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ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1433606
A multilevel analysis of factors associated with unimmunized children in Ethiopia
Provisionally accepted- 1 Addis Ababa Institute of Technology, Addis Ababa University, Addis Ababa, Ethiopia
- 2 Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
- 3 Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
In Ethiopia, 16% of deaths of children under five are attributable to diseases that can be prevented through vaccination. Studies done in Ethiopia to date, however, have not looked at how community and individual-level factors affect children who receive no vaccine at all. Hence, this study aimed to assess the associated factors of unimmunized children in Ethiopia. This study is a secondary analysis of Demographic and Health Survey (DHS) data. A weighted sample of 6219 under-five children was included with a stratified two-stage cluster sampling. To determine the factors that influence children who are not immunized, a multivariable multilevel logistic regression model was built. Adjusted odds ratio with 95% credible interval was used to select variables that have statistically significant effects on unimmunized children. The prevalence of unimmunized under-five children in Ethiopia was 22.45% (95% CI: 21.4-23.5). In the multivariable multilevel analysis: No media exposure 1.33 (AOR 1.33, 95 CI: 1.02-1.63), place of delivery 1.5 (AOR 1.5, CI:1.22-1.91 and relationship to household head as whose relationship from household head among daughters and others increases by 1.5 (AOR 1.5, 95 CI: 1.05 - 2.41) and 1.8 (AOR 1.8, 95, CI: 1.15- 2.74) were individual-level factors. Place of residence 1.8 (AOR 1.8, 95, CI: 1.12-2.58), distance from health facility 1.32 (AOR 1.32, 95, CI: 1.09-1.60), and community poverty level 1.4 (AOR 1.4, 95, CI:1.05-1.78) were community-level predictors associated with unimmunized children. Conclusion: Nearly one-fourth of children could not get basic vaccinations in Ethiopia. Media exposure, place of delivery, relationship to household head, place of residence, distance from the health facility, and community poverty were factors significantly associated with unimmunized children.
Keywords: unimmunized children, multilevel, Associated factors, and Ethiopia, health survey data
Received: 16 May 2024; Accepted: 04 Apr 2025.
Copyright: © 2025 Mamo, Melaku and Aychiluhm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Getnet Mamo, Addis Ababa Institute of Technology, Addis Ababa University, Addis Ababa, Ethiopia
Setognal Birara Aychiluhm, Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
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