Determinants of BCG vaccine coverage among 0-2 months aged Somali children: Promoting equality in vaccination.

Somalia reports low overall immunization rates; the 2020 Somalia Demographic and Health Survey (SDHS) indicated that overall BCG vaccination coverage for children under five years of age was only 37.0%. However, coverage specifically for newborns and early infants remains underexplored. This study assessed the determinants of BCG vaccination among infants aged 0-2 months. Secondary data from the 2020 SDHS were analyzed for 457 mother - infant pairs. Descriptive statistics and multivariable logistic regression were used to identify factors associated with BCG uptake. BCG coverage was 79.7% (95% CI: 75.8%-83.2%). Infants in nomadic communities (OR = 0.18, p < .01) were significantly less likely to be vaccinated than urban infants. Mothers with primary education (OR = 2.62, p < .05) and the lack of maternal healthcare utilization - specifically antenatal care and health-facility delivery in the past 12 months (OR = 0.41, p < .01) - were key determinants of vaccination status. While early infant BCG coverage is significantly higher than the national average for all children under five, severe inequities still exist in nomadic and rural populations. Improving maternal education and increasing contact with healthcare facilities are essential steps to closing the immunization gap.