Sociodemographic Inequalities in Rotavirus vaccination coverage among children in a fragile setting: An analysis of the 2022 Multiple Indicator Cluster survey
1
Community Medicine, Ahmadu Bello University Zaria, Zaria, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A2028
ABSTRACT
BACKGROUND:
Diarrheal disease is a major killer of children under 5, with 1.7 billion cases yearly.(WHO, 2024)Rotavirus is the leading cause, prevalent in low-resource settings like Afghanistan, which has a high burden alongside Pakistan, India, and Democratic Republic of Congo. The virus spreads through faeco-oral contact.(John Hopkins University, no date) Afghanistan introduced the Rotavirus Vaccine in 2018, which has reduced hospitalizations by 41%.(Anwari et al., 2025) However, coverage disparities persist due to healthcare access, security, and socioeconomic factors, hindering optimal vaccination coverage and equitable health outcomes.(John Hopkins University, no date) This study investigates the rotavirus vaccine coverage and associated inequalities among children one and two years in Afghanistan.
METHODS:
We analyzed Afghanistan's 2022 Multiple Indicator Cluster Survey data using WHO's Health Equity Assessment Toolkit (HEAT) to assess inequalities in rotavirus vaccination coverage. Measures of inequality (Difference, Ratio, Population Attributable Risk, and Population Attributable Fraction) were calculated across five dimensions: sex, economic status, education, residence, and sub-national regions.
RESULTS:
Rotavirus vaccination coverage in Afghanistan stands at 55.7% among one-year-olds and 46.9% among two-year-olds. However, significant inequalities persist across various dimensions. Economic status reveals substantial gaps, with differences of 35.5% and 42.7% among one and two-year-olds, respectively. Similarly, disparities exist based on education, place of residence, and subnational regions. Notably, subnational regions exhibit the widest disparities, with differences of 90.4% and 87.4% among one and two-year-olds. In contrast, gender-based disparities are relatively minimal. These findings underscore the need to address these inequalities to improve vaccination coverage and health outcomes.
CONCLUSIONS:
While the introduction of RVV marked a significant step and has brought significant reduction in Rotavirus-associated gastroenteritis, significant disparities still exist and most marked by subnational region. Targeted interventions must be taken into consideration to narrow existing inequalities.
Diarrheal disease is a major killer of children under 5, with 1.7 billion cases yearly.(WHO, 2024)Rotavirus is the leading cause, prevalent in low-resource settings like Afghanistan, which has a high burden alongside Pakistan, India, and Democratic Republic of Congo. The virus spreads through faeco-oral contact.(John Hopkins University, no date) Afghanistan introduced the Rotavirus Vaccine in 2018, which has reduced hospitalizations by 41%.(Anwari et al., 2025) However, coverage disparities persist due to healthcare access, security, and socioeconomic factors, hindering optimal vaccination coverage and equitable health outcomes.(John Hopkins University, no date) This study investigates the rotavirus vaccine coverage and associated inequalities among children one and two years in Afghanistan.
METHODS:
We analyzed Afghanistan's 2022 Multiple Indicator Cluster Survey data using WHO's Health Equity Assessment Toolkit (HEAT) to assess inequalities in rotavirus vaccination coverage. Measures of inequality (Difference, Ratio, Population Attributable Risk, and Population Attributable Fraction) were calculated across five dimensions: sex, economic status, education, residence, and sub-national regions.
RESULTS:
Rotavirus vaccination coverage in Afghanistan stands at 55.7% among one-year-olds and 46.9% among two-year-olds. However, significant inequalities persist across various dimensions. Economic status reveals substantial gaps, with differences of 35.5% and 42.7% among one and two-year-olds, respectively. Similarly, disparities exist based on education, place of residence, and subnational regions. Notably, subnational regions exhibit the widest disparities, with differences of 90.4% and 87.4% among one and two-year-olds. In contrast, gender-based disparities are relatively minimal. These findings underscore the need to address these inequalities to improve vaccination coverage and health outcomes.
CONCLUSIONS:
While the introduction of RVV marked a significant step and has brought significant reduction in Rotavirus-associated gastroenteritis, significant disparities still exist and most marked by subnational region. Targeted interventions must be taken into consideration to narrow existing inequalities.
| eISSN: | 2654-1459 |
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