Factors influencing vaccination coverage among children age 12–23 months in Afghanistan: Analysis of the 2015 Demographic and Health Survey

BACKGROUND: Childhood vaccination plays a key role in reducing morbidity and mortality from vaccine-preventable diseases. Numerous studies have assessed the influence of demographic and socioeconomic factors on child immunization around the world. There are few such studies in Afghanistan, however. Therefore, this study aimed to identify factors influencing vaccination status among children age 12–23 months in Afghanistan. MATERIALS AND METHODS: Nationally representative data from the 2015 Afghanistan Demographic and Health Survey were used for this study. A sample of 5,708 children age 12–23 months with a vaccine card and immunization history was analyzed. Multinomial logistic regression was used to identify significant relationships between cofactors and vaccination status. RESULTS: In the study, 51% the subjects were boys, 48% were born at home, and 76% were residents of rural areas. Background characteristics positively associated with vaccination status included delivery in a health facility (RRR = 2.5, 95% CI = 1.9–3.3), maternal age of 30–39 years (RRR = 2.2, 95% CI = 1.2–4.1), attending at least four visits for antenatal care (RRR = 2.7, 95% CI = 1.7–4.5), health facility visit in the past 12 months (RRR = 1.9, 95% CI = 1.4–2.5), paternal professional occupation (RRR = 4.9, 95% CI = 2.0–12.3), family with richer wealth index (RRR = 2.4, 95% CI = 1.4–4.1), and living in the northeast region (RRR = 2.2, 95% CI = 1.2–3.9)were positively associated with vaccination status. Living in the southern region (RRR = 0.3, 95% CI = 0.2–0.5) was negatively associated with vaccination status. CONCLUSION: This study identified maternal age, ANC visits, place of delivery, health facility visits in past 12 months, paternal occupation, wealth quintile, and geographic region as the factors influencing child’s vaccination status in Afghanistan.