Abstract:
Background: Childhood immunization is a crucial component of public health programs worldwide, as
it prevents the spread of deadly diseases and reduces child mortality rates. In Ethiopia, though
immunization services have expanded, this study examines childhood immunization data from the Ethiopian
Demographic Health Survey (EDHS) 2005–2016. It aims to analyze how immunization coverage is
distributed concerning health equity and trends, offering a fresh perspective. The study's objective is to
understand the trends and disparities in childhood immunization service coverage in Ethiopia.
Methods: The analysis focused on the Ethiopian Demographic Health Survey (EDHS) data spanning from
2005 to 2016, aiming to explore the equitable coverage of services and illustrate the trend in childhood
immunization. Mothers with children aged from 0 to 12 months were specifically chosen, resulting in a
total sample size of 5810. This data gathered through a cross-sectional approach, was collected in
collaboration with the Ethiopian Public Health Institute (EPHI) as part of the EDHS Program.
Socioeconomic, geographical, and demographic factors that affect outcomes were explored using SPSS
version 26 by cross-tabulation. finally, the Health Equity Assessment Toolkit (HEAT) BUILT-IN
DATABASE EDITION, VERSION 4.0 was used.
Result: Addis Ababa, Diredawa, and Tigray have comparatively better basic vaccination coverage. In
2005, the total selected sample was 1.25% children in Addis Ababa, 0.33% in Diredawa, and 6.25% in
Tigray. Vaccine coverage among mothers with no education increased from 18.3% (2005) to 32.6% (2016).
Similarly, vaccine coverage among mothers from poor families rose from 14.5% (2005) to 22.2% (2016).
BCG, DTP, and polio immunization rates rose over time, yet measles vaccine uptake declined. In terms of
equity, the Relative Index of Inequality (RII) was 2.8 (95% CI: 2.0–3.9) in 2005, 4 (95% CI: 2.9–5.3) in
2011, and 3 (95% CI: 2.5–3.8) in 2016. This indicates that coverage in the wealth quintile was nearly 2.8,
4, and 3 times higher than in quintile 1 in 2005, 2011, and 2016, respectively.
Conclusion: Ethiopia's vaccination rates have improved, yet they remain lower compared to Kenya and
Uganda, highlighting the need for increased government efforts. Disparities are evident across urban and
rural areas, affluent and impoverished families, as well as educated and uneducated households, signaling
significant inequity that stakeholders must address.
