Inequities in On-Time Childhood Vaccination: Evidence From Sub-Saharan Africa.

Autor: Mutua MK; African Population and Health Research Center, Nairobi, Kenya. Electronic address: mkavao@aphrc.org., Mohamed SF; African Population and Health Research Center, Nairobi, Kenya., Porth JM; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Global Institute for Vaccine Equity, School of Public Health, University of Michigan, Ann Arbor, Michigan., Faye CM; African Population and Health Research Center, Dakar, Senegal.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2021 Jan; Vol. 60 (1 Suppl 1), pp. S11-S23. Date of Electronic Publication: 2020 Nov 13.
DOI: 10.1016/j.amepre.2020.10.002
Abstrakt: Introduction: Vaccination coverage has improved in the past decade, but inequalities persist: the poorest, least educated, and rural communities are left behind. Programming has focused on increasing coverage and reaching the hardest-to-reach children, but vaccination timeliness is equally important because delays leave children vulnerable to infections. This study examines the levels and inequities of on-time vaccination in the Sub-Saharan African region.
Methods: The most recent Demographic and Health Surveys or Multiple Indicator Clusters Surveys since 2000 from Sub-Saharan Africa were used to assess on-time vaccination and inequalities by household wealth, maternal education, and place of residence. Inequalities were quantified using slope index of inequality and concentration index.
Results: The analysis included 153,632 children aged 12-36 months from 40 Sub-Saharan Africa countries. Median on-time vaccination coverage was <50% in all the 4 subregions. Differences in on-time vaccination were observed by place of residence in the Southern (20.8 percentage points, 95% CI=0.8, 40.8), West (17.5 percentage points, 95% CI=5.1, 29.9), and Eastern (20.9 percentage points, 95% CI=6.5, 35.2) regions. Wealth-related inequities were observed in the Southern (22.6 percentage points, 95% CI=4.0, 41.2), Western (30.6 percentage points, 95% CI=19.1, 42.1), and Eastern (26.1 percentage points, 95% CI=8.2, 44.0) regions. Significant education-related differences in on-time vaccination were observed in the Western (20.7 percentage points, 95% CI=10.9, 30.5) and Eastern (21.2 percentage points, 95% CI=7.0, 35.4) regions.
Conclusions: On-time vaccination coverage was low in all subregions and nearly all countries. Inequalities in on-time immunization by household wealth, place of residence, and education existed in most countries. Concrete strategies to improve levels of timeliness are needed.
Supplement Information: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
(Copyright © 2020 American Journal of Preventive Medicine. All rights reserved.)
Databáze: MEDLINE
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