review · JMIR Public Health and Surveillance
Ethiopia experiences low coverage for the second dose of the measles-containing vaccine, leading to recurrent disease outbreaks. A systematic review and meta-analysis of data concerning children under five years old established that the overall uptake of this second dose in Ethiopia is only 34.4 percent. This rate falls substantially below the national and international target of 95 percent. The analysis identified several primary factors that significantly improve the likelihood of vaccination. These include higher levels of maternal education, attendance at antenatal care sessions, and the use of postnatal care services. Additionally, shorter waiting times at immunisation centres, stronger awareness regarding measles immunisation, and favourable perceptions of the vaccine are strongly linked to higher uptake. The findings point towards the need for better community education programmes, enhanced healthcare access, and streamlined service delivery to lift immunisation rates.
Low coverage of the second measles vaccine dose leaves young children vulnerable to preventable and dangerous outbreaks. Understanding the specific obstacles to immunisation, such as long clinic waiting times and gaps in maternal health service use, gives healthcare planners clear priorities for targeted interventions to raise vaccination levels and protect public health.
The abstract does not indicate an application pathway for commercialisation, as it focuses on epidemiological analysis and public health policy interventions.
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BACKGROUND: Ethiopia is faced with poor measles-containing vaccine second dose (MCV2) coverage, leading to recurrent outbreaks. OBJECTIVE: This meta-analysis and systematic review aimed at combining evidence of MCV2 uptake in Ethiopia and its determinants to inform interventions for increased vaccination uptake and control of public health challenges. METHODS: statistics and the Cochran Q test, and the analysis used a random-effects model. Publication bias was assessed through funnel plots, the Egger test, and nonparametric trim-and-fill tests. RESULTS: The overall MCV2 uptake among children aged <5 years in Ethiopia was only 34.4% (95% CI 18.8%-49.9%). Significant determinants of MCV2 uptake included high level of maternal education (adjusted odds ratio [AOR] 3.31, 95% CI 1.32-5.30), attendance to antenatal care follow-ups (AOR 2.02, 95% CI 1.12-2.92), use of postnatal care services (AOR 3.03, 95% CI 1.77-4.28), reduced waiting times at vaccination sites (AOR 2.56, 95% CI 1.98-3.13), good awareness of measles vaccination (AOR 2.17, 95% CI 1.59-2.74), and positive perceptions of the vaccine (AOR 3.58, 95% CI 1.97-6.30). CONCLUSIONS: This study found that the uptake of MCV2 among children aged <5 years in Ethiopia was 34%, which is far below the global and national goal of 95%. Key factors contributing to low coverage include mothers' educational levels, use of antenatal and postnatal care services, waiting times at vaccination sites, and mothers' awareness of the measles vaccine. Improving community-based education programs, increasing access to antenatal and postnatal care services, reducing waiting times, and raising awareness about immunization all contribute to increasing vaccine uptake. TRIAL REGISTRATION: PROSPERO CRD42024619031; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024619031.
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DOI: 10.2196/77195
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