Peer-reviewed article
Vaccination Coverage and Determinants Among Children Aged 12-35 Months Following Internal Conflict in Yemen: Insights from a Nationwide Population-Based Survey.
Omid Dadras, Christina El Saaidi ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A nationwide survey in Yemen found that only 29% of children aged 12-35 months are fully vaccinated, with significant disparities between urban areas (41%) and rural areas (25%). Vaccination coverage was higher among children whose mothers had secondary or higher education, received prenatal care, or regularly read newspapers. The study identifies major gaps in immunization in conflict-affected Yemen and recommends improvements to health infrastructure and parent education programs.
Key points
- Overall vaccination coverage was only 29% among children aged 12-35 months in Yemen
- Urban areas had vaccination coverage of 41% compared to 25% in rural areas
- Mothers with secondary or higher education were 1.59 times more likely to have fully vaccinated children
- Mothers who received prenatal care had 1.97 times higher odds of having fully vaccinated children
- First-born children had higher vaccination rates than those with higher birth order
Limitations
The study is cross-sectional and cannot establish causality, only associations. It does not explain the mechanisms behind why conflict affects vaccination or how to overcome specific barriers to vaccination access in Yemen.
Abstract
INTRODUCTION: Child vaccination is a crucial public health indicator, especially in conflict-affected regions. Despite the benefits, vaccination rates in Yemen remain suboptimal. This study evaluates vaccination coverage and its correlates among children aged 12-35 months in Yemen. METHODS: Data from the Yemen Multiple Indicator Cluster Survey (MICS) 2022-23 were used. The survey covered 22 governorates, using a two-stage household selection process, and included 7,796 children. Vaccination status was assessed using a binary composite variable for full immunization. Multilevel logistic regression with robust error variance identified predictors of full vaccination. RESULTS: The overall vaccination coverage was 29%, with urban areas (41%) having higher rates compared to rural areas (25%). Female children had slightly lower odds of being fully vaccinated than male children, though not statistically significant. First-born children had the highest vaccination rates (31%), with odds decreasing with higher birth order. Mothers' secondary or higher education (AOR: 1.59, 95% CI: 1.19-2.13), receiving prenatal care (AOR: 1.97, 95% CI: 1.26-3.07), and reading newspapers at least once a week (AOR: 1.72, 95% CI: 1.21-2.44) were significant positive predictors. Higher fathers' education, fewer children under five in the household, higher household wealth, and urban residence were also associated with higher vaccination rates. Other factors such as hospital delivery, TV watching, internet access, and mobile phone ownership were not significantly associated with full vaccination after adjustment. CONCLUSION: Significant gaps in immunization coverage among children in Yemen, particularly in rural areas, highlight the need for educational programs for parents, enhanced healthcare infrastructure, and improved health communication strategies.