JMIR Publications

ABSTRACT

Background:

Ethiopia is faced with poor second dose Measles vaccine uptake (MCV2) leading to recurrent outbreaks. This meta-analysis and systematic review aim at combining evidence for MCV2 uptake in Ethiopia and its determinants to inform interventions for increased vaccination uptake and control of public health challenges.

Objective:

To determine the pooled uptake of second dose measles vaccine among under-five children in Ethiopia and to examine determinant factors, through a systematic review and meta-analysis of published studies.

Methods:

This review examined observational quantitative research on second dose measles vaccination among children in Ethiopia, utilizing databases such as PubMed Central, Cochrane Library, Web of Science, Scopus, MEDLINE, and Embase. The quality of included studies was assessed using the Newcastle-Ottawa Scale. Heterogeneity was evaluated with I² statistics and Cochran's Q test, while analysis employed a random-effects model. Publication bias was assessed through funnel plots, Egger's test, and non-parametric trim-and-fill tests.

Results:

The overall second-dose measles vaccine uptake among under-five children in Ethiopia was only 34.4% (95% CI: 18.8%–49.9%). Significant determinants of second dose measles vaccine uptake included high maternal education (AOR: 3.31, 95% CI: 1.32–5.30), attendance at ante-natal care follow-ups (AOR: 2.02, 95% CI: 1.12–2.92), utilization of post-natal care services (AOR: 3.03, 95% CI: 1.77–4.28), reduced waiting times at vaccination sites (AOR: 2.56, 95% CI: 1.98–3.13), good awareness of measles vaccination (AOR: 2.17, 95% CI: 1.59–2.74), and positive perceptions of the vaccine (AOR: 3.58, 95% CI: 1.97–6.30).

Conclusions:

The study found that the uptake of second dose measles vaccine among under-five children in Ethiopia was 34%, which is well below the global and national goal of 95%. Key factors contributing to low coverage include mothers' education levels, use of antenatal and post-natal services, and waiting times at vaccination sites, and mothers' awareness of the measles vaccine. Improving community-based education programs, increasing access to antenatal and postnatal services, reducing waiting times, and raising awareness about immunization all contribute to increasing vaccine uptake.