latest disaggregated national health survey immunisation data.
resultsThe weighted average subregional BCG coverage was 60.7% in 2000, peaked at 83.2% in 2009 and was 65.7% in 2017. The weighted average DTP3 coverage was 42.3% in 2000, peaked at 70.3% in 2009 and was 61.5% in 2017. As of 2017, 46.7% of countries (7/15) had met the GVAP targets on DTP3 coverage. Average weighted subregional immunisation dropouts consistently reduced from 16.4% in 2000 to 7.4% in 2017, meeting the GVAP target in 2008. In most countries, inequalities in BCG, and DTP3 coverage and dropouts were mainly related to equity gaps of more than 20% points between the wealthiest and the poorest, high coverage regions and low coverage regions, and between children of mothers with at least secondary education and those with no formal education. A child's sex and place of residence (urban or rural) minimally determined equity gaps.
conclusionsThe West African subregion made progress between 2000 and 2017 in ensuring that its children utilised immunisation services, however, wide equity gaps persist.
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