Peer-reviewed article
Spatial distribution of effective coverage of child immunisation in Ethiopia
Samrawit Birhanu Alemu, Daniel Gashaneh Belay, Aynalem Belay, Melaku Birhanu Alemu ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study maps how well child immunisation services work across Ethiopia, using the 2019 Mini Demographic and Health Survey and the Service Provision Assessment. Effective coverage, which accounts for service quality as well as receipt of vaccines, was 34% nationally. Coverage varied widely by area, with some places having high coverage and others low coverage. Longer travel time to the nearest city was linked to lower effective coverage. The authors recommend that policymakers prioritise underserved areas.
Key points
- National effective coverage of child immunisation was 34% (95% CI: 31.9% to 36.5%).
- High-coverage hotspots included Addis Ababa, western Benishangul-Gumuz, Dire Dawa, northern South West Ethiopia and northwest Amhara.
- Low coverage was found in central Amhara, northern Gambela, central Oromia, Sidama, northern SNNPR and Somali.
- Travel time to the nearest city was a negative predictor of spatial distribution (−0.292; 95% CI −0.533 to −0.052).
- The authors advise policymakers to prioritise underserved areas and improve spatial predictors.
Limitations
The abstract describes a mapping of coverage from survey data and does not test any intervention. Only the predictors reported in the abstract are known, so reasons for regional differences cannot be fully explained.
Abstract
Introduction Child immunisation is a cost-effective strategy to reduce vaccine-preventable diseases. While effective coverage is key to ensuring quality immunisation, little is known about its geographical distribution in Ethiopia. This study aims to assess the spatial distribution of effective coverage of child immunisation and identify areas with low coverage to inform targeted interventions. Methods We used the 2019 Ethiopia Mini Demographic and Health Survey and Ethiopia Service Provision Assessment datasets. After calculating the effective coverage of immunisation, Bayesian model-based geostatistics were employed to assess the spatial distribution of effective immunisation coverage in Ethiopia, using relevant covariates to estimate coverage rates across regions. Results The national effective coverage of immunisation was 34% (95% CI: 31.9% to 36.5%), with significant regional variation. Addis Ababa, western Benishangul-Gumuz, Dire Dawa city administrative, the northern part of South West Ethiopia and the northwest part of Amhara had hotspots for high level of effective coverage of child immunisation. On the other hand, central Amhara, northern Gambela, central Oromia, Sidama, northern Southern Nations, Nationalities and Peoples regions (SNNPR) and Somali had low effective coverage of child immunisation. Travel time to the nearest city (−0.292: 95% CI:−0.533 to −0.052) was found to be negative predictor of spatial distribution. Conclusion There were significant geographical variations in the effective coverage of immunisation services in Ethiopia. Travel time to nearest city was a significant predictor of spatial distribution. Policymakers are advised to prioritise underserved areas and improve spatial predictors to have a safe, effective and life-saving vaccination program in Ethiopia.