Spatial patterns and determinants of childhood measles vaccination in Somalia a multilevel and geospatial analysis of the 2020 demographic and health survey
Cross-sectional geospatial analysis reveals sub-optimal measles vaccine coverage and sharp regional clustering in young children, highlighting critical geographic immunization gaps.
Key Points
To identify spatial distribution patterns and evaluate individual- and community-level determinants of first-dose measles-containing vaccine uptake among young children.
Analyzed cross-sectional demographic and health survey data from 3,436 children aged 12–59 months.
Applied Global Moran’s I, Getis-Ord Gi* hotspot analysis, and SaTScan Bernoulli models alongside multilevel logistic regression adjusting for sampling weights.
Overall weighted prevalence of first-dose measles vaccination was 58.3% (95% CI 55.5–61.1%), with significant spatial clustering (Global Moran’s I = 0.653, p < 0.001) showing northern hotspots and southern coldspots.
Multilevel regression demonstrated higher vaccination odds for child age 48–59 months (AOR = 16.32), maternal secondary education (AOR = 1.83), middle wealth (AOR = 1.88), and nomadic residence (AOR = 1.60), with community factors explaining 13.1% of the total variance.