ArticleEnvironmental health and preventive medicine2021
Geographical variations and associated factors of defaulting from immunization among children aged 12 to 23 months in Ethiopia: using spatial and multilevel analysis of 2016 Ethiopian Demographic and Health Survey.
Article in Environmental health and preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 18 citations in OpenAlex.
- Spatial distribution and multilevel determinants of unvaccinated children in Somaliland: analysis of the 2020 Somaliland Health and Demographic Survey (SLHDS).BMC public health · 2026Article
- Mapping the disparities in childhood immunization status and determinants in East Africa using ordinal logistic regression analysis.Scientific reports · 2025Article
- Effective coverage of child immunisation service in Ethiopia.Scientific reports · 2025Article
- A systematic review on factors influencing immunisation adherence among children under 12 years of age.Health SA = SA Gesondheid · 2025Article
- Spatial distribution of effective coverage of child immunisation in Ethiopia.BMJ public health · 2025Article
- Article
- Determinants of incomplete immunization among 12-23 months old children in Ethiopia: A multilevel analysis.PloS one · 2025Article
- Article
- Low Measles Vaccination Coverage and Spatial Analysis of High Measles Vaccination Dropout in Ethiopia's Underprivileged Areas.Vaccines · 2024Article
- Spatial distribution of zero-dose children in Ethiopia: evidence for a targeted intervention from a large-scale cross-sectional evaluation survey.Frontiers in pediatrics · 2024Article
- Article
- Mapping geographical inequalities of incomplete immunization in Ethiopia: a spatial with multilevel analysis.Frontiers in public health · 2024Article
- Spatiotemporal distributions of under-five mortality in Ethiopia between 2000 and 2019.PLOS global public health · 2023Article
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4 authors at 3 institutions in 1 country.
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Abstract
backgroundIn Ethiopia, despite the considerable improvement in immunization coverage, the burden of defaulting from immunization among children is still high with marked variation among regions. However, the geographical variation and contextual factors of defaulting from immunization were poorly understood. Hence, this study aimed to identify the spatial pattern and associated factors of defaulting from immunization.
methodsAn in-depth analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS 2016) data was used. A total of 1638 children nested in 552 enumeration areas (EAs) were included in the analysis. Global Moran's I statistic and Bernoulli purely spatial scan statistics were employed to identify geographical patterns and detect spatial clusters of defaulting immunization, respectively. Multilevel logistic regression models were fitted to identify factors associated with defaulting immunization. A p value < 0.05 was used to identify significantly associated factors with defaulting of child immunization.
resultsA spatial heterogeneity of defaulting from immunization was observed (Global Moran's I = 0.386379, p value < 0.001), and four significant SaTScan clusters of areas with high defaulting from immunization were detected. The most likely primary SaTScan cluster was seen in the Somali region, and secondary clusters were detected in (Afar, South Nation Nationality of people (SNNP), Oromiya, Amhara, and Gambella) regions. In the final model of the multilevel analysis, individual and community level factors accounted for 56.4% of the variance in the odds of defaulting immunization. Children from mothers who had no formal education (AOR = 4.23; 95% CI: 117, 15.78), and children living in Afar, Oromiya, Somali, SNNP, Gambella, and Harari regions had higher odds of having defaulted immunization from community level.
conclusionsA clustered pattern of areas with high default of immunization was observed in Ethiopia. Both the individual and community-level characteristics were statistically significant factors of defaulting immunization. Therefore, the Federal Ethiopian Ministry of Health should prioritize the areas with defaulting of immunization and consider the identified factors for immunization interventions.
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