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. 2019 Jul 23;19(1):988.
doi: 10.1186/s12889-019-7309-9.

Trends of inequalities in childhood immunization coverage among children aged 12-23 months in Kenya, Ghana, and Côte d'Ivoire

Hermann Pythagore Pierre Donfouet  1   2 , Gaye Agesa  3 , Martin Kavao Mutua  3
Affiliations

Trends of inequalities in childhood immunization coverage among children aged 12-23 months in Kenya, Ghana, and Côte d'Ivoire

Hermann Pythagore Pierre Donfouet et al. BMC Public Health. .

Abstract

Background: Immunization is one of the most cost-effective health intervention to halt the spread of childhood diseases, and improve child health. Yet, there is a substantial disparity in childhood immunization coverage. The overall objective of the study is to investigate the trends of within-country inequalities in childhood immunization coverage among children aged 12-23 months in Kenya, Ghana, and Côte d'Ivoire. The three countries included in this study are countries that are on the verge of entering the accelerated phase of the Gavi, the Vaccine Alliance's co-sharing of costs of vaccine and eventually assuming full costs of vaccines. Côte d'Ivoire is in the Gavi preparatory transition phase, entering the accelerated transition phase in 2020, with an expected transition to full self-financing in 2025. Ghana is expected to enter the accelerated transition phase in 2021 and to full self-financing in 2026 while Kenya will enter in 2022 and fully self-finance in 2027. We examine the pattern of inequality in childhood immunization coverage over time through an equity lens by mainly exploring the direction of inequality in coverage.

Methods: We use data from the Demographic Health Surveys and Multiple Indicator Cluster Surveys. The rate difference, rate ratio, and relative concentration index are used as measures of inequality.

Results: Results of the study suggest that in most years inequality in immunization coverage in the three countries persist over time, and it favors the most-advantaged households. However, there is a sharp decrease pattern in inequalities in childhood immunization coverage in Ghana over time.

Conclusion: Policymakers could be more strategic in addressing pro-rich inequality in immunization coverage by designing health interventions through an equity lens. Using inequality data and putting disadvantaged households at the center of health intervention designs could increase the efficiency of the primary health care system and reduce the incidence of mortality and morbidity as a result of vaccine-preventable disease.

Keywords: Childhood immunization coverage; Inequality; Tailoring immunization programmes.

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Conflict of interest statement

All authors declare no competing interest. Furthermore, though the corresponding author is an Associate Editor of BMC Public Health, HPPD declares no competing interest.

Figures

Fig. 1
Fig. 1
Trends in inequality in childhood immunization coverage, Kenya
Fig. 2
Fig. 2
Trends in inequality in childhood in childhood immunization coverage, Ghana
Fig. 3
Fig. 3
Trends in inequality in childhood in childhood immunization coverage, Côte d’Ivoire
See this image and copyright information in PMC

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References

    1. McGovern ME, 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(9):791–798. doi: 10.1093/aje/kwv125. - DOI - PMC - PubMed
    1. Aaby P, Bukh J, Lisse IM, Smits AJ. Measles vaccination and reduction in child mortality: a community study from Guinea-Bissau. J Infect. 1984;8(1):13–21. doi: 10.1016/S0163-4453(84)93192-X. - DOI - PubMed
    1. Koenig MA, Khan MA, Wojtyniak B, Clemens JD, Chakraborty J, Fauveau V, et al. Impact of measles vaccination on childhood mortality in rural Bangladesh. Bull World Health Organ. 1990;68(4):441–447. - PMC - PubMed
    1. Higgins JP, Soares-Weiser K, López-López JA, Kakourou A, Chaplin K, Christensen H, et al. Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review. BMJ. 2016;355:1–13. - PMC - PubMed
    1. Bryce J, Black RE, Walker N, Bhutta ZA, Lawn JE, Steketee RW. Can the world afford to save the lives of 6 million children each year? Lancet. 2005;365(9478):2193–2200. doi: 10.1016/S0140-6736(05)66777-3. - DOI - PubMed