Factors associated with vaccine coverage improvements in Senegal

Introduction Senegal has demonstrated catalytic improvements in national coverage rates for early childhood vaccination, despite lower development assistance for childhood vaccines in Senegal compared to other low and lower-middle income countries. Understanding factors associated with historical changes in childhood vaccine coverage in Senegal, as well as heterogeneities across its 14 regions, can highlight effective practices that might be adapted to improve vaccine coverage elsewhere. Methods Childhood vaccination coverage rates, demographic information, and health system characteristics were identified from Senegal’s Demographic and Health Surveys (DHS) and Senegal national reports. Multivariate logistic and linear regression analyses were performed to determine statistical associations of demographic and health system characteristics with respect to childhood vaccination coverage rates. Results Factors associated with childhood vaccination coverage include urban residence, female literacy, skilled prenatal care, and self-reported ease of access to care when sick, considering travel distance to a healthcare facility and concerns over traveling alone. Higher coverage with less variability over time was reported in urban regions near the capital and the coast, with increased coverage in recent years in more rural and landlocked regions. Conclusion Childhood vaccination was more likely among children whose mothers had higher literacy, received skilled prenatal care, and had perceived ease of access to care when sick. Overall, vaccination coverage is high in Senegal and disparities in coverage between regions have decreased significantly in recent years. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Funding for this study was provided by the Bill & Melinda Gates Foundation, OPP1195041. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data that support the findings of this study are available at .