Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics
Missed opportunities for vaccination (MOV) is an important barrier hindering full immunisation coverage among eligible children. Though factors responsible for MOV are well documented in literature, little attention has been paid to the role of inequalities. The aim of this study is to examine the a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2018-10-01
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| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/21645515.2018.1460985 |
| _version_ | 1797677474281160704 |
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| author | Evanson Z. Sambala Olalekan A. Uthman Abdu A. Adamu Duduzile Ndwandwe Alison B. Wiyeh Tawa Olukade Ghose Bishwajit Sanni Yaya Jean-Marie Okwo-Bele Charles S. Wiysonge |
| author_facet | Evanson Z. Sambala Olalekan A. Uthman Abdu A. Adamu Duduzile Ndwandwe Alison B. Wiyeh Tawa Olukade Ghose Bishwajit Sanni Yaya Jean-Marie Okwo-Bele Charles S. Wiysonge |
| author_sort | Evanson Z. Sambala |
| collection | DOAJ |
| description | Missed opportunities for vaccination (MOV) is an important barrier hindering full immunisation coverage among eligible children. Though factors responsible for MOV are well documented in literature, little attention has been paid to the role of inequalities. The aim of this study is to examine the association between structural or compositional factors and education inequalities in MOV. Blinder-Oaxaca decomposition technique was used to explain the factors contributing to the average gap in missed opportunities for vaccination between uneducated and educated mothers in sub-Saharan Africa using DHS survey data from 35 sub Saharan African countries collected between 2007 and 2016. The sample contained 69,657 children aged 12 to 23 months. We observed a wide variation and inter-country differences in the prevalence of missed opportunity for vaccination across populations and geographical locations. Our results show that the prevalence of MOV in Zimbabwe among uneducated and educated mothers was 9% and 21% respectively while in Gabon corresponding numbers were 85% and 89% respectively. In 15 countries, MOV was significantly prevalent among children born to uneducated mothers (pro-illiterate inequality) while in 5 countries MOV was significantly prevalent among educated mothers (pro-educated inequality). Our results suggest that education-related inequalities in missed opportunities for vaccination are explained by compositional and structural characteristics; and that neighbourhood socio-economic status was the most important contributor to education-related inequalities across countries followed by either the presence of under-five children, media access or household wealth index. The results showed that differential effects such as neighbourhood socio-economic status, presence of under-five children, media access and household wealth index, primarily explained education-related inequality in MOV. Interventions to reduce gaps in education-related inequality in MOV should focus on social determinants of health. |
| first_indexed | 2024-03-11T22:45:40Z |
| format | Article |
| id | doaj.art-56e2250d454246cf96898985fa9739f1 |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T22:45:40Z |
| publishDate | 2018-10-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-56e2250d454246cf96898985fa9739f12023-09-22T08:38:21ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2018-10-0114102365237210.1080/21645515.2018.14609851460985Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristicsEvanson Z. Sambala0Olalekan A. Uthman1Abdu A. Adamu2Duduzile Ndwandwe3Alison B. Wiyeh4Tawa Olukade5Ghose Bishwajit6Sanni Yaya7Jean-Marie Okwo-Bele8Charles S. Wiysonge9Cochrane South Africa, South African Medical Research CouncilFaculty of Medicine and Health Sciences, Stellenbosch UniversityCochrane South Africa, South African Medical Research CouncilCochrane South Africa, South African Medical Research CouncilCochrane South Africa, South African Medical Research CouncilCenter for Evidence Based Global Health, Department of Research and DevelopmentSchool of International Development and Global Studies, University of OttawaSchool of International Development and Global Studies, University of OttawaIndependent ConsultantCochrane South Africa, South African Medical Research CouncilMissed opportunities for vaccination (MOV) is an important barrier hindering full immunisation coverage among eligible children. Though factors responsible for MOV are well documented in literature, little attention has been paid to the role of inequalities. The aim of this study is to examine the association between structural or compositional factors and education inequalities in MOV. Blinder-Oaxaca decomposition technique was used to explain the factors contributing to the average gap in missed opportunities for vaccination between uneducated and educated mothers in sub-Saharan Africa using DHS survey data from 35 sub Saharan African countries collected between 2007 and 2016. The sample contained 69,657 children aged 12 to 23 months. We observed a wide variation and inter-country differences in the prevalence of missed opportunity for vaccination across populations and geographical locations. Our results show that the prevalence of MOV in Zimbabwe among uneducated and educated mothers was 9% and 21% respectively while in Gabon corresponding numbers were 85% and 89% respectively. In 15 countries, MOV was significantly prevalent among children born to uneducated mothers (pro-illiterate inequality) while in 5 countries MOV was significantly prevalent among educated mothers (pro-educated inequality). Our results suggest that education-related inequalities in missed opportunities for vaccination are explained by compositional and structural characteristics; and that neighbourhood socio-economic status was the most important contributor to education-related inequalities across countries followed by either the presence of under-five children, media access or household wealth index. The results showed that differential effects such as neighbourhood socio-economic status, presence of under-five children, media access and household wealth index, primarily explained education-related inequality in MOV. Interventions to reduce gaps in education-related inequality in MOV should focus on social determinants of health.http://dx.doi.org/10.1080/21645515.2018.1460985missed opportunities for vaccinationcompositional and structural factorseducation-related inequalityimmunisation coveragedhs survey dataprevalence of mov |
| spellingShingle | Evanson Z. Sambala Olalekan A. Uthman Abdu A. Adamu Duduzile Ndwandwe Alison B. Wiyeh Tawa Olukade Ghose Bishwajit Sanni Yaya Jean-Marie Okwo-Bele Charles S. Wiysonge Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics Human Vaccines & Immunotherapeutics missed opportunities for vaccination compositional and structural factors education-related inequality immunisation coverage dhs survey data prevalence of mov |
| title | Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics |
| title_full | Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics |
| title_fullStr | Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics |
| title_full_unstemmed | Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics |
| title_short | Mind the Gap: What explains the education-related inequality in missed opportunities for vaccination in sub-Saharan Africa? Compositional and structural characteristics |
| title_sort | mind the gap what explains the education related inequality in missed opportunities for vaccination in sub saharan africa compositional and structural characteristics |
| topic | missed opportunities for vaccination compositional and structural factors education-related inequality immunisation coverage dhs survey data prevalence of mov |
| url | http://dx.doi.org/10.1080/21645515.2018.1460985 |
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