Subnational Trends and Inequalities of Under-Immunisation and Zero-Dose among Children Aged 12 - 23 Months in Uganda: A National Population-Based Cross-Sectional Study.

Abstract

Despite the Global Vaccine Action Plan's goal of at least 90% vaccine coverage for all children, Uganda has made limited progress in vaccination over the past decade. The objective of this study was to examine the subnational trends in the prevalence and inequalities in under-immunisation and zero-dose among children aged 12 - 23 months in Uganda. The samples selected for analyses were 1507 in 2006, 1409 in 2011 and 2650 children in 2016. The primary outcomes were under-immunisation and zero-dose vaccination. While some progress was made in reducing under-vaccination rates in Uganda within the study period, no region achieved an under-vaccination rate below 20%. This indicates significant challenges in reaching the Sustainable Development Goal target of at least 80% immunisation coverage. Targeted interventions are necessary to improve healthcare access, enhance public health communication and strengthen the health system, particularly in underserved communities and among vulnerable populations.