Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges
Introduction The COVID-19 pandemic disrupted healthcare provision and access in sub-Saharan Africa. Lockdowns and travel restrictions, coupled with fear of contracting the virus, disrupted services, especially for women’s and children’s health, derailing progress on sustainable development goals. Th...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-07-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/1/e000857.full |
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| author | McEwen Khundi Themba Mzembe Michael Give Chipeta Chimwemwe Chifungo Nyovani Janet Madise Chifuniro Somanje Mankhwala Tabitha Ngwira Maame B Peterson |
| author_facet | McEwen Khundi Themba Mzembe Michael Give Chipeta Chimwemwe Chifungo Nyovani Janet Madise Chifuniro Somanje Mankhwala Tabitha Ngwira Maame B Peterson |
| author_sort | McEwen Khundi |
| collection | DOAJ |
| description | Introduction The COVID-19 pandemic disrupted healthcare provision and access in sub-Saharan Africa. Lockdowns and travel restrictions, coupled with fear of contracting the virus, disrupted services, especially for women’s and children’s health, derailing progress on sustainable development goals. This paper examines the impact of the COVID-19 pandemic on routine child immunisation coverage in Ethiopia and Kenya at both national and subnational levels.Methods Health management information systems data were used to estimate changes in child immunisation. Mean differences in coverage between the pre-COVID-19 and during COVID-19 were tested at a 5% significance level. Geospatial maps for coverage and differences between the two periods were created using aggregated proportions. Interrupted time series analyses provided counterfactual coverage assessments, assuming no COVID-19 impact.Results At the national level, minor short-term disruptions in coverage were observed following pandemic peaks in Kenya and Ethiopia, which were considered statistically insignificant. In Ethiopia, a subnational assessment reveals that full vaccination coverage remained relatively stable, with significant changes observed in the southeast regions of Somali and Dire Dawa. Specific vaccines such as BCG, diphtheria, pertussis and tetanus 3 and polio (OPV3) showed considerable coverage changes in most regions except Oromia, Gambela and Sidama. Measles vaccine coverage experienced major changes across almost all regions of Ethiopia. In Kenya, full vaccination coverage experienced significant changes in eight counties, including Kisii, Turkana and Marsabit, with most Kenyan counties experiencing significant changes in measles vaccine coverage.Conclusion In conclusion, while routine immunisation services were mostly sustained with short-term disruptions at the national level in Ethiopia and Kenya, subnational levels experienced notable changes. The resilience of child immunisation was due to the implementation of community-based healthcare, mobile vaccinations and collaboration and partnerships for mass vaccination campaigns. The temporary disruptions were likely due to pandemic-related fears and supply chain restrictions. |
| format | Article |
| id | doaj-art-7c1e89381ce14d628d3fd4f4cf968e24 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-7c1e89381ce14d628d3fd4f4cf968e242025-01-28T15:40:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-07-012110.1136/bmjph-2023-000857Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challengesMcEwen Khundi0Themba Mzembe1Michael Give Chipeta2Chimwemwe Chifungo3Nyovani Janet Madise4Chifuniro Somanje Mankhwala5Tabitha Ngwira6Maame B Peterson7Public Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi2 African Institute for Development Policy Malawi Office, Lilongwe, Malawi2 African Institute for Development Policy Malawi Office, Lilongwe, Malawi2 African Institute for Development Policy Malawi Office, Lilongwe, Malawi2 African Institute for Development Policy Malawi Office, Lilongwe, Malawi1 Health and Wellbeing, African Institute for Development Policy Malawi Office, Lilongwe, Malawi2 African Institute for Development Policy Malawi Office, Lilongwe, Malawi2 African Institute for Development Policy Malawi Office, Lilongwe, MalawiIntroduction The COVID-19 pandemic disrupted healthcare provision and access in sub-Saharan Africa. Lockdowns and travel restrictions, coupled with fear of contracting the virus, disrupted services, especially for women’s and children’s health, derailing progress on sustainable development goals. This paper examines the impact of the COVID-19 pandemic on routine child immunisation coverage in Ethiopia and Kenya at both national and subnational levels.Methods Health management information systems data were used to estimate changes in child immunisation. Mean differences in coverage between the pre-COVID-19 and during COVID-19 were tested at a 5% significance level. Geospatial maps for coverage and differences between the two periods were created using aggregated proportions. Interrupted time series analyses provided counterfactual coverage assessments, assuming no COVID-19 impact.Results At the national level, minor short-term disruptions in coverage were observed following pandemic peaks in Kenya and Ethiopia, which were considered statistically insignificant. In Ethiopia, a subnational assessment reveals that full vaccination coverage remained relatively stable, with significant changes observed in the southeast regions of Somali and Dire Dawa. Specific vaccines such as BCG, diphtheria, pertussis and tetanus 3 and polio (OPV3) showed considerable coverage changes in most regions except Oromia, Gambela and Sidama. Measles vaccine coverage experienced major changes across almost all regions of Ethiopia. In Kenya, full vaccination coverage experienced significant changes in eight counties, including Kisii, Turkana and Marsabit, with most Kenyan counties experiencing significant changes in measles vaccine coverage.Conclusion In conclusion, while routine immunisation services were mostly sustained with short-term disruptions at the national level in Ethiopia and Kenya, subnational levels experienced notable changes. The resilience of child immunisation was due to the implementation of community-based healthcare, mobile vaccinations and collaboration and partnerships for mass vaccination campaigns. The temporary disruptions were likely due to pandemic-related fears and supply chain restrictions.https://bmjpublichealth.bmj.com/content/2/1/e000857.full |
| spellingShingle | McEwen Khundi Themba Mzembe Michael Give Chipeta Chimwemwe Chifungo Nyovani Janet Madise Chifuniro Somanje Mankhwala Tabitha Ngwira Maame B Peterson Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges BMJ Public Health |
| title | Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges |
| title_full | Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges |
| title_fullStr | Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges |
| title_full_unstemmed | Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges |
| title_short | Assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in Ethiopia and Kenya amidst the COVID-19 pandemic: tracking coverage and identifying key challenges |
| title_sort | assessing the resilience of child immunisation programmes using geospatial modelling and interrupted time series analysis in ethiopia and kenya amidst the covid 19 pandemic tracking coverage and identifying key challenges |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000857.full |
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