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Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis

BACKGROUND: Immunization has been promoted as a global strategy aimed at improving child survival. The World Health Organization strives to make immunization services available to everyone, everywhere to save over 50 million lives by 2030. Monitoring the change and identifying the factors contributi...

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Autores principales: Asresie, Melash Belachew, Dagnew, Gizachew Worku, Bekele, Yibeltal Alemu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10499235/
https://www.ncbi.nlm.nih.gov/pubmed/37703252
http://dx.doi.org/10.1371/journal.pone.0291499
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author Asresie, Melash Belachew
Dagnew, Gizachew Worku
Bekele, Yibeltal Alemu
author_facet Asresie, Melash Belachew
Dagnew, Gizachew Worku
Bekele, Yibeltal Alemu
author_sort Asresie, Melash Belachew
collection PubMed
description BACKGROUND: Immunization has been promoted as a global strategy aimed at improving child survival. The World Health Organization strives to make immunization services available to everyone, everywhere to save over 50 million lives by 2030. Monitoring the change and identifying the factors contributing to the change in immunization coverage over time and across the nations is imperative for continuing global success in increasing immunization coverage. In this study, we examined the changes and factors that contributed to the change in full immunization coverage over time in Ethiopia (2000 to 2019). METHODS: We analyzed data on children aged 12–23 months, extracted from the 2000 and 2019 Ethiopian Demographic and Health Survey (EDHS) datasets. A total of 3,072 weighted samples (2,076 in 2000 and 966 in 2019) were included in the analysis. A multivariate decomposition analysis technique was used to determine change and identify factors that contributed to the change over time. Statistical significance was defined at a 95% confidence interval with a p-value of less than 0.05. RESULTS: There was a 29.56% (95% CI: 24.84, 34.28) change in full immunization coverage between the two surveys. It increased from 14.62% (95% CI: 12.43, 17.11) in 2000 to 44.18% (95% CI: 37.19, 51.41) in 2019. The decomposition analysis showed that about 75% of explained change was attributed to the differences in the composition of explanatory variables (the endowment effect). Particularly, women aged 35–49 years (-2.11%), those who attended four or more antenatal care visits (17.06%), individual who had postnatal care visits (16.90%), households with two or more under-five children (2.50%), and those with a history of child mortality (17.80%) were significantly attributed to the change. The rest, 25% of the explained change was attributed to the difference in the effects of explanatory variables (coefficient). The change in the coefficient for women who had experienced child death (-20.40%) was statistically significant to the change in full immunization coverage over time. CONCLUSION: The finding of this study revealed that there was a statistically significant change in full immunization coverage over time. The majority of the change was attributed to the differences in the composition of explanatory variables such as antenatal care and postnatal care visits, age of the mother, and number of living children in the household. Therefore, strengthening maternal health services utilization may enhance immunization coverage in Ethiopia. Furthermore, the difference in coefficient of mothers with a history of child death had a substantial counteracting effect on the change, emphasizing the importance of raising awareness and delivering vaccine education to them and the larger community.
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spelling pubmed-104992352023-09-14 Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis Asresie, Melash Belachew Dagnew, Gizachew Worku Bekele, Yibeltal Alemu PLoS One Research Article BACKGROUND: Immunization has been promoted as a global strategy aimed at improving child survival. The World Health Organization strives to make immunization services available to everyone, everywhere to save over 50 million lives by 2030. Monitoring the change and identifying the factors contributing to the change in immunization coverage over time and across the nations is imperative for continuing global success in increasing immunization coverage. In this study, we examined the changes and factors that contributed to the change in full immunization coverage over time in Ethiopia (2000 to 2019). METHODS: We analyzed data on children aged 12–23 months, extracted from the 2000 and 2019 Ethiopian Demographic and Health Survey (EDHS) datasets. A total of 3,072 weighted samples (2,076 in 2000 and 966 in 2019) were included in the analysis. A multivariate decomposition analysis technique was used to determine change and identify factors that contributed to the change over time. Statistical significance was defined at a 95% confidence interval with a p-value of less than 0.05. RESULTS: There was a 29.56% (95% CI: 24.84, 34.28) change in full immunization coverage between the two surveys. It increased from 14.62% (95% CI: 12.43, 17.11) in 2000 to 44.18% (95% CI: 37.19, 51.41) in 2019. The decomposition analysis showed that about 75% of explained change was attributed to the differences in the composition of explanatory variables (the endowment effect). Particularly, women aged 35–49 years (-2.11%), those who attended four or more antenatal care visits (17.06%), individual who had postnatal care visits (16.90%), households with two or more under-five children (2.50%), and those with a history of child mortality (17.80%) were significantly attributed to the change. The rest, 25% of the explained change was attributed to the difference in the effects of explanatory variables (coefficient). The change in the coefficient for women who had experienced child death (-20.40%) was statistically significant to the change in full immunization coverage over time. CONCLUSION: The finding of this study revealed that there was a statistically significant change in full immunization coverage over time. The majority of the change was attributed to the differences in the composition of explanatory variables such as antenatal care and postnatal care visits, age of the mother, and number of living children in the household. Therefore, strengthening maternal health services utilization may enhance immunization coverage in Ethiopia. Furthermore, the difference in coefficient of mothers with a history of child death had a substantial counteracting effect on the change, emphasizing the importance of raising awareness and delivering vaccine education to them and the larger community. Public Library of Science 2023-09-13 /pmc/articles/PMC10499235/ /pubmed/37703252 http://dx.doi.org/10.1371/journal.pone.0291499 Text en © 2023 Asresie et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Asresie, Melash Belachew
Dagnew, Gizachew Worku
Bekele, Yibeltal Alemu
Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis
title Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis
title_full Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis
title_fullStr Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis
title_full_unstemmed Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis
title_short Changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis
title_sort changes in immunization coverage and contributing factors among children aged 12–23 months from 2000 to 2019, ethiopia: multivariate decomposition analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10499235/
https://www.ncbi.nlm.nih.gov/pubmed/37703252
http://dx.doi.org/10.1371/journal.pone.0291499
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