ArticleVaccine: X2024
In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study.
Article in Vaccine: X, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Disparities and barriers to life-course vaccination in Ethiopia: Evidence from a household survey.Human vaccines & immunotherapeutics · 2026Article
- Article
- 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
- Article
- Barriers to and enablers of childhood immunization uptake in Ethiopia's Amhara, Oromia, and Somali Regions: A multi-perspective qualitative study.PLOS global public health · 2026Article
- Article
- Prevalence of zero-dose vaccination and its associated factors in urban areas of Somali region, Ethiopia: a mixed-methods approach.BMJ public health · 2026Article
- Zero-Dose Childhood Immunization in Conflict-Affected PSNP Districts of Ethiopia: A Comparative Cross-Sectional Study.Gates open research · 2026Article
- Behavioural and social drivers of immunisation among zero dose children in pastoralist communities of Ethiopia: a qualitative study.BMJ open · 2025Article
- Enhancing the use of routine program data for immunization decision-making: The role of coincidence analysis in localized learning and adaptation.Human vaccines & immunotherapeutics · 2025Article
- The future impact of zero-dose children in inaccessible conflict-affected areas of Somalia: aligned with the immunization agenda 2030.Tropical medicine and health · 2025Article
- Gender-Associated Factors on the Occurrence and Prevalence of Zero-Dose Children in Sub-Saharan Africa: A Critical Literature Review.Tropical medicine and infectious disease · 2025Review
- Gender Dynamics in Vaccine Acceptance and Hesitancy Among Primary Caregivers in Ethiopia: A Mixed-Methods Study.Vaccines · 2025Article
- Decentralized Immunization Monitoring: Lessons Learnt from a Pilot Implementation in Kumbotso LGA, Kano State, Nigeria.Vaccines · 2025Article
- Risk factors associated with zero-dose and under-immunized children, and the number of vaccination doses received by children in Ethiopia: a negative binomial regression analysis.BMC public health · 2025Article
- Determinants of Under-Immunization Among Children Between 0 and 59 Months in Buea Municipality, South Western Cameroon: Implications for National Immunization Campaign.Healthcare (Basel, Switzerland) · 2025Article
- Insights from a measles outbreak root cause analysis in Ethiopia - 2024.The Pan African medical journal · 2025Article
- Zero-Dose Vaccination Among Children Aged 12-35 Months in Ethiopia.TheScientificWorldJournal · 2025Article
- Understanding Socioeconomic Inequalities in Zero-Dose Children for Vaccination in Underserved Settings of Ethiopia: Decomposition Analysis Approach.International journal of environmental research and public health · 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
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Increasing attention is being given to reach children who fail to receive routine vaccinations, commonly designated as zero-dose children. A comprehensive understanding of the supply- and demand-side barriers is essential to inform zero-dose strategies in high-burden countries and achieve global immunization goals. This qualitative study aimed to identify the barriers for reaching zero-dose and under-immunized children and what and explore gender affects access to vaccination services for children in Ethiopia. Data was collected between March-June 2022 using key informant interviews and focus group discussions with participants in underserved settings. The high proportion of zero-dose children was correlated with inadequate information being provided by health workers, irregularities in service provision, suboptimal staff motivation, high staff turnover, closure and inaccessibility of health facilities, lack of functional health posts, service provision limited to selected days or hours, and gender norms viewing females as responsible for childcare. Demand-side barriers included religious beliefs, cultural norms, fear of vaccine side effects, and lack of awareness and sustained interventions. Recommendations to increase vaccination coverage include strengthening health systems such as services integration, human resources capacity building, increasing incentives for health staff, integrating vaccination services, bolstering the EPI budget especially from the government side, and supporting reliable outreach and static immunization services. Additionally, immunization policy should be revised to include gender considerations including male engagement strategies to improve uptake of immunization services.
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