Peer-reviewed article
Determinants of childhood vaccination differ between conflict-affected and non-conflict regions in Cameroon
Rodolfo Rossi, Siaka Konaté, Amalid Chebly, Benjamin Awouyiegnigni, Kurt Barbé et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study analysed the 2018 Cameroon Demographic and Health Survey to see what is linked to full vaccination in 1,824 children aged 12–23 months. About 53% of children were fully vaccinated, with lower coverage in conflict-affected regions (45.29%) than in non-conflict regions (55.97%). After adjusting for other factors, conflict status was no longer significantly linked to full vaccination. Household wealth, mother's education and contact with maternal health services were the factors most clearly linked to full vaccination.
Key points
- Overall, 53.08% of children aged 12–23 months were fully vaccinated.
- Coverage was 45.29% in conflict-affected regions versus 55.97% in non-conflict regions.
- Conflict status was linked to lower odds of full vaccination in unadjusted analysis but not in the adjusted model.
- Nationally, richer household wealth, maternal secondary or higher education, antenatal care and postnatal care were linked to higher odds of full vaccination.
- In conflict-affected regions, maternal secondary or higher education, postnatal care and facility delivery remained significant predictors.
Limitations
This is a secondary analysis of cross-sectional survey data from 2018, so it shows associations only and cannot show cause and effect or changes since then. It does not evaluate any vaccination intervention.
Abstract
Introduction Childhood vaccination remains one of the most effective public health interventions, yet coverage is often lowest in settings affected by conflict and structural disadvantage. Cameroon has faced overlapping humanitarian crises in its Far North, North-West, and South-West regions, but evidence comparing determinants of full vaccination between conflict-affected and non-conflict regions remains limited. This study explores determinants of full vaccination status in 12–23 months children in Cameroon, stratified by conflict regions. Methods We conducted a secondary analysis of the 2018 Cameroon Demographic and Health Survey, including 1,824 living children aged 12–23 months. Full basic vaccination was defined as receipt of one dose of BCG, three doses of pentavalent vaccine, three doses of polio vaccine, and one dose of measles vaccine. Survey-weighted logistic regression was used to identify factors associated with full vaccination overall and by conflict status. Results Overall, 53.08% of children were fully vaccinated. Coverage was lower in conflict-affected than in non-conflict regions (45.29% versus 55.97%). In unadjusted analysis, conflict status was associated with lower odds of full vaccination, but this association was no longer significant in the adjusted model. At the national level, higher odds of full vaccination were associated with richer household wealth, maternal secondary or higher education, antenatal care attendance, and postnatal care. In conflict-affected regions, maternal secondary or higher education, postnatal care, and facility delivery remained significant predictors of full vaccination. Discussion Full vaccination coverage in Cameroon remains below desirable levels, with lower crude coverage in conflict-affected regions. However, after adjustment, conflict status was not independently associated with full vaccination, suggesting that socioeconomic conditions and contact with maternal health services are more important determinants. Strengthening antenatal and postnatal care and reducing socioeconomic barriers may improve vaccination coverage, especially in fragile settings.