Peer-reviewed article
Socioeconomic inequalities in child vaccination coverage in Tanzania over time: a decomposition analysis using the 2004/05, 2010 and 2015/2016 demographics and health surveys
Magashi Joseph Ntegwa, Laura Rossouw ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed vaccination coverage data from Tanzania across three time periods (2004/05, 2010, 2015/16) to understand why children from wealthier families are more likely to be vaccinated than those from poorer families. The researchers found that vaccination inequalities have actually grown over time, driven mainly by differences in household wealth, where families live, access to media, and mothers' education levels. The study concludes that vaccination programmes need to ensure all children receive vaccines regardless of their family's economic status.
Key points
- Child vaccination coverage is concentrated among children from wealthier households in Tanzania
- Socioeconomic disparities in vaccination have intensified over time from 2004/05 to 2015/16
- Key drivers of inequality include household wealth, rural/urban residence, media exposure, and maternal education
- Vaccination is provided free in Tanzania's public healthcare sector, yet inequalities persist
- Vulnerable and privileged groups in society show widening gaps in vaccination access
Limitations
This is a secondary data analysis using survey data, which describes patterns of inequality but does not explain the underlying causal mechanisms that prevent poorer households from accessing free vaccines. The study does not test interventions to reduce these inequalities.
Abstract
Background. Despite global strides to reduce child morbidity and mortality, the number of infant and child deaths from preventable causes in low-and middle-income countries remains unacceptably high. A cost-effective strategy to improve child health outcomes is through child vaccination and subsequent immunisation. Despite free child vaccination in the public healthcare sector in Tanzania, the country’s vaccination rates have plateaued and remain concentrated among children from wealthier households. Objective. To identify the factors contributing to inequality in childhood vaccination in Tanzania. Methods. This retrospective study used secondary data from the Tanzania Demographic and Health Survey for 2004/05, 2010 and 2015/16. Inequalities were measured using the Erreygers’ corrected concentration indices. These inequalities were then decomposed to gain a deeper understanding of the contributing factors. Results. Child vaccinations are higher among children from wealthier households in Tanzania, and this disparity has intensified over time. Socioeconomic differences in wealth, residential locations, mass media exposure and maternal education have become increasingly important drivers of these inequalities among Tanzanians. Conclusions. Socioeconomic divisions in Tanzania threaten to perpetuate inequalities in access to healthcare and subsequent health. Child vaccination should be provided equitably to all children regardless of their household’s socioeconomic background. Moreover, efforts should be made to address these gaps between the vulnerable and the more privileged groups in society.