abstract: 'Background Sub-Saharan Africa is one of the highest under-five mortality

  and low childhood immunization region in the world. Children in

  Sub-Saharan Africa are 15 times more likely to die than children from

  high-income countries. In sub-Saharan Africa, more than half of

  under-five deaths are preventable through immunization. Therefore, this

  study aimed to identify the determinant factors of full childhood

  immunization among children aged 12-23 months in sub-Saharan Africa.

  Methods Data for the study was drawn from the Demographic and Health

  Survey of nine sub-Saharan African countries. A total of 21,448 children

  were included. The two-level mixed-effects logistic regression model was

  used to identify the individual and community-level factors associated

  with full childhood immunization Result The prevalence of full childhood

  immunization coverage in sub-Saharan Africa countries was 59.40\% (95\%

  CI: 58.70, 60.02). The multilevel logistic regression model revealed

  that secondary and above maternal education (AOR = 1.38; 95\% CI: 1.25,

  1.53), health facility delivery (AOR = 1.51; 95\% CI: 1.41, 1.63),

  fathers secondary education and above (AOR = 1.28, 95\% CI: 1.11, 1.48),

  four and above ANC visits (AOR = 2.01; 95\% CI: 1.17, 2.30), PNC

  visit(AOR = 1.55; 95\% CI: 1.46, 1.65), rich wealth index (AOR = 1.26;

  95\% CI: 1.18, 1.40), media exposure (AOR = 1.11; 95\% CI: 1.04, 1.18),

  and distance to health facility is not a big problem (AOR = 1.42; 95\%

  CI: 1.28, 1.47) were significantly associated with full childhood

  immunization. Conclusion The full childhood immunization coverage in

  sub-Saharan Africa was poor with high inequalities. There is a

  significant variation between SSA countries in full childhood

  immunization. Therefore, public health programs targeting uneducated

  mothers and fathers, rural mothers, poor households, and those who have

  not used maternal health care services to promote full childhood

  immunization to improve child health. By enhancing institutional

  delivery, antenatal care visits and maternal tetanus immunization, the

  government and other stakeholders should work properly to increase child

  immunization coverage. Furthermore, policies and programs aimed at

  addressing cluster variations in childhood immunization need to be

  formulated and their implementation must be strongly pursued.'
affiliation: 'Fenta, SM (Corresponding Author), Debre Tabor Univ, Dept Stat Fac Nat
  \& Computat Sci, Debre Tabor, Ethiopia.

  Fenta, Setegn Muche; Biresaw, Hailegebrael Birhan; Fentaw, Kenaw Derebe; Gebremichael,
  Shewayiref Geremew, Debre Tabor Univ, Dept Stat Fac Nat \& Computat Sci, Debre Tabor,
  Ethiopia.'
article-number: '29'
author: Fenta, Setegn Muche and Biresaw, Hailegebrael Birhan and Fentaw, Kenaw Derebe
  and Gebremichael, Shewayiref Geremew
author-email: setegn14@gmail.com
author_list:
- family: Fenta
  given: Setegn Muche
- family: Biresaw
  given: Hailegebrael Birhan
- family: Fentaw
  given: Kenaw Derebe
- family: Gebremichael
  given: Shewayiref Geremew
da: '2023-09-28'
doi: 10.1186/s41182-021-00319-x
eissn: 1349-4147
files: []
issn: 1348-8945
journal: TROPICAL MEDICINE AND HEALTH
keywords: Full immunization; Multi-level analysis; Sub-Saharan Africa
keywords-plus: LOGISTIC-REGRESSION; COVERAGE; ETHIOPIA; MORTALITY
language: English
month: APR 1
number: '1'
number-of-cited-references: '44'
orcid-numbers: Fenta, Setegn Muche/0000-0003-4006-3455
papis_id: 21b0944c51949a9561f84d9cba8bc28b
ref: Fenta2021determinantsfull
researcherid-numbers: Fenta, Setegn Muche/ABB-7296-2020
times-cited: '14'
title: 'Determinants of full childhood immunization among children aged 12-23 months
  in sub-Saharan Africa: a multilevel analysis using Demographic and Health Survey
  Data'
type: Article
unique-id: WOS:000635910500001
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '49'
web-of-science-categories: Tropical Medicine
year: '2021'