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Childhood vaccination in Kenya: socioeconomic determinants and disparities among the Somali ethnic community

Abstract

Objectives

Kenya has a significant refugee population, including large numbers of Somali migrants. This study examines the vaccination status of Kenyan children and sociodemographic predictors of vaccination, including Somali ethnicity.

Methods

Using the 2014 Kenyan Demographic and Health Survey, we calculated the proportion of non-vaccinated, under-vaccinated, and fully vaccinated children, defining full vaccination as one dose Bacille Calmette-Guerin, three doses polio, three doses pentavalent, and one dose measles. We assessed associations among various factors and vaccination status using multinomial logistic regression and explored the effect of Somali ethnicity through interaction analysis.

Results

The study sample comprised 4052 children aged 12–23 months, with 79.4% fully, 19.0% under-, and 1.6% non-vaccinated. Among Somalis, 61.9% were fully, 28.7% under-, and 9.4% non-vaccinated. Somalis had significantly greater odds of under- and non-vaccination than the Kikuyu ethnic group. Wealth and birth setting were associated with immunization status for Somalis and non-Somalis.

Conclusions

Disparities persist in pediatric vaccinations in Kenya, with Somali children more likely than non-Somalis to be under-vaccinated. Health inequalities among migrants and ethnic communities in Kenya should be addressed.

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Acknowledgements

We are grateful to the data collectors who diligently worked in the DHS program.

Funding

This work was supported by the Pharmaceutical Research and Manufacturers of America Foundation (PhRMA) Foundation (Health Outcomes Post Doctoral Fellowship [ALW]). The PhRMA Foundation did not have any role in the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the paper for publication. We report no other external funding for this manuscript.

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Correspondence to Nina B. Masters.

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Conflict of interest

The authors have no potential, perceived, or real conflicts of interest relevant to this article to disclose. NBM wrote the first draft of the article.

Ethical approval

This study was exempt from ethical approval because it was limited to the publicly available Demographic and Health Surveys (DHS) dataset which contained no personally identifiable information beyond birthdates.

Informed consent

All participants provided informed consent before being enrolled in the DHS.

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Masters, N.B., Wagner, A.L., Carlson, B.F. et al. Childhood vaccination in Kenya: socioeconomic determinants and disparities among the Somali ethnic community. Int J Public Health 64, 313–322 (2019). https://doi.org/10.1007/s00038-018-1187-2

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Keywords

  • Pediatric vaccination
  • Vaccination coverage
  • Somali
  • Kenya
  • Health disparities
  • Migrant health