Individual and community level maternal factors for zero-dose children in Ethiopia using mini-EDHS 2019: a mixed
Muluken Chanie Agimas1, Meron Asmamaw Alemayehu2, Tigabu Kidie Tesfie3
1Epidemiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia mulukensrc12@gmail.com.
Insights
In Ethiopia, 16.3% of children aged 12-35 months were zero-dose, meaning they received no childhood vaccines. Key risk factors included lack of antenatal care, no formal education, and home births, highlighting the need for improved maternal health services.
Area of Science:
- Public Health
- Pediatrics
- Global Health
Background:
- Zero-dose children, defined as those unvaccinated, represent a significant global public health challenge.
- In sub-Saharan Africa, approximately one in five children lack access to essential vaccines.
- Identifying factors contributing to zero-dose status in Ethiopia remains underexplored.
Purpose of the Study:
- To investigate individual and community-level maternal risk factors associated with zero-dose children in Ethiopia.
- Utilized data from the mini-Ethiopian Demographic Health Survey 2019.
Main Methods:
- Employed a secondary analysis of a cross-sectional study involving 3208 participants.
- Utilized STATA-14 for descriptive statistics and multilevel binary logistic regression (mixed effects model).
- Model selection was guided by Akaike information criteria, with statistical significance set at p <0.05 and 95% Confidence Intervals.
Main Results:
- The prevalence of zero-dose children aged 12-35 months was 16.3% (523 children).
- Identified risk factors included: no antenatal care (AOR=1.55), maternal lack of education (AOR=1.47), home delivery (AOR=1.39), poor wealth index (AOR=2.15), and low community media exposure (AOR=1.39).
Conclusions:
- The prevalence of zero-dose children in Ethiopia was found to be relatively low compared to previous studies.
- Maternal factors such as urban residence, no education, home delivery, poor wealth index, no antenatal care visits, and limited community media exposure are significant risk factors.
- Enhancing maternal health services and increasing media access for women are crucial recommendations to decrease zero-dose children mortality.
Introduction:
Zero-dose children refer to a child who has not yet received any childhood vaccines. Globally, zero-dose children are the major public health problem. In sub-Saharan African countries, one among five children do not have access to vaccines. But the efforts to identify the factors contributing to the zero-dose children are not well addressed in Ethiopia.
Objectives:
To assess individual and community-level maternal factors of zero-dose children in Ethiopia using mini-Ethiopian Demographic Health Survey 2019.
Methods:
A secondary analysis of a cross-sectional study was used among a total of 3208 participants. STATA-14 was used for descriptive and multilevel binary logistic regression (mixed effects model) analysis. Model selection was conducted using Akaike information criteria. To identify significant factors for zero-dose children, a p value of <0.05 with 95% CI was used.
Results:
The prevalence of zero-dose children among children aged 12-35 months was 523 (16.3%, 95% CI 15% to 17.6%). Women with no antenatal care follow-up (adjusted OR (AOR)=1.55, 95% CI 1.02 to 2.35), uneducated women (AOR=1.47, 95% CI 1.11 to 1.95), women who gave birth at home (AOR=1.39, 95% CI 1.04 to 1.86), women who had poor wealth index (AOR=2.15, 95% CI 1.62 to 2.85) and women from low proportions of community media exposure (AOR=1.39, 95% CI 1.13 to 1.71) were the risk factors for zero-dose children in Ethiopia.
Conclusion:
Compared with previous studies, the prevalence of zero-dose children was low in Ethiopia. Variables like urban residence, no education, home delivery, poor wealth index, no antenatal care(ANC) visit and women from low proportions of community media exposure were the risk factors for zero-dose children in Ethiopia. Therefore, expanding maternal health services and media access for women is highly recommended to reduce zero-dose children mortality.
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