Peer-reviewed article
Factors Associated with Vaccination Coverage among 0–59-Month-Old Children: A Multilevel Analysis of the 2020 Somaliland Demographic and Health Survey
Mohamed Abdalle Osman, Alexander Waits, Li‐Yin Chien ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed data from 2,673 caregivers in Somaliland to identify factors affecting vaccination coverage in children under five. Only 34% of children had received any vaccination, indicating very low coverage. Vaccination was more common in wealthier regions, areas with more healthcare facilities, urban areas, and among children whose mothers had attended antenatal care or could read. The researchers recommend improving maternal health services and literacy to increase vaccination rates, particularly for nomadic populations.
Key points
- Only 34% of children aged 0-59 months in Somaliland were ever vaccinated
- Vaccination coverage was higher in high-budget regions and areas with greater healthcare facility density
- Children aged over 23 months were more likely to be vaccinated than younger children
- Maternal antenatal care attendance was strongly associated with child vaccination, even a single visit increased likelihood
- Nomadic populations had significantly lower vaccination coverage than urban and rural residents
Limitations
This is a cross-sectional survey and cannot establish causation, only associations. The analysis describes factors correlated with vaccination status but does not evaluate the effectiveness of any specific intervention to improve vaccination coverage.
Abstract
Globally, there has been little growth in vaccination coverage, with countries in the Horn of Africa having the lowest vaccination rates. This study investigated factors associated with vaccination status among children under five years old in Somaliland. The 2020 Somaliland Demographic and Health Survey surveyed women aged 15-49 years from randomly selected households. This multilevel analysis included 2673 primary caregivers of children under five. Only 34% of children were ever vaccinated. Childhood vaccination coverage was positively associated with high-budget regions, high healthcare facility density, and children older than 23 months. Vaccination coverage was greater for urban and rural residents than for nomadic people. Children whose mothers could read part of one sentence or one complete sentence were more likely to be vaccinated than illiterate mothers. Children whose mothers received antenatal care (ANC) once, two to three times, or four times or more were more likely to be vaccinated than those whose mothers received no ANC. Childhood vaccination coverage in Somaliland is low. Promoting maternal ANC visits and increasing women's literacy may enhance vaccination coverage. Funds should be allocated to areas with low resources, particularly for nomadic people, to boost vaccination uptake.