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. 2020 Apr 14;17(8):2696.
doi: 10.3390/ijerph17082696.

Inequalities in Rotavirus Vaccine Uptake in Ethiopia: A Decomposition Analysis

Abrham Wondimu  1   2 , Jurjen van der Schans  2   3 , Marinus van Hulst  2   4 , Maarten J Postma  2   3   5   6
Affiliations

Inequalities in Rotavirus Vaccine Uptake in Ethiopia: A Decomposition Analysis

Abrham Wondimu et al. Int J Environ Res Public Health. .

Abstract

A previous study in Ethiopia reported significant variation in rotavirus vaccine uptake across socioeconomic strata. This study aims to quantify socioeconomic inequality of rotavirus vaccine uptake in Ethiopia and to identify the contributing factors for the inequality. The concentration curve (CC) and the Erreygers Normalized Concentration Index (ECI) were used to assess the socioeconomic related inequality in rotavirus vaccine uptake using data from the 2016 Ethiopian Demographic and Health Survey. Decomposition analysis was conducted to identify the drivers of inequalities. The CC for rotavirus vaccine uptake lay below the line of equality and the ECI was 0.270 (p < 0.001) indicating that uptake of rotavirus vaccine in Ethiopia was significantly concentrated among children from families with better socioeconomic status. The decomposition analysis showed that underlining inequalities in maternal health care services utilization, including antenatal care use (18.4%) and institutional delivery (8.1%), exposure to media (12.8%), and maternal educational level (9.7%) were responsible for the majority of observed inequalities in the uptake of rotavirus vaccine. The findings suggested that there is significant socioeconomic inequality in rotavirus vaccine uptake in Ethiopia. Multi-sectoral actions are required to reduce the inequalities, inclusive increasing maternal health care services, and educational attainments among economically disadvantaged mothers.

Keywords: Ethiopia; concentration curve; concentration index; decomposition analysis; inequalities; rotavirus vaccine; uptake.

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Conflict of interest statement

Postma reports grants and honoraria from various pharmaceutical companies, including those developing, producing and marketing rotavirus vaccine.

Figures

Figure 1
Figure 1
Hypothetical concentration curves for rotavirus vaccine uptake.
Figure 2
Figure 2
Distribution of rotavirus uptake among children aged 12–23 months in Ethiopia, 2016 EDHS (The error bar shows a 95% confidence interval).
Figure 3
Figure 3
Concentration curve for rotavirus vaccine uptake among children aged 12–23 months in Ethiopia, 2016 EDHS.
See this image and copyright information in PMC

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