Full immunization coverage and associated factors among children age 12-23 months in Ethiopia: systematic review and meta-analysis of observational studies

Abstract

ABSTRACT Background: Millions of children in developing countries remained unvaccinated and under-vaccinated. This study was aimed to determine the pooled full vaccination coverage and associated factors in Ethiopia. Methods: This review and meta-analysis were included observational studies conducted from 2013 to 2020. The international online databases as well as gray literatures were retrieved from April 15 to 30/2020. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using Microsoft excel 2016 and analyzed using STATA 11.0 statistical software. Heterogeneity among studies was assessed using the Cochran Q statistics and I2 test. The pooled effect sizes were determined using pooled proportion for the full vaccination coverage and odds ratios for the associated factors with the corresponding 95% confidence interval. Result: Sixteen studies with 8305 children aged 12–23 months were included. The overall pooled full vaccination coverage was 65% (95% CI: 56%-74%). Institutional delivery (OR: 2.12, 95% CI: 1.78–2.52), travel to vaccination site for <2 hours (OR: 2.43, 95%CI: 1.97–3.00), received at least one antenatal (ANC) visit (OR: 3.2, 95%CI: 2.46–4.1), good maternal knowledge of immunization (OR: 3.63, 95%CI: 2.82–4.67), being informed on immunization schedule (OR: 2.54, 95%CI: 2.02–3.2), living in urban areas (OR: 2, 95% CI: 1.54–2.6), and a household visit by health-care providers during the postnatal period (OR: 2.23, 95%CI: 1.22–4.09) were the independent predictors of full immunization coverage among children age 12–23 months. Conclusion: The study showed that the pooled full immunization coverage is still far from the national target (90%). Therefore, the government should strengthen both the outreach and facility-based immunization services.