Determinants of post-campaign measles vaccination coverage in Madagascar: A geographically stratified analysis
PLOS Global Public Health·
- DOI
- 10.1371/journal.pgph.0006390
- PMID
- —
- PMCID
- —
- OpenAlex
- —
- Study type
- Cross-sectional study
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The study identifies persistent geographical and socio-demographic inequities in measles vaccination coverage in Madagascar despite overall gains, supporting tailored urban-focused strategies, strengthened communication, improved logistics, and community engagement to advance measles elimination.
Structured evidence summary
Research question
The study examined determinants of post-campaign measles vaccination coverage across different geographical areas in Madagascar following the October 2024 vaccination campaign.
Study design
A retrospective, cross-sectional, convergent parallel mixed-methods post-campaign evaluation combining quantitative household surveys and semi-structured qualitative interviews, conducted from December 2024 to April 2025, with two-stage stratified random sampling and multivariate logistic regression analysis.
Population and setting
Children aged 9–59 months and their caregivers across all 23 regions of Madagascar, with sampling stratified by large cities, landlocked districts, and intermediate districts, following the October 2024 measles vaccination campaign.
Main findings
National post-campaign coverage was 75.3% in 2024, up from 65.3% in 2022. Significant geographical disparities persisted, with lower coverage in large cities (63.2%) versus landlocked (78.4%) and intermediate (76.2%) districts. Residing in a large city was associated with substantially lower coverage (ORa = 0.25; p = 0.010), while higher coverage was associated with male child gender, facility-based birth, possession of a birth certificate, having a Christian caregiver, or a housewife caregiver. Qualitative findings highlighted urban misinformation and perceptions that previously vaccinated children do not need campaign doses.
Public-health relevance
The study identifies persistent geographical and socio-demographic inequities in measles vaccination coverage in Madagascar despite overall gains, supporting tailored urban-focused strategies, strengthened communication, improved logistics, and community engagement to advance measles elimination.
Important limitations
No explicit limitations are stated in the supplied abstract. This summary is limited to the supplied single-article abstract and metadata, and the original paper is required for decision-grade interpretation.
GIDS interpretation
The article is indexed in the GIDS evidence base under measles, vaccination, and Madagascar. This entry contributes context on post-campaign coverage determinants in Madagascar and may help users locate the study; it does not, on its own, confirm or update any live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.