Inequalities in the prevalence of full immunization coverage among one-year-olds in Ghana, 1993–2014

Budu, Eugene, Ahinkorah, Bright Opoku, Okyere, Joshua, Seidu, Abdul-Aziz, and Duah, Henry Ofori (2022) Inequalities in the prevalence of full immunization coverage among one-year-olds in Ghana, 1993–2014. Vaccine, 40. pp. 3614-3620.

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Background: We examined the inequalities in the prevalence of full immunization coverage among one-year-olds in Ghana using nationally representative data from the 1993-2014 Ghana Demographic and Health Surveys (GDHSs).

Methods: Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the 1993–2014 GDHSs were analyzed. We disaggregated full immunization by five equity stratifiers: wealth quintile, education, sex, residence, and region. Second, we measured the inequality through summary measures, namely Difference, Population Attributable Risk, Ratio, and Population Attributable Fraction. Statistical significance was pegged at 95% Uncertainty Interval.

Results: From 1993 to 2014, full immunization was higher among children born to mothers of the richest wealth index compared with those born to mothers of the poorest wealth index. Children with highly educated mothers dominated in full immunization coverage from 1993 (86.67%; UI = 70.38, 94.68] to 2014 (79.90%; UI = 73.94, 84.78). Within the same period, children of women without education recorded the least prevalence. Full immunization coverage was high among urban children in 1993 (71.07%; UI = 63.20, 77.84) but favoured rural children in 2008 (80.09%; UI = 74.30, 84.84) and 2014 (79.50%; UI = 74.00, 84.09) compared to urban children. More females were fully immunized in 1993 (56.68%; UI = 50.32, 62.82). In 2003, 2008 and 2014, Volta region (82.29%; UI = 70.32, 90.11), Brong Ahafo (93.94%; UI = 82.00, 98.14) and Upper East (95.27%; UI = 87.35, 98.32) regions dominated in full immunization coverage respectively.

Conclusion: The inequality estimates revealed significant socio-economic inequality in full immunization coverage between 1993 and 2014 in Ghana. Similarly, urban children and children of women with secondary or higher education were predominantly fully immunized. To accelerate full immunization, policy makers should consider these disparities in the implementation of policies on childhood immunization in Ghana.

Item ID: 74672
Item Type: Article (Research - C1)
ISSN: 1873-2518
Keywords: Demographic and Health Surveys, Ghana, Global health, Immunization, Inequality
Copyright Information: © 2022 Elsevier Ltd. All rights reserved.
Date Deposited: 24 Nov 2022 00:47
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420601 Community child health @ 100%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200412 Preventive medicine @ 100%
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