Childhood vaccination in Kenya: socioeconomic determinants and disparities among the Somali ethnic community

Int J Public Health. 2019 Apr;64(3):313-322. doi: 10.1007/s00038-018-1187-2. Epub 2018 Dec 10.

Abstract

Objectives: Kenya has a significant refugee population, including large numbers of Somali migrants. This study examines the vaccination status of Kenyan children and sociodemographic predictors of vaccination, including Somali ethnicity.

Methods: Using the 2014 Kenyan Demographic and Health Survey, we calculated the proportion of non-vaccinated, under-vaccinated, and fully vaccinated children, defining full vaccination as one dose Bacille Calmette-Guerin, three doses polio, three doses pentavalent, and one dose measles. We assessed associations among various factors and vaccination status using multinomial logistic regression and explored the effect of Somali ethnicity through interaction analysis.

Results: The study sample comprised 4052 children aged 12-23 months, with 79.4% fully, 19.0% under-, and 1.6% non-vaccinated. Among Somalis, 61.9% were fully, 28.7% under-, and 9.4% non-vaccinated. Somalis had significantly greater odds of under- and non-vaccination than the Kikuyu ethnic group. Wealth and birth setting were associated with immunization status for Somalis and non-Somalis.

Conclusions: Disparities persist in pediatric vaccinations in Kenya, with Somali children more likely than non-Somalis to be under-vaccinated. Health inequalities among migrants and ethnic communities in Kenya should be addressed.

Keywords: Health disparities; Kenya; Migrant health; Pediatric vaccination; Somali; Vaccination coverage.

MeSH terms

  • Demography
  • Ethnic Groups / statistics & numerical data*
  • Female
  • Health Surveys*
  • Humans
  • Immunization Programs / statistics & numerical data*
  • Infant
  • Kenya / ethnology
  • Logistic Models
  • Male
  • Patient Acceptance of Health Care / ethnology*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Sampling Studies
  • Socioeconomic Factors
  • Somalia / ethnology
  • Transients and Migrants / statistics & numerical data*
  • Vaccination / statistics & numerical data*
  • Vaccination Coverage / statistics & numerical data*