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.

BMJ Open
|January 8, 2025
PubMed

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.
Abstract