Socioeconomic inequalities in immunisation of 12–23 months old children in Malawi

A decomposition analysis

Bibliographic Data

ID22083337
AuthorsBridget Naphiyo (University of Malawi, corresponding author), Jacob Mazalale (0000-0001-9856-1268, University of Malawi), Gowokani Chijere Chirwa (0000-0003-0199-779X, University of Malawi)
Year2025
Volume13
Pages1514635-1514635
Publication date2025-04-09
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1514635
PMID40270734
OpenAlexW4409308442
LanguageEN
References cited16

Background: Given the benefits of the Expanded Program on Immunisation (EPI) to Malawians' health and, consequently, Malawi's economic development, coverage and equity in immunisation are necessary to track. In the 2019-20 Malawi Multiple Indicator Cluster Survey (MICS), immunisation coverage of basic vaccines among 12-23-month-old children was at 72%. However, disaggregated immunisation coverage in some groups of children was below or above 72%. The disparities compelled the need to investigate the extent of socioeconomic inequalities drivers in child immunisation in Malawi. Study design: This study uses secondary data sets from three of Malawi's national representative cross-sectional surveys: the Malawi MICS 2013-14, the Malawi MICS 2019-20 and the Malawi Service Provision Assessment (MSPA) 2013-14. The MSPA 2013-14 was used to estimate the shortest distance between a MICS 2019-20 cluster and a facility offering immunisation services. Methods: The study utilized the concentration index to measure socioeconomic inequality and the Wagstaff decomposition to measure the marginal contributions of socioeconomic factors to inequality. Results: < 0.01. Wealth, maternal education and place of residence were significant factors contributing to the pro-rich inequalities in 2019. Conclusion: The results call for interventions that improve affordability and accessibility of vaccines and interventions that educate caregivers of the benefits of child immunisation to ensure equity. The results, therefore, suggest that to improve equality in health outcomes, the Government of Malawi needs to embrace wider policies that do not only address the consumption of healthcare services but also policies that affect socioeconomic determinants of health

Biology · Decomposition · Environmental health · Inequality · Population · Socioeconomic status · Sociology · COVID-19 Impact on Reproduction · Demography · Global Maternal and Child Health · Mathematics · Medicine · Vaccine Coverage and Hesitancy · Pediatrics

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