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Background Childhood immunization is one of the most cost-effective prevention measures for children’s mortality and morbidity, saving 2–3 million lives per year. In Ethiopia, under-five mortality rates, about 190,000 children die each year. Different research conducted in Ethiopia on childhood vaccination have focused on either vaccination coverage of individual vaccine or complete and incomplete vaccination. As far as my literature searching, studies separated the vaccination status into non-vaccinated, partially vaccinated and full vaccinated and assorted factors among children age 12–23 month in Ethiopia were limited. Therefore, the aim of this study was to identify factors associated with vaccination status among children 12–23 months of age in Ethiopia. Method A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1911 children age 12–23 months of age were included in the study. Logit based Multinomial logistic regression analysis was computed to distinguish factors associated with routine vaccination of children aged 12–23 months. P-value less than 0.05 was used to declare statistical significance of each independent variables, and adjusted odd ratio (AOR) with 95% confidence interval were used to present the result and STATA 14 was utilized for data management and analysis. Result Overall the prevalence of full vaccinated children was 35%, while 49% of children were partially vaccinated and 16% were non-vaccinated. In multinomial analysis, having focused ANC (at least four visits) contrasted to no ANC visits at all had 9.7 higher odd of being fully vaccinated than not vaccinated [AOR = 9.74, 95% CI = 3.52–26.94], and 5 times higher odd of being partially vaccinated than not vaccinated [AOR = 4.97, 95% CI = 2.00–12.33]. Conclusion The present study found that childhood full vaccination status was low compared with the World Health Organization targets. Frequency of ANC visit and visited by field worker were significantly associated both partially and full vaccination whereas, visited health facility last 12 months and wealth status were significantly associated with childhood full vaccination.
The study was conducted in Ethiopia. Ethiopia is located in the Horn of Africa. The current population of Ethiopia is 116,870,377 in 2021, with 78.3% living in rural areas based on World meter elaboration of the latest United Nations data. It has nine Regional states (A far, Amhara, Benishangul-Gumuz, Gambella, Harari, Oromia, Somali, Southern Nations, Nationalities, and People’s Region (SNNP) and Tigray) and two city Administrative (Addis Ababa and Dire-Dawa). Ethiopia has followed 3 tiers of preventive healthcare system approaches. These are primary-level healthcare comprising of a primary hospital, health center, and health post; secondary-level healthcare (general hospital); and tertiary-level healthcare (specialized hospital). A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). In 2016 EDHS, a two stage stratified sampling technique was employed to select representative samples for the country as whole. The regions in the country were stratified into urban and rural areas. Then, samples of enumeration areas (EAs) were selected in each stratum in two stages. In the first stage, 645 EAs were selected with probability proportional to the EA size. The EA size is the number of residential households in the EA as determined in the 2007 Ethiopian Population and Housing Census. In the second stage, a fixed number of 28 households per cluster were selected randomly from the household listing [10]. All women aged 15–49 years who were usual members of the selected households were eligible for female survey. Out of 7,193 women who gave birth in the past 5 years preceding of the survey, 5,980 were interviewed about the vaccination status of their children and children of age 12–23 months with missing age of child and outcome variable were excluded from the study. A total weighted sample of 1911 children age 12–23 months of age were included in the study. Vaccination status. Number of children aged 12–23 months received one dose of BCG vaccine, three doses of polio vaccine, and three doses of pentavalent vaccine (DTP-hepB-Hib), three dose of pneumococcal conjugate vaccine (PCV), two dose of virus vaccine and one dose of measles vaccine was considered as “fully vaccinated”; partially vaccinated status was defined as having received some but not all vaccines; and non-vaccinated status was defined as not having received any vaccines. Fully vaccination definition is adopted from Ethiopian national HMIS (health management information system) indicators guideline [16]. But, the vaccine IPV (injectable polio vaccine) was not collected in 2016 EDHS and not included in this analysis. The independent variables included in this study were: maternal age, women educational status, husband/partner’s education status, place of residence, women working status, wealth status, media exposure, frequency of ANC visit, region, and visited health facility last 12 months, visited by field worker, child sex, and place of delivery and participation of decision-making. Participation on decision making. women who decided their health issue alone are labeled as”yes” and coded as “1”, who decide jointly with their partner were labeled as “some” and coded as “2”, while those responded their partner alone decide on their health issue were labeled as “no” and coded as “0”. Logit based Multinomial (polytomous) logistic regression analysis was computed to distinguish factors associated with routine vaccination of children aged 12–23 months. Multinomial Logistic Regression is a simple continuation of binomial logistic regression model to be used when the dependent variable is nominal and has more than two categories. Children who were not vaccinated to any routine vaccination were considered as referent category and specified as “0” and the remaining categories i.e. fully vaccinated and partially vaccinated were considered as alternative category (not the reference category). Variance inflation factors (VIF) were assessed to check multicollinearity among the variables. A VIF value greater than 10 was considered as an indication of multi-collinearity; however, no significant multicollinearity was observed. P-value less than 0.05 was used to declare statistical significance of each independent variables, and adjusted Odd ratio (AOR) with 95% confidence interval were used to present the result. The parameter AOR indicates the likely to membership of one category of the independent variable compared reference category. The closer a value of AOR to zero the less effect of the explanatory variable has on the dependent variable’s alternative category as compared to reference category [17]. Authors have requested DHS Program through an online request by written letter of objective and significance of the study. Permission for data access was granted to download and use the data from http://www.dhsprogram.com. The DHS programs permitted data access, and data were used for only the current study.
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