A total of 1,911 (weighted) children aged 12 to 23 months were included in this study. The majority of the children (11.1%) are at the age of one year. The children's and mother's mean age were 16.9 months and 29.18 years, respectively.
Generally, in Ethiopia prevalence of full vaccinated children was 35%, while 49% of children were partially vaccinated and 16% were non-vaccinated. In terms of maternal age fully vaccinated children were exhibited among women aged 15–19 (40.6%) and 20–29 (38.4%) years. Conversely, partially vaccinated children are highly noticed among women aged 40–49 (56.4%) & 30–39 (49.3%) years. Regarding educational status of maternity of uneducated women 624(52.5%) and 329 (28%) their children belongs to partially vaccinated and fully vaccinated respectively. Of 713 women who give birth at health facility to their last birth, more than half of their children were partially vaccinated. (Table 1)
Table 1
distribution of vaccination status of children aged 12–23 months by selected characteristics 2016 EDHS.
Characteristics | Vaccination status | total |
| Not vaccinated | Partially vaccinated | Fully vaccinated | |
Vaccination status | 309 (16%) | 936 (49%) | 666(35%) | 1911 |
Maternal age |
15–19 | 19(25.8%) | 27(33.7%) | 31(40.6%) | 77 |
20–29 | 124(13.1%) | 464(48.5%) | 366(38.4%) | 954 |
30–39 | 146(20.1%) | 360(49.3%) | 224(30.6%) | 730 |
40–49 | 18(12.2%) | 85(56.4%) | 47(31.4%) | 150 |
Child sex |
Male | 143(16.5%) | 437(49.8%) | 293(33.7%) | 873 |
Female | 166(16.0%) | 499(48.0%) | 374(36.0%) | 1038 |
Maternal educational status |
no education | 232(19.7%) | 624(52.5%) | 329(27.8%) | 1185 |
Primary | 66(11.8%) | 265(47.4%) | 227(40.8%) | 558 |
Secondary | 7(6.6%) | 32(32.3%) | 63(61.2%) | 102 |
Higher | 4(5.5%) | 14(21.2%) | 48(73.4%) | 66 |
Occupation |
Working | 110(12.7%) | 413(47.2%) | 349(40.1%) | 873 |
Not working | 198(19.2%) | 522(50.2%) | 318(30.6%) | 1038 |
Place of delivery |
Home | 233(19.5%) | 655(54.5%) | 310(26.0%) | 1198 |
Health facility | 76(10.7%) | 280(39.3%) | 357(50.0%) | 713 |
Frequency of ANC visit |
No ANC | 188(28.5%) | 360(54.4%) | 113(17.1%) | 665 |
1_3 visit | 65(12.1%) | 265(49.4%) | 207(38.6%) | 537 |
>=4 visits | 28(4.6%) | 260(42.7%) | 320(52.6%) | 611 |
Health facility visit in the past 12 months |
No | 197 (20.3%) | 538(55.5%) | 234(24.2%) | 968 |
Yes | 112(12.0%) | 398(42.0%) | 432(46.0%) | 942 |
Visited by field worker in the last 12 months |
Not visited | 255(13.3%) | 671(35.1%) | 388(20.3%) | 1314 |
Visited | 54(2.8%) | 264(13.8%) | 596(14.5%) | 596 |
Wealth status |
Poorest | 120(24.9%) | 264(54.8%) | 97(20.3%) | 481 |
Poorer | 66(17.8%) | 185(49.1%) | 123(33.1%) | 373 |
Middle | 60(14.2%) | 227(53.9%) | 134(31.9%) | 421 |
Richer | 39(11.2%) | 169(47.6%) | 145(41.2%) | 353 |
Richest | 24(8.6%) | 91(32.3%) | 167(59.2%) | 282 |
Place of residency |
Rural | 300(17.9%) | 850(50.7%) | 525(31.4%) | 1674 |
Urban | 9(3.8%) | 80(34.9%) | 140(61.3%) | 228 |
Region |
Urban admin | 1(1.6%) | 14(21.4%) | 51(77.1%) | 66 |
Agrarian | 283(16.5%) | 857(49.5%) | 585(34.0%) | 1725 |
Pastoralist | 65(20.3%) | 65(54.0%) | 30(25.7%) | 119 |
Media exposure |
No | 245(12.7%) | 665(47.2%) | 349(40.1%) | 1260 |
Yes | 63(19.2%) | 270(50.2%) | 316(30.6%) | 650 |
Participation on decision making |
No | 66(18.4%) | 194(54.1%) | 98(27.5%) | 358 |
Some | 198(16.4%) | 563(46.3%) | 451(37.3%) | 1212 |
Yes | 25(10.7%) | 123(51.5%) | 89(37.8%) | 237 |
Husband/partner’s educational status |
None | 165(19.6%) | 441(52.3%) | 236(28.1%) | 842 |
Primary | 98(13.7%) | 353(49.1%) | 268(37.2%) | 718 |
Secondary | 16(11.5%) | 52(36.2%) | 75(52.3%) | 1438 |
Higher | 9(9.1%) | 29(29.9%) | 59(61.0%) | 96 |
Agrarian; Tigray, Amhara, Oromo, and South nation nationality and peoples. Pastoralist; Afar, Gambella, Benishangul, and Somalia and urban administration; Addis-Ababa, Harari and Dire-Dawa |
Highest fully vaccinated children was observed in Addis Ababa, Dire Dawa, Tigray and Benishangul regions, while lowest prevalence were noticed in Somalia, Afar and Oromia region (Fig. 1).
Logit based multinomial logistic regression analysis
Output of Logit based logistic regression analysis shown in (Table 2) using the category not vaccinated as base outcome (reference group) adjusted relative risk ratio (RRR) was estimated for child being partially vaccinated along with not vaccinated and fully vaccinated along with not vaccinated. The variables associated with partially and fully vaccination were; ANC visits, visited by field worker in the last 12 months, visit to health facility in the last 12 months, place of residency and wealth status. Being visited by field workers and ANC visits were variables that predicts both fully and partially vaccination status uniformly. But, the variable place of residency predicts only partially vaccinated, while visits to HF within the last 12 months and wealth status predicts only fully vaccination.
In contrast to children from rural residents, children from urban area had 3.8 times higher relative risk of being partially vaccinated compared to not vaccinated children [RRR = 3.82, 95% CL: 1.32–11.12]. In the same way, Children whose mothers visited a health facility in the past 12 months in comparison to those who did not have any visit had 2.16 greater relative risk of being fully vaccinated relative to non-vaccinated children (RRR = 2.16, 95% CI = 1.4–3.52].
Table 2
Association between independent variables and vaccination status among children age 12–23 months after adjusting for covariates (reference group = not vaccinated) using multivariable multinomial logistic regression.
Characteristics | Partially vaccinated | full vaccinated |
| 95% CI | | 95% CI |
| Adjusted RRR | LL | UL | Adjusted RRR | LL | UL |
Maternal age | | | | | |
15–19 | 1.00 | | | 1.00 | | |
20–29 | 1.28 | 0.36 | 4.52 | 0.75 | 0.23 | 2.47 |
30–39 | 0.96 | 0.26 | 3.62 | 0.48 | 0.13 | 1.85 |
40–49 | 1.56 | 0.32 | 7.56 | 0.82 | 0.17 | 4.03 |
Sex of child | | | | | | |
Male | 1.00 | | | 1.00 | | |
Female | 0.94 | 0.60 | 1.47 | 1.05 | 0.63 | 1.75 |
Working status | | | | | |
Working | 1.00 | | | 1.00 | | |
Not working | 0.84 | 0.50 | 1.40 | 0.77 | 0.46 | 1.31 |
Place of delivery | | | | | |
Home | 1.00 | | | 1.00 | | |
Facility | 0.61 | 0.30 | 1.25 | 0.83 | 0.39 | 1.76 |
ANC visits | | | | | | |
None | 1.00 | | | 1.00 | | |
1 to 3 visits | 2.25 | 1.25** | 4.05** | 3.94 | 2.05*** | 7.56*** |
≥ 4 visits | 4.97 | 2.00** | 12.33** | 9.74 | 3.52*** | 26.94*** |
Visit to HF | | | | | | |
No | 1.00 | | | 1.00 | | |
Yes | 1.18 | 0.69 | 2.01 | 2.16 | 1.32** | 3.52** |
Place of residency | | | | | |
Rural | 1.00 | | | 1.00 | | |
Urban | 3.82 | 1.32* | 11.12* | 2.87 | 0.81 | 10.20 |
Region | | | | | | |
urban admin | 1.00 | | | 1.00 | | |
Agrarians | 0.38 | 0.07 | 2.09 | 0.19 | 0.03 | 1.11 |
Pastoralists | 0.36 | 0.06 | 2.11 | 0.19 | 0.03 | 1.17 |
Visited by field worker | | | | | |
No | 1.00 | | | 1.00 | | |
Visited | 2.13 | 1.13* | 4.02* | 2.97 | 1.58** | 5.60** |
media exposure | | | | | |
No | 1.00 | | | 1.00 | | |
Yes | 1.05 | 0.51 | 2.18 | 1.35 | 0.69 | 2.64 |
Decision making autonomy | | | | |
No | 1.00 | | | 1.00 | | |
Some | 0.61 | 0.34 | 1.10 | 0.83 | 0.41 | 1.71 |
Yes | 1.17 | 0.53 | 2.56 | 1.32 | 0.53 | 3.29 |
Husband’s/partner’s education |
None | 1.00 | | | 1.00 | | |
Primary | 1.20 | 0.66 | 2.19 | 1.21 | 0.66 | 2.20 |
Secondary | 0.67 | 0.22 | 2.04 | 0.65 | 0.19 | 2.18 |
Higher | 0.94 | 0.15 | 5.93 | 0.52 | 0.09 | 3.11 |
Maternal education | | | | |
None | 1.00 | | | 1.00 | | |
Primary | 1.64 | 0.77 | 3.47 | 1.77 | 0.82 | 3.80 |
Secondary | 0.65 | 0.13 | 3.18 | 1.13 | 0.25 | 5.05 |
Higher | 0.23 | 0.02 | 2.17 | 0.76 | 0.09 | 6.46 |
Wealth status | | | | |
Poorest | 1.00 | | | 1.00 | | |
Poorer | 1.30 | 0.63 | 2.66 | 1.89 | 0.88 | 4.03 |
Middle | 1.97 | 0.91 | 4.26 | 2.31* | 1.07* | 5.01* |
Richer | 1.63 | 0.80 | 3.32 | 2.59* | 1.22* | 5.49* |
Richest | 0.74 | 0.24 | 2.25 | 1.69 | 0.50 | 5.79 |
Constants | 4.06 | 0.40 | 41.17 | 1.86 | 0.19 | 18.53 |
p-value*<0.05, **<0.01, ***=<0.001 HF; health facility, LL; lower limit, UL; upper limit |
Children belongs to middle wealth households relative to poorest had 2.3 higher risk of being fully vaccinated in contrast to not vaccinated children [RRR = 2.31, 95% CI = 1.07–5.01]. In the same manner, children from richer households relative to poorest had 2.6 higher relative risk of being fully vaccinated than not vaccinated. [RRR = 2.59, 95% CI = 1.22–5.49].
Children whose mothers made 1–3 ANC visits compared to no ANC visit had nearly four times higher relative risk of being fully vaccinated compared to non-vaccinated [RRR = 3.94, 95% CI = 2.05–7.56], and 2.2 folds higher relative risk of being partially vaccinated compared to non-vaccinated [RRR = 2.25, 95% CI = 1.25–4.05].in similar fashion, having focused ANC (at least four visits) contrasted to no ANC visits at all had 9.7 higher relative risk of being fully vaccinated than not vaccinated [RRR = 9.74, 95% CI = 3.52–26.94], and 5 times higher relative risk of being partially vaccinated than not vaccinated [RRR = 4.97, 95% CI = 2.00-12.33]. The relative risk of being fully vaccinated compared to not vaccinated is threefold higher in children whose mother was visited by field workers in the past 12 months compared to not visited [RRR = 2.97, 95% CI = 1.58–5.60], and 2.13 fold higher relative risk of being partially vaccinated in contrary to not vaccinated [RRR = 2.13, 95% CI = 1.13–4.02] holding other covariates constant.