Exploring Factors Influencing Childhood Immunization Status in East Africa using  Spatial and Multilevel Ordinal Logistic Regression

Addisu, Aster

dc.contributor.author	Addisu, Aster
dc.date.accessioned	2024-08-01T12:14:27Z
dc.date.available	2024-08-01T12:14:27Z
dc.date.issued	2024-07
dc.identifier.uri	http://ir.bdu.edu.et/handle/123456789/15905
dc.description.abstract	Background: Childhood vaccines play a vital role in protecting children from infectious diseases and have been recognized as one of the most cost effective public health interventions. However East African countries, have more than fifteen-fold increased risk of death caused by Vaccine Preventable Disease compared to children in high-income nations. Therefore this study aimed to identify factors influencing childhood immunization status in East Africa. Methods: A sample of 22,734 children aged 12-23 months was enrolled to study the immunization status, using the recent data from the Demographic and Health Survey conducted from 2015 to 2022 in 10 East African countries. Spatial and level-3 multilevel generalized odds model with logit link function was employed. Result: Out of the total sample of 22,734 children, only 67.4% were fully immunized, 27.7% were partially immunized and the remaining were not immunized. The null hypothesis of proportionality was rejected based on the Brant-test. As a result, various partial- and non proportional odds models were fitted where the generalized odds model was found to be the best compared to other ordinal regression models. The result of this study revealed that 43.14% of the variation in child’s immunization status exists between countries, and 18.18% exists between regions. Regarding specific factors associated with immunization status, the analysis revealed that mothers who had antenatal care visits, and postnatal care were 1.23, and 1.13 times more likely to fully Vs partially or not immunize their children, also 1.07 and 1.08 times more likely to fully or partially Vs not immunize their children respectively compared to those who did not attend antenatal and postnatal services. Conclusion: The fitted generalized odds model indicated that age of mother, number of antenatal care visits, number of postnatal care visits, mothers tetanus injections received, taking vitamin A1, presence of health documentation, place of delivery, Birth order, mother occupation, sex of house hold head, distance to health facility, occupation of mother, and mother education, community mother education, community wealth index, and community media exposure were factors significantly associated with childhood immunization status. Thus, it is recommended that interventions focus on improving household wealth index, educating mothers, and improving health systems	en_US
dc.language.iso	en_US	en_US
dc.subject	Statistics	en_US
dc.title	Exploring Factors Influencing Childhood Immunization Status in East Africa using Spatial and Multilevel Ordinal Logistic Regression	en_US
dc.type	Thesis	en_US