High prevalence of zero-dose children in underserved and special setting populations in ethiopia using a generalize estimating equation and concentration index analysis

Title : High prevalence of zero-dose children in underserved and special setting populations in ethiopia using a generalize estimating equation and concentration index analysis

Abstract:

Background: The WHO/UNICEF estimates that over 18 million children in low- and middle-income countries, especially in Africa and South-East Asia, are not being vaccinated, with Ethiopia being one of the top four countries contributing to this issue.

Objective: To estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia.

Methods: A cross sectional survey conducted in June 2022 analyzed vaccine coverage among mothers of children aged 12-35 months using the CommCare application system and Stata version 17. Weighted analysis estimated vaccination coverage, and a model determined predictors of zero-dose children. Statistically significant findings were based on an adjusted odds ratio, 95% confidence interval, and a p-value of 0.05 or less.

Results: The overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR=2.78; 95% CI: 1.70, 4.53], poorer [AOR=1.96; 95% CI: 1.02, 3.77]), single marital status [AOR=2.4; 95% CI: 1.7, 3.3], and maternal age (15-24 years) [AOR=1.2; 95% CI: 1.1, 1.3] were identified determinant factors of zero-dose children in the study settings. Additional factors included fewer than four ANC visits [AOR=1.3; 95% CI: 1.2, 1.4], not receiving PNC services [AOR=2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR=3.7; 95% CI: 2.6, 5.4], women-headed household [AOR=1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR=1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR=1.7; 95% CI: 1.2, 2.5].

Conclusion: In study settings, high prevalence of zero-dose children due to factors like poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilization of antenatal/postnatal services. Recommended to target tailored integrated and context-specific service delivery approach, including extended immunization session hours in city administrations.

Biography:

Professor Gashaw is a Public health specialist in the field of public health, his expertise in implementation sciences has made him an invaluable asset to project HOPE. Joining the project two years ago as the Senior Implementation Sciences Advisor for the Zero Dose Children Project, Professor Gashaw has been instrumental in driving the research activities of the project. One of his primary responsibilities is the development of project protocols. Professor Gashaw ensures that the protocols are robust and effective in achieving the project goals. He also oversees the field research activities, providing guidance and support to the team. His hands-on approach ensures that the research is carried out meticulously, yielding accurate and reliable results.

Apart from his involvement in the field, Professor Gashaw writing manuscripts that are published in international peer-reviewed journals. As a professor, he imparts his wisdom in public health courses such as research methods, neonatal and child health, and health systems, economics, leadership, and management. He has been teaching these subjects for over 25 years, shaping the future of public health professionals. Professor Gashaw's passion for education is evident through his dedication to teaching and advising PhD and master's students. His desire to empower the next generation of public health professionals has motivated him to write teaching modules and lecture notes in the field. With over 120 publications in national and international peer-reviewed journals, Professor Gashaw has established himself as a prominent figure in public health research.