Charles Shey Wiysonge|Olalekan A. Uthman|Peter M. Ndumbe|Gregory Hussey
Individual and Contextual Factors Associated with Low Childhood Immunisation Coverage in Sub-Saharan Africa: A Multilevel Analysis
South African Tuberculosis Vaccine Initiative|University of Cape Town|Keele University|University of Buea|South African Tuberculosis Vaccine Initiative|University of Cape Town
2010 six million children subsaharan africa receive full series three doses diphtheriatetanuspertussis vaccine one year age evidencebased approach addressing burden unimmunised children requires accurate knowledge underlying factors therefore developed tested model childhood immunisation includes individual community countrylevel characteristicswe conducted multilevel logistic regression analysis demographic health survey data 27094 children aged 1223 months nested within 8546 communities 24 countries subsaharan africa according intracountry intracommunity correlation coefficient implied estimated intercept component variance 21 32 variance unimmunised children attributable country communitylevel factors respectively children born mothers 135 95ci 118 153 fathers 113 95ci 112 140 formal education likely unimmunised born parents secondary higher education children poorest households 36 likely unimmunised counterparts richest households maternal access media significantly reduced odds children unimmunised 094 95ci 094 099 mothers health seeking behaviours less likely unimmunised children 056 95ci 054 058 however children urban areas 112 95 ci 101 123 communities high illiteracy rates 113 95 ci 105 123 countries high fertility rates 443 95 ci 104 1892 likely unimmunisedwe found individual contextual factors associated childhood immunisation suggesting public health programmes designed improve coverage childhood immunisation address people communities societies live