Subnational Trends and Inequities of under-Immunization among Children Aged 12-23 Months in Uganda

Ronald Wasswa, Makerere University School of Public Health
Aluisio Barros, Universidade Federal de Pelotas
Jennifer Harris Requejo, World Health Organization WHO
Thiago Melo, International Center for Equity in Health
Kananura Rornald Muhumuza, Makerere University School of Public Health
Peter Waiswa, Makerere University School of Public Health

Background: Nearly half of Ugandan children are either under-vaccinated or unvaccinated. This study seeks to investigate subnational trends and inequities in zero-dose and under-immunization among children aged 12-23 months in Uganda, aiming to identify populations left behind in vaccination efforts. Method: A total of 5,566 children from three consecutive Uganda Demographic and Health Surveys conducted in 2006, 2011, and 2016 were analyzed. Absolute and relative measures of inequality were employed to measure inequality. Results: Regional disparities in zero-dose and under-immunization are evident. East Central, North-Central, South-Central, and Kampala exhibit the highest under-immunization rates, surpassing the national average. In rural areas, under-immunization varies from 41% in West-Nile to 57% in East Central. Among the uneducated and the poorest households, under-immunization rates are notably high, exceeding 60% in some areas. Conclusion: Government policies should prioritize equitable healthcare access, focusing on reducing discrepancies in immunization coverage across socioeconomic groups and geographic regions.