Understanding the Improvement in Full Childhood Vaccination Coverage in Ethiopia Using Oaxaca-Blinder Decomposition Analysis

doi:10.3390/vaccines8030505

. 2020 Sep 4;8(3):505.

doi: 10.3390/vaccines8030505.

Understanding the Improvement in Full Childhood Vaccination Coverage in Ethiopia Using Oaxaca-Blinder Decomposition Analysis

Abrham Wondimu^{1

2}, Qi Cao^{2

3}, Derek Asuman⁴, Josué Almansa², Maarten J Postma^{2

3

5

6}, Marinus van Hulst^{2

7}

Affiliations

¹ Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia.
² Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 AV Groningen, The Netherlands.
³ Unit of Pharmaco-Therapy, Epidemiology & Economics (PTE2), Department of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands.
⁴ Health Economics Unit, Medicon Village, Lund University, SE-223 81 Lund, Sweden.
⁵ Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, 9747 AE Groningen, The Netherlands.
⁶ Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
⁷ Department of Clinical Pharmacy and Toxicology, Martini Hospital, 9728 NT Groningen, The Netherlands.

PMID: 32899805
PMCID: PMC7564632
DOI: 10.3390/vaccines8030505

Free PMC article

Understanding the Improvement in Full Childhood Vaccination Coverage in Ethiopia Using Oaxaca-Blinder Decomposition Analysis

Abrham Wondimu et al. Vaccines (Basel). 2020.

Free PMC article

. 2020 Sep 4;8(3):505.

doi: 10.3390/vaccines8030505.

Authors

Abrham Wondimu^{1

2}, Qi Cao^{2

3}, Derek Asuman⁴, Josué Almansa², Maarten J Postma^{2

3

5

6}, Marinus van Hulst^{2

7}

Affiliations

¹ Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia.
² Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 AV Groningen, The Netherlands.
³ Unit of Pharmaco-Therapy, Epidemiology & Economics (PTE2), Department of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands.
⁴ Health Economics Unit, Medicon Village, Lund University, SE-223 81 Lund, Sweden.
⁵ Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, 9747 AE Groningen, The Netherlands.
⁶ Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
⁷ Department of Clinical Pharmacy and Toxicology, Martini Hospital, 9728 NT Groningen, The Netherlands.

PMID: 32899805
PMCID: PMC7564632
DOI: 10.3390/vaccines8030505

Abstract

In Ethiopia, full vaccination coverage among children aged 12-23 months has improved in recent decades. This study aimed to investigate drivers of the improvement in the vaccination coverage. The Oaxaca-Blinder decomposition technique was applied to identify the drivers using data from Ethiopian Demographic and Health Survey conducted in 2000 and 2016. The vaccination coverage rose from 14.3% in 2000 to 38.5% in 2016. The decomposition analysis showed that most of the rise in vaccination coverage (73.7%) resulted from the change in the effect of explanatory variables over time and other unmeasured characteristics. Muslim religion had a counteracting effect on the observed increase in vaccination coverage. The remaining 26.3% of the increase was attributed to the change in the composition of the explanatory variables between 2000 and 2016, with maternal educational level and maternal health care utilization as significant contributors. The findings highlight the need for further improvements in maternal health care utilization and educational status to maintain the momentum towards universal coverage of childhood vaccination. Targeted intervention among Muslim-dominated communities is also needed to improve the current situation. Besides which, future studies need to be conducted to identify additional potential modifiable factors.

Keywords: Ethiopia; Oaxaca–Blinder decomposition; childhood vaccination; coverage; improvement.

PubMed Disclaimer

Conflict of interest statement

Postma reports grants and honoraria from various pharmaceutical companies, including those developing, producing, and marketing vaccines considered in this study. The funders of this study had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Cited by

Maternal satisfaction on quality of childhood vaccination services and its associated factors at public health centers in Addis Ababa, Ethiopia.
Tesfaye E, Debie A, Sisay F, Tafere TZ. Tesfaye E, et al. BMC Health Serv Res. 2023 Nov 29;23(1):1315. doi: 10.1186/s12913-023-10174-7. BMC Health Serv Res. 2023. PMID: 38031017 Free PMC article.
Oral and Inactivated Polio Vaccine Coverage and Determinants of Coverage Inequality Among the Most At-Risk Populations in Ethiopia.
Gebremedhin S, Shiferie F, Tsegaye DA, Alemayehu WA, Wondie T, Donofrio J, DelPizzo F, Belete K, Biks GA. Gebremedhin S, et al. Am J Trop Med Hyg. 2023 Sep 25;109(5):1148-1156. doi: 10.4269/ajtmh.23-0319. Print 2023 Nov 1. Am J Trop Med Hyg. 2023. PMID: 37748762 Free PMC article.
Changes in immunization coverage and contributing factors among children aged 12-23 months from 2000 to 2019, Ethiopia: Multivariate decomposition analysis.
Asresie MB, Dagnew GW, Bekele YA. Asresie MB, et al. PLoS One. 2023 Sep 13;18(9):e0291499. doi: 10.1371/journal.pone.0291499. eCollection 2023. PLoS One. 2023. PMID: 37703252 Free PMC article.
Urban-rural disparities in immunization coverage among children aged 12-23 months in Ethiopia: multivariate decomposition analysis.
Asresie MB, Fekadu GA, Dagnew GW. Asresie MB, et al. BMC Health Serv Res. 2023 Sep 7;23(1):969. doi: 10.1186/s12913-023-09940-4. BMC Health Serv Res. 2023. PMID: 37679707 Free PMC article.
Exploring the Pattern of Immunization Dropout among Children in India: A District-Level Comparative Analysis.
Dhalaria P, Kapur S, Singh AK, Priyadarshini P, Dutta M, Arora H, Taneja G. Dhalaria P, et al. Vaccines (Basel). 2023 Apr 13;11(4):836. doi: 10.3390/vaccines11040836. Vaccines (Basel). 2023. PMID: 37112748 Free PMC article.

See all "Cited by" articles

References

1. McGovern M.E., Canning D. Vaccination and All-Cause Child Mortality from 1985 to 2011: Global Evidence from the Demographic and Health Surveys. Am. J. Epidemiol. 2015;182:791–798. doi: 10.1093/aje/kwv125. - DOI - PMC - PubMed
1. Immunization Coverage. [(accessed on 24 December 2019)]; Available online: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage.
1. Luyten J., Beutels P. The social value of vaccination programs: Beyond Cost-Effectiveness. Health Aff. 2016;35:212–218. doi: 10.1377/hlthaff.2015.1088. - DOI - PubMed
1. Klugman K.P., Black S. Impact of existing vaccines in reducing antibiotic resistance: Primary and secondary effects. Proc. Natl. Acad. Sci. USA. 2018;115:12896–12901. doi: 10.1073/pnas.1721095115. - DOI - PMC - PubMed
1. Bogler L., Jantos N., Bärnighausen T., Vollmer S. Estimating the effect of measles vaccination on child growth using 191 DHS from 65 low- and middle-income countries. Vaccine. 2019;37:5073–5088. doi: 10.1016/j.vaccine.2019.06.054. - DOI - PubMed

LinkOut - more resources

Full Text Sources

[1] McGovern M.E., Canning D. Vaccination and All-Cause Child Mortality from 1985 to 2011: Global Evidence from the Demographic and Health Surveys. Am. J. Epidemiol. 2015;182:791–798. doi: 10.1093/aje/kwv125. - DOI - PMC - PubMed

[2] McGovern M.E., Canning D. Vaccination and All-Cause Child Mortality from 1985 to 2011: Global Evidence from the Demographic and Health Surveys. Am. J. Epidemiol. 2015;182:791–798. doi: 10.1093/aje/kwv125. - DOI - PMC - PubMed

[3] Immunization Coverage. [(accessed on 24 December 2019)]; Available online: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage.

[4] Immunization Coverage. [(accessed on 24 December 2019)]; Available online: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage.

[5] Luyten J., Beutels P. The social value of vaccination programs: Beyond Cost-Effectiveness. Health Aff. 2016;35:212–218. doi: 10.1377/hlthaff.2015.1088. - DOI - PubMed

[6] Luyten J., Beutels P. The social value of vaccination programs: Beyond Cost-Effectiveness. Health Aff. 2016;35:212–218. doi: 10.1377/hlthaff.2015.1088. - DOI - PubMed

[7] Klugman K.P., Black S. Impact of existing vaccines in reducing antibiotic resistance: Primary and secondary effects. Proc. Natl. Acad. Sci. USA. 2018;115:12896–12901. doi: 10.1073/pnas.1721095115. - DOI - PMC - PubMed

[8] Klugman K.P., Black S. Impact of existing vaccines in reducing antibiotic resistance: Primary and secondary effects. Proc. Natl. Acad. Sci. USA. 2018;115:12896–12901. doi: 10.1073/pnas.1721095115. - DOI - PMC - PubMed

[9] Bogler L., Jantos N., Bärnighausen T., Vollmer S. Estimating the effect of measles vaccination on child growth using 191 DHS from 65 low- and middle-income countries. Vaccine. 2019;37:5073–5088. doi: 10.1016/j.vaccine.2019.06.054. - DOI - PubMed

[10] Bogler L., Jantos N., Bärnighausen T., Vollmer S. Estimating the effect of measles vaccination on child growth using 191 DHS from 65 low- and middle-income countries. Vaccine. 2019;37:5073–5088. doi: 10.1016/j.vaccine.2019.06.054. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Understanding the Improvement in Full Childhood Vaccination Coverage in Ethiopia Using Oaxaca-Blinder Decomposition Analysis

Affiliations

Understanding the Improvement in Full Childhood Vaccination Coverage in Ethiopia Using Oaxaca-Blinder Decomposition Analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

LinkOut - more resources

Full Text Sources