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How common are zero-dose children in underserved Ethiopia?

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In June 2022 surveys of underserved settings, 33.7% of children were zero-dose; poverty, young/single motherhood, and weak ANC/PNC strongly predicted the gap.

Source

High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis

Biks GA, Shiferie F, Tsegaye DA, et al. · BMC public health · 2024

doi.org/10.1186/s12889-024-18077-wRead the full paper ↗25 citationscc by

What they did

Ran a cross-sectional vaccine coverage survey (CommCare; Stata 17) among mothers of children aged 12–35 months (3,646 interviews), estimated weighted prevalence, and modeled predictors with generalized estimating equations plus concentration-index analyses.

What they found

Overall zero-dose prevalence 33.7%, highest in pastoralist/developing regions, IDP, newly formed, and conflict-affected areas. Poorest wealth AOR 2.78; single marital status AOR 2.4; maternal age 15–24 AOR 1.2; fewer ANC visits and no PNC also raised odds.

The limits

What it doesn't show

Cross-sectional associations are not proof of causal levers; CI reported in the abstract looks atypical and estimates are setting-specific, not a national DHS replacement.

Key terms

Zero-dose children
Children who have not received any routine vaccinations.
GEE
Generalized estimating equations accounting for clustered survey data.
Concentration index
Inequality metric summarizing socioeconomic gradients in coverage.
ANC / PNC
Antenatal and postnatal care contacts linked to immunization uptake.
Pastoralist / IDP settings
Hard-to-reach populations with elevated zero-dose prevalence here.
Wealth index
Household socioeconomic ranking used as a key predictor.

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Zero-dose prevalence reported:

Common questions

Zero-dose prevalence?

33.7% in the study settings.

How many caregivers interviewed?

3,646 (97.7% response).

Strong wealth effect?

Poorest AOR 2.78 vs richer groups.

Where was burden highest?

Pastoralist/developing, IDP, new, and conflict-affected areas.

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