Olalekan A Uthman1,2, Duduzile Ndwandwe3, Muhammed M B Uthman4, Sanni Yaya5,6, Charles S Wiysonge2,3,7. 1. Warwick Centre for Global Health, Division of Health Sciences, University of Warwick Medical School, Coventry CV4 7AL, UK. 2. Department of Global Health, Division of Epidemiology and Biostatistics, Faculty of Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa. 3. Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town 7501, South Africa. 4. Department of Epidemiology & Community Health, College of Health Sciences, University of Ilorin, Ilorin 240211, Nigeria. 5. School of International Development and Global Studies, University of Ottawa, Ottawa, ON K1N 6N5, Canada. 6. The George Institute for Global Health, Imperial College London, London SW7 2AZ, UK. 7. Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa.
Abstract
Background: Africa was certified polio-free in 2020 and to maintain the polio-free status, African countries need to attain and maintain optimal routine polio vaccination coverage. One indicator for optimal polio vaccination coverage is the prevalence of children who have received no polio vaccination through routine services. The objective of the study was to examine the individual-, neighbourhood-, and country-level factors associated with non-vaccination against polio in Africa. Methods: We applied multivariable multilevel logistic regression analyses on recent demographic and health survey data collected from 2010 onwards in Africa. We identified 64,867 children aged 12-23 months (Level 1) nested within 16,283 neighbourhoods (Level 2) from 32 countries (Level 3). Results: The prevalence of non-vaccination for polio ranged from 2.19% in Egypt to 32.74% in Guinea. We found the following factors to be independent predictors of the increased odds of non-vaccination for polio: being a male child, born to mother with no formal education, living in poorer households; being from a polygamous family, living in neighbourhoods with high maternal illiteracy, high unemployment rate, and low access to media. Conclusions: We found that both individual and contextual factors are associated with non-vaccination for Polio.
Background: Africa was certified polio-free in 2020 and to maintain the polio-free status, African countries need to attain and maintain optimal routine polio vaccination coverage. One indicator for optimal polio vaccination coverage is the prevalence of children who have received no polio vaccination through routine services. The objective of the study was to examine the individual-, neighbourhood-, and country-level factors associated with non-vaccination against polio in Africa. Methods: We applied multivariable multilevel logistic regression analyses on recent demographic and health survey data collected from 2010 onwards in Africa. We identified 64,867 children aged 12-23 months (Level 1) nested within 16,283 neighbourhoods (Level 2) from 32 countries (Level 3). Results: The prevalence of non-vaccination for polio ranged from 2.19% in Egypt to 32.74% in Guinea. We found the following factors to be independent predictors of the increased odds of non-vaccination for polio: being a male child, born to mother with no formal education, living in poorer households; being from a polygamous family, living in neighbourhoods with high maternal illiteracy, high unemployment rate, and low access to media. Conclusions: We found that both individual and contextual factors are associated with non-vaccination for Polio.
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