Determinants of Immunization Among Children Aged 12-23 Months in Ethiopia: A Proportional Odds Model Approach
DOI:
https://doi.org/10.6000/1929-6029.2015.04.01.15Keywords:
Immunization, Children aged 12-23 months old, Socioeconomic and Demographic factors, Proportional Odds ModelAbstract
Childhood immunization is recognized as one of the most cost-effective public health interventions to prevent morbidity and mortality caused by infectious diseases, particularly in a high-endemic setting. According to the 2011 EDHS report by the Central Statistical Agency (CSA) of Ethiopia, nationally, only 24 percent of children age 12-23 months was fully immunized at the time of the survey. The main objective of this study was to identify and describe the determinants of immunization among children aged 12-23 months in Ethiopia. The source of the data was the Ethiopian Demographic and Health Survey conducted in 2011 (EDHS) 2011. In order to meet our objectives descriptive, and ordinal logistic regression (proportional odds model) statistical techniques were used for data analysis using socio-economic and demographic variables as explanatory variables and immunization status of children aged 12-23 months as the response variable. The results of the analysis predicts that place of delivery, wealth index, possession of radio and region were found to be significant determinants for full immunization among children aged 12-23 months in Ethiopia.
References
World Health Organization. WHO immunization work: 2006–2007 highlights 2008. http://who.int/publications/2008/ 9789241596749_eng.pdf
World Bank. World Development Report 1993: Investing in Health.Washington, D.C.: The World Bank 1993.
World Bank. Better Health for Africa: Experience and Lessons Learned. Washington, D.C.: The World Bank 1994. http://dx.doi.org/10.1596/0-8213-2817-4 DOI: https://doi.org/10.1596/0-8213-2817-4
World Health Organization, UNICEF. GIVS: Global Immunization Vision and Strategy 2006-2015. Geneva, Switzerland: World Health Organization, United Nations Children’s Fund 2005.
World Health Organization, UNICEF and the World Bank. State of the World’s Vaccines and Immunization. 3rd edn. Geneva: World Health Organization 2009.
UNICEF, WHO. Immunization Facts and Figure April 2013.
Lee S. Demand for Immunization, Parental Selection and Child Survival: Evidence From Rural India. Review of Economics of the Household 2005; 3: 171-197. http://dx.doi.org/10.1007/s11150-005-0709-x DOI: https://doi.org/10.1007/s11150-005-0709-x
Wiysonge CS, Waggie Z, Rhoda l, Hussey G. Improving communication for immunization in Africa: contribution of the Vaccines for Africa website; Pan African Medical Journal 2009.
Andre FE, Booy R, Bock HL, Clemens J, Datta SK, John TJ, et al. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the World Health Organization 2008; 86(2): 140-6. http://dx.doi.org/10.2471/BLT.07.040089 DOI: https://doi.org/10.2471/BLT.07.040089
JAMA. Vaccine Preventable Deaths and the GlobalImmunization Vision and Strategy, 2006-2015. JAMA 2006; 295: 2840-2. http://dx.doi.org/10.1001/jama.295.24.2840 DOI: https://doi.org/10.1001/jama.295.24.2840
NSW. NSW Immunization Strategy 2003-2006. North South Wales Department of Health, North Sydney 2003. www.nsw.gov.au/pubs/i/pdf/imm˙strategy 2003.
Center for Disease Control and Prevention (CDC 1999a). Vaccine preventable diseases: improving vaccination coverage inchildren, adolescents, and adults. Morbidity and Mortality Weekly Report 1999; 48: RR-8.
EDHS. Ethiopian Demographic and health survey (EDHS), Addis Ababa, Ethiopia and Carverton, Mary land, USA 2011.
World Health Organization. Weekly Epidemiological Record 2012; No. 2.
Haber M, Barskey A, Baughman W, Barker L, Whitney CG, Shaw KM, Orenstein & Stephens DS. Herd immunity and pneumococcal conjugate vaccine: a quantitative model. Vaccine 2007; 25: 5390-98. http://dx.doi.org/10.1016/j.vaccine.2007.04.088 DOI: https://doi.org/10.1016/j.vaccine.2007.04.088
Kidane T, Yigzaw A, Sahilemariam Y, Bulto T, Mengistu H, Belay T, et al. National EPI coverage survey report. Ethio-pian Journal of Health Development 2008; 22(2): 148-57. DOI: https://doi.org/10.4314/ejhd.v22i2.10065
Berhane Y. Universal Childhood Immunization: a realistic yet not achieved goal. Ethiopian Journal of Health Development 2008; 22(2): 146-7.
Streefland P, Chowdhury A, Ramos-Jimenez P. Patterns of vaccination acceptance. Journal of Social Science Medicine 1999; 49: 1705-1716. DOI: https://doi.org/10.1016/S0277-9536(99)00239-7
New S, Senior M. I don’t believe in needles: Qualitative aspects of a study into uptake of infant immunization in two English Health Authorities. Journal of social science Medicine 1991; 33: 509-519. DOI: https://doi.org/10.1016/0277-9536(91)90333-8
EDHS. Ethiopian Demographic and health survey (EDHS), Addis Ababa, Ethiopia and Carverton, Mary land, USA 2005.
Tadesse H, Deribew A, Woldie M. Predictors of defaulting from completion of child immunization in south Ethiopia, A case control study. BMC Public Health 2009; 9(150). DOI: https://doi.org/10.1186/1471-2458-9-150
Aitchison J, Silvey SD. The Generalization of Probit Analysis to the Case of Multiple Responses. Biometrika 1957; 44(1/2): 131-140. http://dx.doi.org/10.2307/2333245 DOI: https://doi.org/10.1093/biomet/44.1-2.131
McCullagh P. Regression models for ordinal data (with discussion). Journal of the Royal Statistical Society Series B 1980; 42: 109-142. DOI: https://doi.org/10.1111/j.2517-6161.1980.tb01109.x
Scott SC, Goldberg MS, Mayo NE. Statistical assessment of ordinal outcomes in comparative studies. Journal of Clinical epidemiology 1997; 50(1): 45-55. http://dx.doi.org/10.1016/S0895-4356(96)00312-5 DOI: https://doi.org/10.1016/S0895-4356(96)00312-5
Wolfe R, Gould W. An approximate likelihood-ratio test for ordinal response models. Stata Technical Bulletin 1998; 42: 24-27. In Stata Technical Bulletin Reprints vol. 7: 199-204. College Statio, TX: Stata Press.
Long JS, Freese J. Regression Models for Categorical Dependent Variables Using Stata. Texas, Stata Press 2003.
SAS Institute Inc. SAS/STAT 9.1 User’s Guide. Cary, NC: SAS Institute Inc 2004.
Williams R. Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata Journal 2006; 6: 58-82. DOI: https://doi.org/10.1177/1536867X0600600104
Agresti A. An Introduction to Categorical Data Analysis. Second Edition, Wiley, Inc., New York 2007. http://dx.doi.org/10.1002/0470114754 DOI: https://doi.org/10.1002/0470114754
Everitt BS. The Cambridge Dictionary of Statistics. Cambridge University Press 1998.
Agresti A. Categorical data analysis (2nd Ed.). New York: John Wiley & Sons 2002. http://dx.doi.org/10.1002/0471249688 DOI: https://doi.org/10.1002/0471249688
Lipsitz SR, Fitzmaurice GM, Molenberghs G. Goodness-of-fit tests for ordinal response regression models. Applied Statistics 1996; 45: 175-190. http://dx.doi.org/10.2307/2986153 DOI: https://doi.org/10.2307/2986153
Breslow NE, Clayton DG. Approximate inference in generalized linear mixed Models. J Am Statist Assoc 1993; 88: 9-25. DOI: https://doi.org/10.1080/01621459.1993.10594284
Cook RD, Weisberg S. Residuals and influence in regression. New York: Chapman and Hall 1982.
Hosmer DW, Lemeshow S. Applied logistic regression (2nd ed.). New York: Wiley & Sons 2000. http://dx.doi.org/10.1002/0471722146 DOI: https://doi.org/10.1002/0471722146
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 Mesay Tefera, M.K. Sharma
This work is licensed under a Creative Commons Attribution 4.0 International License.
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
