This peer-reviewed article published in Vaccine resents a systematic review and meta-analysis of quantitative research from January 2013 to May 2025 to assess both the prevalence of full immunization coverage among children under five in sub-Saharan Africa and the determinants associated with achieving full immunization across settings in the region. The authors synthesized data from multiple databases and used random-effects meta-analysis to quantify overall coverage and subgroup determinants.
Key findings:
The pooled prevalence of full immunization among children under five in sub-Saharan Africa was approximately 51%, with coverage ranging widely from 6% to 96% across studies.
Maternal and paternal education were strongly associated with higher odds of full immunization, indicating the importance of parental education in vaccine uptake.
Antenatal care attendance and institutional delivery were significant positive determinants of full immunization, highlighting links between broader maternal health services and vaccination coverage.
Children in rural areas and those with higher maternal parity were less likely to be fully immunized, pointing to persistent equity gaps within and between populations.
Household wealth was positively associated with full immunization, underscoring socioeconomic barriers to accessing immunization services.
How can the findings be used?
These findings can inform policymakers and immunization program planners about both the persistent gaps in routine vaccination coverage across sub-Saharan Africa and the key social and health system determinants to target to strengthen routine immunization performance across the region.
Thumbnail image credit: Gavi
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