The Knowledge Hub

Children in female-headed households were less likely to be fully vaccinated compared to male-headed households

An equity impact analysis of the 2016 Ethiopia Demographic and Health Survey dataset for full vaccination coverage among children aged up to 36 months found that children living in female-headed households were 49% less likely to have full vaccination coverage compared to children living in male-headed households.

Geweniger A, Abbas KM. 2020. Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal, and child characteristics. Vaccine. 38(20).

Immunization coverage can vary dramatically across regions, with some areas having better access than others

An equity impact analysis of the 2016 Ethiopia Demographic and Health Survey dataset identified significant disparities in full immunization coverage across different regions of Ethiopia among children aged up to 36 months. Children in the Addis Ababa and Dire Dawa regions of Ethiopia were 7 times more likely to have full vaccination coverage compared to children living in the Afar region, a rural region with large numbers of pastoralist nomadic communities.

Geweniger A, Abbas KM. 2020. Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal, and child characteristics. Vaccine. 38(20).

Investments in polio eradication in Africa improved overall immunization systems and increased coverage of routine vaccinations

A systematic review of 8 African countries that had wild polio virus transmission and significant polio eradication activities found evidence that the huge investments made in polio have strengthened capacity in almost all aspects of the overall immunization systems, especially in the areas of microplanning, service delivery, capacity-building (especially supportive supervision and on-the-job training), and program management. This led to substantial increases in coverage of other routine vaccinations – BCG, DPT, measles – in all 8 countries over a 25-year period (1989-2014), including a more than a 3-fold increase in DPT3 coverage in 2 countries and a more than a 2-fold increase in 3 other countries.

Anya BPM, Moturi E, Aschalew T et al.. 2016. Contribution of polio eradication initiative to strengthening routine immunization: lessons learnt in the WHO African region. Vaccine. 34(43).

Children who received measles vaccines performed better in cognitive tests than those who did not

A 2019 analysis of survey data from India, Ethiopia and Vietnam found that children vaccinated against measles scored better on cognitive tests of language development, math and reading than children who did not receive measles vaccines.

Nandi A, Shet A, Behrman JR et al.. 2019. Anthropometric, cognitive, and schooling benefits of measles vaccination: Longitudinal cohort analysis in Ethiopia, India, and Vietnam. Vaccine. 37(31).

Vaccinating children against measles leads to an extra 0.2-0.3 years of schooling

A 2019 analysis of survey data from school aged children in Ethiopia, India and Vietnam shows that children vaccinated against measles achieved 0.2 – 0.3 years of additional schooling compared to children who did not receive the measles vaccine.

Nandi A, Shet A, Behrman JR et al.. 2019. Anthropometric, cognitive, and schooling benefits of measles vaccination: Longitudinal cohort analysis in Ethiopia, India, and Vietnam. Vaccine. 37(31).

Immunization rates increase when Ethiopian mothers receive maternal health services

Ethiopian mothers use of any of three maternal health services — antenatal care, delivery services, or tetanus vaccination — significantly increased the likelihood of their children being fully immunized by 12-23 months of age. Therefore, national immunization initiatives should concentrate on improving access of pregnant women to these key maternal health services.

Regassa N, Bird Y, Moraros J. 2019. Preference in the use of full childhood immunizations in Ethiopia: The role of maternal health services. Patient Preference and Adherence. 13.

High measles vaccination coverage in Ethiopia linked to lower rates of acute malnutrition in children

An analysis conducted in areas of Ethiopia with high proportions of refugees found that high measles vaccination coverage was linked to lower rates of acute malnutrition (wasting) in children under five. For each percentage point increase in measles vaccination coverage, there was a 0.65% decrease in the rate of acute malnutrition in these areas.

Altare C, Delbiso TD, Guha-Sapir D. 2016. Child wasting in emergency pockets: A meta-analysis of small-scale surveys from Ethiopia. International Journal of Environmental Research and Public Health. 13(2).

Efforts to eradicate polio have also led to improved access to other vaccines

The expertise and assets gained through efforts to eradicate polio at least partially explain the improvement between 2013 and 2015 in vaccination coverage of DPT3 in six out of ten “focus” countries of the Polio Eradication Endgame strategic plan. This includes substantial increases in vaccination rates in India, Nigeria, and Ethiopia, which, combined, reduced the number of children not fully vaccinated with DPT by 2 million in 2 years.

van den Ent MMVX, Mallya A, Sandhu H et al.. 2017. Experiences and lessons from polio eradication in 10 focus countries of the polio endgame strategic plan. Journal of Infectious Diseases. 216(1).

Empowering women in a community improves children’s immunization rates and overall health

The level of women’s community-level autonomy is associated with an increased number of children immunized above and beyond that which is seen with individual-level women’s autonomy. These results indicate that empowering women within households not only improves the individual mother’s children’s health, but also serves to improve the lives of other children within the community.

This analysis is from the 2011 Ethiopian Demographic and Health Survey that investigated the relationship between individual- and community-levels of women’s autonomy and children’s immunization status.

Ebot, J.O.. 2014. Place Matters: Community Level Effects of Women’s Autonomy on Ethiopian Children’s Immunization Status. African Population Studies. 28(2).

Empowering women can lead to greater vaccination rates in children

In a systematic review of qualitative research from low- and middle-income countries, women’s low social status was shown to be a barrier to their children accessing vaccinations. Specific barriers included access to education, income, resource allocation, and autonomous decision-making related to time. The authors suggest that expanding the responsibility for children’s health to both parents (mothers and fathers) may be one important element in removing persistent barriers to immunization often faced by mothers.

Merten, S., Hilber, A.H., Biaggi, C., et al.. 2015. Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.. PloS ONE. 10(8).