Peer-reviewed article

Coverage and associated factors of inactivated polio vaccine uptake among children aged 12-23 months in Sub-Saharan Africa.

Wubet Tazeb Wondie, Alemu Birara Zemariam, Zenebe Abebe Gebreegziahber, Bruck Tesfaye Legesse, Kefyalew Taye Belete et al. · 11 Mar 2026

Abstract

The Inactivated Polio Vaccine (IPV) protects against all strains of the polio virus and poses no risk of vaccine-associated paralytic poliomyelitis. However, its coverage remains below an optimal level in Sub-Saharan Africa (SSA), and instances of vaccine-derived poliovirus have been reported. While several studies explored vaccine coverage, research specifically focused on IPV in SSA remains limited. Hence, this study aimed to assess the coverage and determinants of IPV uptake among children 12–23 months of age. A secondary data analysis was conducted using data from the recent demographic and health survey in 20 SSA countries between 2016 and 2023. The study included a total weighted sample of 43,564 children aged 12–23 months. Due to the hierarchical nature of the data, multilevel logistic regression was employed to identify associated factors. Model fitness and comparison were assessed using the median odds ratio, intra-class correlation coefficient, proportional change in variance, and deviance. Adjusted Odds Ratios (AORs) with their 95% CI were computed. Variables with a P-value < 0.05 in the multivariable multilevel analysis were considered statistically significant. The pooled inactivated polio vaccine coverage was 65.01% with a 95% CI (55.44, 74.76). Maternal age 20–35 years (AOR = 1,08, 95% CI: 1.00, 1.18) and above 35 years (AOR = 1.22, 95%CI: 1.11, 1.34), maternal education at primary level (AOR = 1.30, 95% CI: 1.23,1.37), and secondary level or above (AOR = 1.87, 95% CI: 1.76, 1.99), marital status (married (AOR = 0.83, 95% CI: 0.75,0.90), and widowed/divorced (AOR = 0.85, 95% CI: 0.75, 0.95))), media exposure (AOR = 1.20, 95% CI: 1.14,1.25), antenatal visit 1–3 (AOR = 1.86, 95%CI: 1.72, 2.01) and ≥ 4 visit (AOR = 2.51, 95% CI: 2.33,2.70), postnatal care (AOR = 1.73, 95%CI: 1.65,1.82), delivery at a health facility(AOR = 1.86, 95%CI: 1.77,1.97), birth interval more than 48 months (AOR = 1.34, 95%CI: 1.24, 1.44), urban residence (AOR = 1.24, 95%CI: 1.17,1.31), high community female literacy (AOR = 1.68, 95%CI: 1.54,1.83) were statistically significant positive determinants of IPV uptake. Conversely, rich household wealth (AOR = 0.84, 95% CI: 0.79,0.89) showed an inverse association. In most SSA countries, the inactivated polio vaccine coverage among children aged 12–23 months is substantially below the WHO-recommended herd immunity threshold of 90%, as well as beneath the 2024 global coverage of 85%. To improve this, stakeholders should focus on public health interventions like investing in maternal education, promoting antenatal and postnatal care, strengthening health service delivery, and raising community awareness through social media. Additionally, vaccination programs should target underserved areas and include mobile vaccination services.