Peer-reviewed article

Determinants of Second Dose Measles Vaccination Coverage in Somaliland: A Binary and Multivariate Logistic Regression Analysis.

Ladna Hussein Ali, Abdiqani Muse Muhumed, Asma Siyad Dirie, Abdirahman Abdilahi Adan, Nouh Sulaiman Yousuf et al. · 25 Mar 2026

Abstract

INTRODUCTION: Understanding the predictors of second dose measles vaccination (MCV2) is essential for designing effective interventions to prevent outbreaks and reduce child mortality in Somaliland, thereby informing targeted public health strategies and policy decisions. METHODS: A cross-sectional study was conducted using a national health survey of Somaliland. The study analyzed data from mothers regarding their children, selecting one child per household to ensure statistical independence. Binary and multivariate logistic regression models were applied to identify determinants of MCV2 coverage among 1417 eligible children. RESULTS: The sample prevalence of MCV2 coverage was low at 33.5%. Significant predictors included maternal age, region, and prior receipt of DPT and BCG vaccinations. The adjusted odds ratio (AOR) MCV2 were higher among children of older mothers compared to those aged 15-19, specifically those aged 40-44 (AOR = 4.30; 95% confidence interval [CI]: 1.84-10.04) and 45-49 (AOR = 5.31; 95% CI: 1.55-18.16). Prior vaccination with DPT (AOR = 3.87; 95% CI: 2.92-5.15) and BCG (AOR = 2.47; 95% CI: 1.86-3.29) were also powerful predictors of MCV2 completion. Urban residence and maternal education were not significantly associated with coverage in the final adjusted model. CONCLUSION: The findings highlight the importance of maternal experience and the strength of the routine immunization system. Addressing systemic barriers through targeted interventions may encourage stakeholders to strengthen routine immunization programs, especially by utilizing prior healthcare contacts like DPT/BCG visits to potentially improve MCV2 follow-up.