Understanding Socioeconomic Inequalities in Zero-Dose Children for Vaccination in Underserved Settings of Ethiopia: Decomposition Analysis Approach
Abstract
:1. Background
2. Methods
2.1. Study Design and Setting
2.2. Study Population and Sample Size
2.3. Data Collection Process
2.4. Statistical Analysis
2.5. Decomposing Inequality
3. Results
3.1. Sociodemographic Characteristics
3.2. CI and Decomposition
3.3. Decomposition of Socioeconomic Inequality
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Types of Study Population | Number of EAs | Sample Size |
---|---|---|
Afar | 30 | 360 |
Somali | 30 | 360 |
Benishangul Gumuz | 30 | 360 |
Gambella | 30 | 360 |
Newly formed regions Sidama and Southwest | 30 | 360 |
Urban slums | 40 | 480 |
Pastoralist areas in Oromia, SNNP, and Southwest | 30 | 360 |
Hard-to-reach areas | 30 | 360 |
Conflict affected areas | 30 | 360 |
Refugees | 30 | 360 |
Internally displaced persons | 30 | 360 |
Total | 340 | 4080 |
Characteristics | Frequency (%) |
---|---|
Child’s sex | |
Male | 1985 (54.4) |
Female | 1661 (45.6) |
Child’s age in months | |
12–23 | 1849 (50.7) |
24–35 | 1797 (49.3) |
Age of mother/caregiver in years | |
15–24 | 875 (24.0) |
25–34 | 1969 (54.0) |
35–44 | 572 (15.7) |
≥45 | 105 (2.9) |
Do not know | 126 (3.5) |
Educational status of mother/caregiver | |
No formal education or preschool | 2158 (59.2) |
Primary education | 788 (21.6) |
Secondary education | 616 (16.9) |
Tertiary education | 84 (2.3) |
Marital status | |
Not ever married | 43 (1.2) |
Married/Living together | 3312 (90.8) |
Separated | 83 (2.3) |
Divorced | 110 (3.0) |
Widowed | 98 (2.7) |
Place of residence | |
Urban | 677 (18.6) |
Rural | 2969 (81.4) |
Employment status of mother/caregiver | |
Unemployed | 2098 (57.6) |
Employed | 1548 (42.4) |
Region * | |
Afar | 636 (17.4) |
Amhara | 372 (10.2) |
Oromia | 431 (11.8) |
Somali | 480 (13.2) |
Benishangul Gumuz | 216 (5.9) |
SNNP | 300 (8.2) |
Sidama | 239 (6.6) |
Southwest Ethiopia | 181 (5.0) |
Gambella | 479 (13.1) |
Harari | 60 (1.6) |
Addis Ababa | 192 (5.3) |
Dire Dawa | 60 (1.6) |
Household size | |
2–5 | 2044 (56.1) |
≥6 | 1602 (43.9) |
Wealth index | |
Richest | 729 (19.99) |
Richer | 731 (20.05) |
Middle | 728 (19.97) |
Poorer | 729 (19.99) |
Poorest | 729 (19.99) |
Index | No. of Obs. | Index Value | Standard Error | p-Value |
---|---|---|---|---|
Erreygers norm. CI | 3646 | −0.2250 | 0.01729332 | <0.001 |
Variable | Elasticity | CI | % Contribution |
---|---|---|---|
Wealth index | |||
Poorest | Ref | Ref | Ref |
Poorer | −0.0790175 | −0.0248157 | −11.02817 |
Middle | −0.0899104 | 0.0077767 | 3.558421 |
Richer | −0.1232491 | 0.0516888 | 22.04815 |
Richest | −0.1125731 | 0.0548704 | 24.3477 |
Overall | 38.926 | ||
Place of residence | |||
Urban | Ref | Ref | Ref |
Rural | 0.1337818 | −0.0187361 | 7.690324 |
Child’s age in months | |||
12–23 | Ref | Ref | Ref |
24–35 | 0.0184178 | 0.000758 | −0.4484304 |
Marital status | |||
Not married | Ref | Ref | Ref |
Married/Living together | 0.1023875 | 0.0015589 | 2.079752 |
Child’s sex | |||
Male | Ref | Ref | Ref |
Female | 0.0073494 | −0.0000692 | 0.0053105 |
Household head’s sex | |||
Female | Ref | Ref | Ref |
Male | 0.2410311 | 0.0073635 | −1.718179 |
Age of mother/caregiver in years | |||
15–24 | Ref | Ref | Ref |
25–34 | −0.0369372 | 0.0010394 | −0.6262123 |
35–44 | 0.0204524 | 0.0006407 | −0.1870499 |
45 or above | 0.0037871 | −1.96 × 10−6 | 0.0013107 |
Caregiver’s employment status | |||
Not working | Ref | Ref | Ref |
Working | 0.055089 | 0.0025283 | −1.764959 |
≥4 ANC visits during pregnancy | |||
Yes | Ref | Ref | Ref |
No | −0.1157852 | −0.019626 | 8.662506 |
PNC services for index child | |||
Yes | Ref | Ref | Ref |
No | −0.2482841 | −0.0183511 | 8.618182 |
Skilled birth attendance | |||
Yes | Ref | Ref | Ref |
No | −0.1612879 | −0.0435716 | 20.35813 |
Number of under-five children | |||
One child | Ref | Ref | Ref |
Two children | −0.0531308 | −0.0187361 | −2.203588 |
Three and above | 0.0259274 | 0.000758 | 0.6659956 |
Availability of health facility in the kebele | |||
Yes | Ref | Ref | Ref |
No | −0.8824569 | −0.1367844 | 61.02996 |
One-way walking distance to the nearest health facility | |||
Time to walk ≤ 30 min | Ref | Ref | Ref |
Time to walk > 30 min | 0.0173218 | −0.0022571 | 0.4631407 |
Maternal education | |||
No formal education or preschool | Ref | Ref | Ref |
Primary education | 0.0306062 | 0.0011367 | −0.3098591 |
Secondary education | 0.0517623 | 0.011027 | −4.494141 |
Tertiary education | −0.0001716 | −0.0000108 | 0.0904441 |
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Biks, G.A.; Shiferie, F.; Tsegaye, D.A.; Asefa, W.; DelPizzo, F.; Gebremedhin, S. Understanding Socioeconomic Inequalities in Zero-Dose Children for Vaccination in Underserved Settings of Ethiopia: Decomposition Analysis Approach. Int. J. Environ. Res. Public Health 2024, 21, 1086. https://doi.org/10.3390/ijerph21081086
Biks GA, Shiferie F, Tsegaye DA, Asefa W, DelPizzo F, Gebremedhin S. Understanding Socioeconomic Inequalities in Zero-Dose Children for Vaccination in Underserved Settings of Ethiopia: Decomposition Analysis Approach. International Journal of Environmental Research and Public Health. 2024; 21(8):1086. https://doi.org/10.3390/ijerph21081086
Chicago/Turabian StyleBiks, Gashaw Andargie, Fisseha Shiferie, Dawit Abraham Tsegaye, Wondwossen Asefa, Frank DelPizzo, and Samson Gebremedhin. 2024. "Understanding Socioeconomic Inequalities in Zero-Dose Children for Vaccination in Underserved Settings of Ethiopia: Decomposition Analysis Approach" International Journal of Environmental Research and Public Health 21, no. 8: 1086. https://doi.org/10.3390/ijerph21081086