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Does it really matter where you live? A multilevel analysis of factors associated with missed opportunities for vaccination in sub-Saharan Africa
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Uthman, Olalekan A., Sambala, Evanson, Adamu, Abdu A., Ndwandwe, Duduzile, Wiyeh, Alison B., Olukade, Tawa, Bishwajit, Ghose, Yaya, Sanni, Okwo-Bele, Jean-Marie and Wiysonge, Charles S. (2018) Does it really matter where you live? A multilevel analysis of factors associated with missed opportunities for vaccination in sub-Saharan Africa. Human Vaccines & Immunotherapeutics, 14 (10). pp. 2397-2404. doi:10.1080/21645515.2018.1504524
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WRAP-does-really-matter-analysis-vaccination-sub-Sahara-Uthman-2018.pdf - Accepted Version - Requires a PDF viewer. Download (1491Kb) | Preview |
Official URL: http://dx.doi.org/10.1080/21645515.2018.1504524
Abstract
There is an urgent need to examine the magnitude and factors responsible for missed opportunities for vaccination, to rapidly achieve national immunization targets. The objective of the study was to examine the influence of individual, neighbourhood and country level socioeconomic position on missed opportunities for vaccination (MOV) in Sub-Saharan Africa. We used multilevel logistic regression analysis on Demographic and Health Survey data collected between 2007 and 2016 in sub-Saharan Africa. We analysed data for 43,637 children aged 12 to 23 months (Level 1) nested within 15,122 neighbourhoods (Level 2) from 35 countries (Level 3). After adjustment for individual-, neighbourhood- and country-level factors, respondents, the following appeared as significant risk factors for increased odds of MOV: high birth order, high number of under-five children in the house, poorest household, lack of maternal education, lack of media access, and living in poorer neighbourhood. According to the intra-country and intra-neighbourhood correlation coefficient, 18.4% and 37.4% of the variance in odds of MOV could be attributed to the country and neighbourhood level factors, respectively; and if a child moved to another country or neighbourhood with a higher probability of MOV, the median increase in their odds of MOV would be 2.47 and 2.56 fold respectively. This study has revealed that the risk of missed opportunities for vaccination in sub-Saharan Africa are influenced by not only individual factors but also by compositional factors such as family’s financial capacity and place of birth and upbringing.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | |||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School | |||||||||
| Library of Congress Subject Headings (LCSH): | Vaccination -- Africa | |||||||||
| Journal or Publication Title: | Human Vaccines & Immunotherapeutics | |||||||||
| Publisher: | Landes Bioscience | |||||||||
| ISSN: | 2164-5515 | |||||||||
| Official Date: | 29 August 2018 | |||||||||
| Dates: |
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| Volume: | 14 | |||||||||
| Number: | 10 | |||||||||
| Page Range: | pp. 2397-2404 | |||||||||
| DOI: | 10.1080/21645515.2018.1504524 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Publisher Statement: | This is an Accepted Manuscript of an article published by Taylor & Francis in Human Vaccines & Immunotherapeutics on 30/07/2018 available online | |||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||
| RIOXX Funder/Project Grant: |
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