Peer-reviewed article
Vaccination coverage and its associated factors among children under-5 in Somalia.
Hassan MS, Abdulla F, Hossain M ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed vaccination coverage data from 9,290 Somali children under-5 using the 2020 Demographic and Health Survey. It found that complete basic immunization coverage (BCG, Polio 3, DPT 3, and Measles) was influenced by several factors including maternal education, household wealth, antenatal care attendance, and child characteristics such as birth order and age. The research identifies that children in poorer households, those born to less educated mothers, and those with fewer antenatal care visits were less likely to be fully vaccinated. The authors recommend that policymakers focus on improving antenatal care attendance and support for socioeconomically disadvantaged families.
Key points
- BCG vaccination was influenced by maternal education, place of residence, number of antenatal visits, and household wealth index
- DPT3 coverage was significantly lower in first-born children (AOR: 0.425) and higher with maternal primary education and urban residence
- Polio 3 vaccination was associated with higher wealth index (AOR: 1.883) and more prenatal care visits (AOR: 1.356)
- Measles vaccination was lower in first-born children (AOR: 0.311) and increased with maternal age, urban residence, and antenatal care attendance
- Household wealth and antenatal care attendance emerged as critical determinants across all four basic vaccinations
Limitations
The study is observational and cannot establish causation, only associations. It does not explain the mechanisms through which these factors influence vaccination decisions or identify specific barriers to vaccination access in different regions of Somalia.
Abstract
Objectives Despite global efforts to improve vaccination, the coverage of completing basic immunization (BCG, Polio 3, DPT 3, and Measles vaccines) remains unsatisfactory in Somalia. Limited research exists on the determinants influencing immunization among under-5 Somali children, highlighting the novelty of this study. This study aims to identify the coverage and factors influencing the coverage of complete basic immunization among under-5 Somali children. Methods A dataset of 9,290 children was extracted from the Somali Demographic and Health Survey-2020 (SDHS-2020). Vaccination coverage was defined as the proportion of children receiving all four basic vaccinations. The association between coverage and covariates was assessed using chi-square tests, and multivariable logistic regression identified influential determinants. Results Findings showed that the BCG was influenced by maternal education, place of residence, number of antenatal visits, and highest wealth index. The DPT3 was influenced by birth order (AOR: 0.425; 95% Cl:0.241, 0.750), maternal primary education (AOR: 1.525; 95% Cl: 1.130, 2.059), place of residence (AOR: 2.549; 95% Cl: 1.863, 3.487), number of ANC visit and wealth index; Polio 3 was influenced by the wealth index (1.883; Cl: 95%, 1.283, 2.764) and the number of prenatal care visits (AOR: 1.356; Cl: 95%, 1.043, 1.762) and measles was influenced by mother age (AOR: 3.458; 95%Cl: 1.429, 8.370), place of residence (AOR: 1.630; 95% Cl: 1.280, 2.077), number of ANC visits (AOR: 1.510; 95%, Cl: 1.074, 2.123), child age (AOR: 3.264, 95% Cl: 2.131, 5.001), birth order (AOR: 0.311; 95% Cl: 0.199, 0.486), and wealth index (AOR: 2.079; 95%, 1.496, 2.888). Conclusion Complete basic vaccination among under-5 Somali children was influenced by maternal education, age, residence, antenatal visits, household wealth, and child characteristics, e.g., place of delivery, size of child at birth, age, and birth order. Policymakers should prioritize interventions that enhance antenatal care attendance and support mothers from socioeconomically disadvantaged households.