Trends of socioeconomic and geographic inequalities in COVID-19 vaccine uptake in Ethiopia: using the WHO Health Equity Assessment Toolkit

BMC Health Serv Res. 2024 Dec 20;24(1):1629. doi: 10.1186/s12913-024-12082-w.

Abstract

Background: Equity in COVID-19 vaccine uptake is the heart of managing the ongoing pandemic of COVID-19 disease. However, the evidence of inequality in COVID-19 vaccination in Ethiopia is limited. Therefore, this study investigated the trends of socioeconomic and geographic inequality of COVID-19 vaccine uptake in Ethiopia.

Method: This study used the Global COVID-19 trends and impact survey as part of the WHO Health Equity Assessment Toolkit software 2021 version. The trends of socioeconomic and geographic inequalities in COVID-19 vaccine uptake between surveys were calculated with a 95% confidence interval (CI). A 95% CI was calculated along with measures of inequality in COVID-19 vaccine uptake and statistical significance was declared if the 95% CI of absolute and relative measures of inequalities does not include 0 and 1 respectively.

Result: The COVID-19 vaccine uptake in the 45-65 age group significantly increased from 40.04%, 95% CI (32.49, 48.1) to 72.7%, 95%CI (63.7, 80.2) in 05/2021 to 03/2022 respectively. The absolute inequality of COVID-19 vaccine uptake among male vs female respondents was 3.6%, 95% CI (3.9, 11.2) in 08/2021 which was obtained by subtraction of the respecting proportion of vaccines uptakes 32.9% for males minus 29.28% for females and there was a significant more prevalence of vaccine uptake in males than in females. The absolute inequality in COVID-19 vaccine uptake among health workers vs non-health workers was 28.5%, 95% CI (17.8, 37.2), 03/2022 and there was a significantly higher prevalence of vaccine uptake in health workers than non-health workers in each survey. The relative measures of inequality in the ratios of COVID-19 vaccine uptake among urban vs rural was 0.85, 95%CI (0.7, 0.994) in 08/2021 which was obtained by dividing the respecting proportion of vaccine uptakes of urban by rural residents.

Conclusion: The study showed that the proportion of COVID-19 vaccine uptake in Ethiopia significantly increased from 2021 to 2022 with distinct inequality. The study indicated there is significant absolute and relative inequality in COVID-19 vaccine uptake between health workers and non-health workers, male and female, and urban and rural residents in Ethiopia. Therefore, the effort should be geared towards reducing health workers vs non-health workers, urban vs rural, and gender inequalities in COVID-19 vaccine uptake through health literacy and recommend geographic and equity-oriented policies, to ensure effective pandemic management of COVID-19.

Keywords: COVID-19; Ethiopia; Health equity assessment toolkit; Socioeconomic and geographic inequalities; Trends; WHO.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Ethiopia / epidemiology
  • Female
  • Health Equity*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • SARS-CoV-2
  • Socioeconomic Factors*
  • Vaccination / statistics & numerical data
  • World Health Organization
  • Young Adult

Substances

  • COVID-19 Vaccines