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Determinants of BCG vaccine coverage among 0-2 months aged Somali children: Promoting equality in vaccination

Abdirashid M Yousuf1, Mohamed A Hussein2, Hassan Sh Abdirahman Elmi3

  • 1Research and Innovation Center, Amoud University, Borama, Somaliland.

Human Vaccines & Immunotherapeutics
|June 26, 2026
PubMed

Insights

BCG vaccination coverage for infants in Somalia is 79.7%, significantly higher than the national average. However, nomadic infants and those whose mothers lack healthcare access show lower uptake, highlighting persistent inequities.

Area of Science:

  • Public Health
  • Pediatrics
  • Epidemiology

Background:

  • Somalia faces low overall immunization rates, with only 37.0% BCG coverage for children under five in 2020.
  • BCG vaccination coverage for newborns and early infants in Somalia is underexplored, despite its importance.

Purpose of the Study:

  • To assess the determinants of BCG vaccination among infants aged 0-2 months in Somalia.
  • To identify factors associated with BCG uptake in early infancy.

Main Methods:

  • Secondary data analysis of the 2020 Somalia Demographic and Health Survey (SDHS).
  • Inclusion of 457 mother-infant pairs.
  • Descriptive statistics and multivariable logistic regression were employed.

Main Results:

  • BCG coverage among infants aged 0-2 months was 79.7% (95% CI: 75.8%-83.2%).
  • Infants in nomadic communities were significantly less likely to be vaccinated (OR=0.18, p<.01).
  • Maternal primary education (OR=2.62, p<.05) and lack of maternal healthcare utilization (antenatal care, health-facility delivery) (OR=0.41, p<.01) were key determinants.

Conclusions:

  • Early infant BCG coverage in Somalia is higher than the national average for all children under five.
  • Significant inequities in BCG vaccination persist, particularly affecting nomadic and rural populations.
  • Improving maternal education and increasing healthcare facility contact are crucial for reducing immunization gaps.

Keywords:
BCG vaccination coverageSDHSSomaliainfant immunizationpublic health

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