Main Article Content


In 2012, the global number of children who did not receive the third dose of Diphtheria, Pertussis and Tetanus vaccine was estimated to 22.6 million. Factors associated with immunization status among children in Côte d’Ivoire were examined in order to determine the trends of these factors and inform health policy makers. The study was a retrospective one using 1998-1999 and 2011-2012 Côte d’Ivoire Demography and Health Surveys data. The sample included 3878 children aged 12 to 59 months representing 1326 children from 1998-1999 data, and 2552 children from the 2011-2012 data. The outcome variable was vaccination status defined as “not fully immunized”. A child defined as not fully immunized if he/she did not received at least one of the following vaccines: BCG, the third dose of pentavalent, the third dose of polio, and measles vaccine. Data was analyzed using SPSS. Chi-square test was computed and Spearman correlation analysis were used to describe the sample. Univariate analysis, and multivariate analysis using logistic regression were performed to unclose the factors. Findings showed that not fully immunized children increased significantly (P<0.0001) from 1998-1999 (41.9%) to 2011-2012 (48.9%). Children who did not received BCG, DPT3, polio3 and measles vaccine increased significantly from 1998-1999 to 2011-2012. Child birth place (adjusted OR = 2.57, CI95=1.96, 3.37), media access (adj. OR = 1.82, CI95=1.38, 2.38), literacy (adj. OR = 1.95, CI95 = 1.19, 3.20), place of residence (adj. OR = 1.38, CI95 = 1.04, 1.83), and religion (adj. OR = 1.89, CI95 = 1.28, 2.79) were associated with odds of not being fully immunized in 1998-1999 as well as in 2011-2012. Health officials should take into account these factors in immunization strategies and policy making in Côte d’Ivoire.


Factors immunization children Côte d’Ivoire

Article Details

How to Cite
Douba, A., Aka Lepri Bernadin, N., Attoh-Toure, H., Bangaman Akani, C., Yao, G. H. A., Konan, N., & Accray-Zengbe, P. (2016). An analysis of risk factors for incomplete immunization for children in Côte d’Ivoire: Examination of 1998-1999 and 2011-2012 demographic and health survey. HEALTH SCIENCES AND DISEASE, 17(1).


  1. - Smallpox-related virus. 2010. Retrieved from
  3. - Henderson DA. Eradication: Lessons from the Past. MMWR Supplements, 1999, 48(SU01), 16-22
  4. - Etana B, Deressa W. Factors associated with complete immunization coverage in children aged 12–23 months in Ambo Woreda, Central Ethiopia. BMC Public Health, 2012, 12(566), 1-9
  6. - WHO. Immunization service delivery: Expended Program on Immunization. 2013 Retrieved from
  7. - Bugvi AS, Rahat R, Zakar R, Zakar MZ, Fischer F, Nasrullah M, Manawar R. Factors associated with non-utilization of child immunization in Pakistan: Evidence from the demographic and health survey 2006-07. BMC Public Health, 2014, 14(232), 1-7
  9. - Institut National de santé publique du Quebec. Enquête sur la couverture vaccinale des enfants québécois en 2006. Québéc, 2007, 103p
  10. - Antai D. Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of individual and contextual determinants. BMC Infectious Diseases, 2009, 9(181), 1-10.
  11. - Machingaidze S, Wiysonge CS, Hussey GD. Strengthening the Expanded Programme on Immunization in Africa: Looking beyond 2015. PLoS Med, 2013, 10(3), e1001405.
  12. - Center for Disease Control and Prevention. Global routine vaccination coverage – 2012. MMWR, 2013, 62 (43), 858-861
  13. - Fernancez RC, Awofeso N, Rammohan A. Determinants of apparent rural-urban differentials in measles vaccination uptake in Indonesia. Rural and Remote Health, 2011, 11(1702), 1-14
  14. - Maina LC, Karanja S, Kombich J. Immunization coverage and its determinants among children aged 12 - 23 months in a peri-urban area of Kenya. PAMJ, 2013, 14(3), 1-7
  16. - Han K, Zheng H., Huang, Z., Qiu, Q., Zeng, H., Chen, B., & Xu, J. Vaccination coverage and its determinants among migrant children in Guangdong, China. BMC Public Health, 2014, 14(203), 1-8
  18. - Republique de Côte d’Ivoire. Enquête Démographique et de Santé: Côte d’Ivoire 1998-1999. 2001, Abidjan, 226p
  19. - Republique de Côte d’Ivoire. Enquête Démographique et de Santé et à indicateurs multiples: 2011-2012. 2013, Abidjan, 561p
  20. - Direction de Coordination du Programme Elargi de Vaccination de Côte d’Ivoire. Revue externe 2010 du Programme Elargi de Vaccination. 2010, Abidjan, 12-14
  21. - Direction de Coordination du Programme Elargi de Vaccination de Côte d’Ivoire. Plan Pluriannuel Complet 2011-2015 du Programme Elargi de Vaccination. 2011, Abidjan, 108p
  22. - Direction de Coordination du Programme Elargi de vaccination de Côte d’Ivoire. Plan d’action 2013 du Programme Elargi de Vaccination. 2013, Abidjan, 31p
  23. - WHO, UNICEF. Côte d’Ivoire: WHO and UNICEF estimates of immunization coverage; 2011 revision. 2011. Retrieved from
  25. - Direction de Coordination du Programme Elargi de vaccination de Côte d’Ivoire. Plan d’action 2011 du Programme Elargi de Vaccination: plan d’urgence. 2011, Abidjan, 82p
  26. - Nankabirwa, V., Tylleskär, T., Tumwine, J. K., Sommerfelt, H., & Promise-ebf Study Group. Maternal education is associated with vaccination status of infants less than 6 months in Eastern Uganda: a cohort study. BMC Pediatrics, 2010, 10(92), 1-9
  28. - Nath, B., Singh, J. V., Awasthi, S., Bhushan, V., Kumar, V., & Singh, S. K. A study on determinants of immunization coverage among 12-23 months old children in urban slums of Lucknow district, India. Indian J Med Sci, 2007, 61(11), 598-606
  30. - Montagu, D., Yamey, G., Visconti, A., Harding, A., & Yoong, J. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data. PLoS ONE, 2011, 6(2): e17155
  32. - Kitui, J., Lewis, S., & Davey, G. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009. BMC Pregnancy and Childbirth, 2013, 13(40), 1-10
  34. - Munthali, A. C. Determinants of vaccination coverage in Malawi: Evidence from the demographic and health surveys. Malawi Medical Journal, 2007, 19(2):79 – 82
  36. - Komlan, Q., Roméo, G., Gaudence, D. J., Léonard, F., Flore, O., and Hugue, T. Equité d’accès et immunisation au Bénin: Rapport sur le profil des inégalités d’accès des enfants à la vaccination. 2005, 56p
  37. - Payne, S., Townend, J., Jasseh, M., Jallow, Y. L., & Kampmann, B. Achieving comprehensive childhood immunization: an analysis of obstacles and opportunities in The Gambia. Health Policy and Planning, 2013, 29, 193–203
  39. - Wiysonge, C. S., Uthman, O. A., Ndumbe, P. M., & Hussey, G. D. Individual and contextual factors associated with low childhood immunization coverage in Sub-Saharan Africa: A multilevel analysis. PLoS ONE, 2012, 7(5), e37905
  41. - Rainey, J. J., Watkins, M., Rymana, T. K., Sandhua, P., Boa, A., Banerjee, K. Reasons related to non-vaccination and under-vaccination of children in low and middle income countries: Findings from a systematic review of the published literature, 1999–2009. Vaccine, 2011, 29, 8215– 8221
  43. - Bosch-Capblanch, X., Banerjee, K., & Burton, A. Unvaccinated children in years of increasing coverage: how many and who are they? Evidence from 96 low- and middle-income countries. Trop Med Internat Health, 2012, 17(6), 697-710.
  44. - Rasmuson, M. Sustaining EPI: What Can Communication Do? A publication of the HEALTHCOM Project, 1990, 17p
  45. - Noar, S. M. A 10-year retrospective of research in health mass media campaigns: where do we go from here? J Health Comm, 2006. 11, 21-42.
  46. - Waisbord, S. & Larson, H. Why invest in communication for immunization: Evidence and lessons learned. 2005. Retrieved from
  48. - Edwards, A. E. Maternal barriers to childhood vaccinations in Tanzania: an examination of the 2004-2005 demographic and health survey (master’s thesis). 2010. Retrieved from
  49. - Greenaway, E. S., Leon, J., & Baker, D. P. Understanding the association between maternal education and use of health services in Ghana: Exploring the role of health knowledge. J Biosoc Sci., 2012, 44(6), 733–747
  51. - Grabenstein JD. What the World’s religions teach, applied to vaccines and immunoglobulins. Vaccine, 2013, 31, 2011-2023

Most read articles by the same author(s)