Prevalence and determinants of child immunization coverage in Ethiopia: Evidence from the 2019 mini-demographic and health survey

Immunization is a crucial public health intervention, and in Ethiopia, a nation characterized by diversity, immunization coverage shows considerable variations. This study aims to assess immunization coverage across various vaccines in Ethiopia and understand the prevalence and factors affecting immunization rates. This study utilized secondary data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS), a community-based cross-sectional study. A Poisson regression model was used to evaluate the children's immunization coverage: the number of vaccinations a child received across 18 different vaccines. The overall immunization coverage in Ethiopia was found to be 40%, with significant regional disparities. Coverage was highest in Addis Ababa and Harari and lowest in Afar and Somali regions. BCG had the highest coverage (34.42%), while measles-2 vaccination had the lowest (3.7%). The Poisson regression analysis identified several significant predictors of immunization uptake. Children from wealthier households, those born in public health facilities, and those whose mothers attended antenatal care (ANC) visits had higher immunization counts (<i>p</i> < .001). Conversely, children from rural areas, female children, and those born into larger families had lower immunization rates (<i>p</i> < .01). Maternal education, pregnancy counseling, and family planning utilization were positively associated with vaccine uptake. Despite improvements in immunization coverage, Ethiopia's rates remain below the African regional average. Socioeconomic disparities, healthcare access, and maternal education significantly influence vaccination rates. Strengthening community-based outreach, expanding ANC services, improving healthcare infrastructure, and addressing gender-related disparities can enhance immunization coverage.