Determinants of Childhood Immunisation in sub-Saharan Africa: a Multilevel Analysis

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This study investigates the relationship between childhood vaccination and household wealth as well as various other socio-economic indicators in sub-Saharan Africa. Compared to other regions worldwide, sub-Saharan Africa is lagging behind in terms of its vaccination rate, leading to a vast number of premature deaths each year. Whereas previous studies used varying wealth indices derived from the DHS and UNICEF MICS surveys, this study uses the International Wealth Index as measure of household wealth, allowing data to be compared over time and place. Multilevel linear regression models are used to examine the relationship in a dataset consisting of 422 regions within 37 countries from 2000 through 2018. The analyses indicate that there is a positive relationship between household wealth and the vaccination rate. Additionally, various other socio-economic determinants are found to be of importance, among which maternal education, health expenditure, and household size. The results indicate that most of the variance in the vaccination rate can be explained by characteristics at the national level. The main conclusion is that childhood vaccination is positively influenced by household wealth.
Faculteit der Managementwetenschappen