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Meta-Analysis
. 2020 Nov 26;20(1):1803.
doi: 10.1186/s12889-020-09890-0.

Predictors of immunization coverage among 12-23 month old children in Ethiopia: systematic review and meta-analysis

Tahir Yousuf Nour  1 , Alinoor Mohamed Farah  2 , Omer Moelin Ali  2 , Mohamed Omar Osman  2 , Mowlid Akil Aden  2 , Kalkidan Hassen Abate  3
Affiliations
Meta-Analysis

Predictors of immunization coverage among 12-23 month old children in Ethiopia: systematic review and meta-analysis

Tahir Yousuf Nour et al. BMC Public Health. .

Abstract

Background: Immunization is one of modern medicine's greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12-23 months in Ethiopia.

Method: Electronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I2, Funnel plot and Egger's test was used to check for publication bias.

Results: We identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62-3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27-3.77), residence, (OR = 2.11; 95% CI: 1.00-4.45), birth at health facility (OR = 1.86; 95% CI: 0.99-3.49), family size less than four, (OR = 1.81; 95% CI: 1.16-2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07-12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35-4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62-4.89), antennal care, (OR = 3.11; 95% CI: 1.64-5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99-7.75).

Conclusion: Our findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to "hard to reach areas" to improve immunization coverage for children aged 12-23 months.

Keywords: Ethiopia; Meta-analysis; Predictors of immunization coverage; Systematic review.

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Conflict of interest statement

The author declares there was no competing of interest.

Figures

Fig. 1
Fig. 1
Flow chart explaining selection of primary studies
Fig. 2
Fig. 2
Forest plot depicting the association between mother with formal education and immunization coverage among 12–23 months old children in Ethiopia
Fig. 3
Fig. 3
Forest plot depicting the association between Father with formal Education and immunization coverage among 12–23 months old children in Ethiopia
Fig. 4
Fig. 4
Forest plot depicting the association between residence and immunization coverage among 12–23 months old children in Ethiopia
Fig. 5
Fig. 5
Forest plot depicting the association between place of delivery and immunization coverage among 12–23 months old children in Ethiopia
Fig. 6
Fig. 6
Forest plot depicting association between Family size and immunization coverage among 12–23 months old children in Ethiopia
Fig. 7
Fig. 7
Forest plot depicting the association between knowledge on age to complete immunization and immunization coverage among 12–23 months old children in Ethiopia
Fig. 8
Fig. 8
. Forest plot depicting the association between knowledge on immunization schedule and immunization coverage in Ethiopia
Fig. 9
Fig. 9
funnel plot of publication bias knowlege on immunization schedule among 12–23 months old children in Ethiopia
Fig. 10
Fig. 10
Forest plot depicting the association between knowledge benefit of immunization and immunization coverage among 12–23 months old children in Ethiopia
Fig. 11
Fig. 11
Forest plot depicting the association between traveling time to the health facility and immunization coverage among 12–23 months old children in Ethiopia
Fig. 12
Fig. 12
Forest plot depicting the association between ANC and immunization coverage among 12–23 months old children in Ethiopia
Fig. 13
Fig. 13
Funnel plot for publication bias of ANC in Ethiopia
Fig. 14
Fig. 14
Forest plot depicting the association between PNC and immunization coverage among 12–23 month old children in Ethiopia
Fig. 15
Fig. 15
Forest plot depicting the association between TT vaccination and immunization coverage among 12–23 months old children in Ethiopia
See this image and copyright information in PMC

References

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