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

Qi Cao · Derek Asuman · Josué Almansa · Maarten Jacobus Postma · Marinus van Hulst

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Vaccine Coverage and Hesitancy Child Nutrition and Water Access Global Maternal and Child Health

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.

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References

1973Male-Female Wage Differentials in Urban Labor Markets 1973Wage Discrimination: Reduced Form and Structural Estimates 2007Analyzing Health Equity Using Household Survey Data 2003Decomposing differences in the first moment 2017A systematic review of factors affecting vaccine uptake in young children 2012Individual and Contextual Factors Associated with Low Childhood Immunisation Coverage in Sub-Saharan Africa: A Multilevel Analysis 2015Factors influencing full immunization coverage among 12–23 months of age children in Ethiopia: evidence from the national demographic and health survey in 2011 2019Global Routine Vaccination Coverage, 2018

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