BCG Vaccination Coverage and Determinants Among Children in Somalia: A Nationwide Survey Study.

Abstract

BCG vaccination is the primary defense against severe childhood tuberculosis, yet data on its uptake in Somalia are limited. Data from the Somalia Demographic and Health Survey were analyzed, including 2025 children aged 0 to 59 months with vaccination cards. Descriptive statistics estimated national and regional BCG coverage, and 2-level logistic regression assessed individual and community-level determinants. National BCG coverage was 57.3%, ranging from 31% in Nugal to 78% in Mudug. Children with higher birth orders were less likely to be vaccinated. Older children had higher vaccination odds, and maternal tetanus toxoid receipt was positively associated with BCG uptake. Middle-income children were more likely to be vaccinated. Children from rural and urban areas had lower odds than nomadic children. Community-level factors explained 10.9% of the variance. BCG coverage in Somalia is below the WHO’s 90% target. Addressing inequities in birth order, maternal health, wealth, and geography is essential.