Evidence map›Paper›PMID 41536922›Full record

ArticleGates open research2026

Zero-Dose Childhood Immunization in Conflict-Affected PSNP Districts of Ethiopia: A Comparative Cross-Sectional Study.

Fisseha Shiferie, Gashaw Andargie Biks, Kidist Negash, Dawit A Tsegaye, Gobena Seboka, Getnet Birhanu, Shibabaw Ewnetie, Tenaye Abate, Uche RalphOpara, Wondwossen A Alemayehu and 4 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Gates open research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Fisseha ShiferieProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Gashaw Andargie BiksProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Kidist NegashProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Dawit A TsegayeProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Gobena SebokaProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Getnet BirhanuProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Shibabaw EwnetieProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Tenaye AbateProject HOPE Ethiopia Country Office, Addis Ababa, Ethiopia.
Uche RalphOparaProject HOPE Headquarters, Washington, D.C., USA.
Wondwossen A AlemayehuProject HOPE Headquarters, Washington, D.C., USA.
Joseph OduProject HOPE Africa Regional Office, Windhoek, Namibia.
Steven NeriProject HOPE Africa Regional Office, Windhoek, Namibia.
Frank DelPizzoGates Foundation, Seattle, Washington, USA.
Kidist BeleteUSAID Ethiopia Country Office, Addis Ababa, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Childhood immunisation is one of the most cost-effective public health interventions, preventing 4-5 million deaths annually. This study assessed the prevalence and determinants of zero-dose immunisation among children aged 12-35 months in conflict-affected districts implementing Ethiopia's Productive Safety Net Programme (PSNP) to determine whether intervention and comparison areas are comparable before rollout of the enhanced service-integration model. Methods: A comparative cross-sectional survey was conducted among 4,099 mothers and caregivers of children aged 12-35 months in intervention and comparison PSNP districts. Data were collected using a structured questionnaire administered by trained enumerators. Multivariable logistic regression was used to identify factors associated with zero-dose status. Results: Zero-dose prevalence was 30% in intervention districts and 27% in comparison districts, with notable regional disparities: 22.5% in Amhara, 23% in Afar, and 39% in Tigray. Vaccination dropout showed a different pattern, with the highest rate in Afar (57.6%) and the lowest in Tigray (13.6%). DTP3 coverage was lowest in Afar (42.9%) and highest in Amhara (69.4%), while MCV1 coverage was highest in Tigray (83.8%), followed by Amhara (79.6%) and Afar (49.1%). In intervention districts, zero-dose status was significantly associated with region (AOR = 1.5; 95% CI: 1.1-2.2), lack of maternal education (AOR = 1.7; 95% CI: 1.1-2.7), unmarried status (AOR = 1.8; 95% CI: 1.0-3.2), older child age (24-35 months) (AOR = 3.7; 95% CI: 2.6-5.3), and longer distance to health facilities (AOR = 1.4; 95% CI: 1.0-2.2). In comparison districts, region, maternal education, and older child age remained significant predictors. Conclusions: The study highlights persistent inequities in immunisation coverage in conflict-affected settings. It also demonstrates comparability between intervention and comparison PSNP districts in zero-dose prevalence and its determinants. These baseline findings provide a foundation for attributing future post-intervention improvements to enhanced integration of health services within the PSNP framework.

Indexed as

Armed ConflictsImmunization ProgramsVaccinationVaccination CoverageAdultChild, PreschoolCross-Sectional StudiesEthiopiaFemaleHumansInfantLogistic ModelsMaleMothersSurveys and QuestionnairesUnvaccinated PersonsConflict-affected settingsEthiopiaHealth equityImmunization coverageMaternal educationPSNPVaccination dropoutZero-dose

Identifiers

PMID41536922
PMCPMC12795798

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.