ArticleMaternal and child health journal2026
Completion of the National Childhood Immunization Schedule and Associated Factors Among Children Aged 24-35 Months in Afghanistan: A Nationwide Analysis of MICS 2022-23.
Article in Maternal and child health journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildhood immunization coverage remains low in Afghanistan, but evidence is limited regarding completion of the broader national immunization schedule beyond the first year of life. This study estimated full-schedule immunization coverage and examined factors associated with its completion among Afghan children aged 24-35 months.
methodsWe analysed nationally representative data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2022-23, including 6342 children aged 24-35 months. Full immunization was defined according to the MICS TC.11b indicator for completion of all vaccinations included in the national childhood immunization schedule. Survey-weighted analyses estimated vaccine-specific coverage, within-series dropout and provincial variation. A prespecified survey-weighted multivariable logistic regression model was used to identify factors associated with full-schedule completion.
resultsOnly 16.2% (95% CI 14.7-17.7) of children had completed the full national immunization schedule. Coverage was particularly low for Inactivated Poliovirus Vaccine (IPV2) (24.6%) and measles-containing vaccine (MCV)- 2 (36.8%), and 49.2% of children who had received IPV1 had not received IPV2. Full-schedule completion varied markedly across provinces, from 3.1 to 37.7%. In the adjusted analysis, maternal primary education (AOR 1.55, 95% CI 1.11-2.19) and secondary or higher education (AOR 1.72, 95% CI 1.15-2.57), paternal primary education (AOR 1.68, 95% CI 1.13-2.50) and secondary or higher education (AOR 1.94, 95% CI 1.48-2.55), and maternal mobile-phone ownership (AOR 1.29, 95% CI 1.03-1.61) were associated with greater odds of full-schedule completion.
conclusionCompletion of the national childhood immunization schedule remains very low in Afghanistan, with substantial attrition across multi-dose vaccine series and marked geographical variation. Strengthening continuity of vaccination, follow-up for later doses, and accessible family-focused vaccination communication may help improve schedule completion.
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