Description
Introduction-Objectives
Guinea is recognised as one of the sub-Saharan African countries with the lowest childhood vaccination rates. This significant concern is highlighted in a context where many countries in the region struggle with healthcare challenges. This study investigates the period from 2012 to 2018, which includes the years surrounding the Ebola outbreak. This era is significant for understanding the impact of primary health crises on vaccination programs in Guinea. The main aim is to explore why Guinea's immunisation rates are so low and determine if this issue disproportionately affects children from poorer households.
Methodology
Our methodology harnesses the rich data from the Demographic and Health Surveys (DHS) conducted in Guinea in 2012 and 2018. The focus was on children under five years, with mothers as primary respondents in these surveys. Complete vaccination was defined as receiving all recommended vaccine doses by a child. To gauge the socioeconomic disparities in immunisation coverage, we employed the Concentration Index (CI) and the Slope Index Inequality (SII). These tools are instrumental in measuring immunisation coverage distribution and linear association across different wealth tiers. Further, the decomposition of the CI, following the Erreygers method, allowed us to disentangle the influence of specific sociodemographic factors on the observed inequities. Statistical significance was considered at a p-value of less than 0.05.
Results and Discussions
The study revealed a disturbing decrease in full immunisation coverage, from 46% in 2012 to 28% in 2018. The CI and SII demonstrated that this decline was more severe among poorer families, leading to a widening gap in vaccination coverage. Factors that increased the likelihood of full immunisation among children from low-income households included the mother's university education, attending at least four antenatal care sessions, and urban residency. These results highlight a concentration of vaccination access in areas and demographics that are more affluent, exacerbating existing inequalities.
Conclusions
The period between 2012 and 2018 in Guinea has witnessed a significant drop in full immunisation coverage among children, coupled with an alarming rise in inequalities based on household wealth. The pronounced skew towards children from affluent families necessitates urgent intervention. Strategies to enhance immunisation rates must prioritise educational outreach to women, especially those with lower education levels, promote increased antenatal care engagement, and focus on rural areas where healthcare access is typically limited. These findings advocate for a more equitable and targeted approach to vaccine distribution, ensuring that no child, regardless of socioeconomic status, is left behind in Guinea's journey towards improved public health.
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