Date of Conferral

2023

Degree

Doctor of Public Health (DrPH)

School

Health Services

Advisor

Heba Tawfik

Abstract

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study revealed that internal population displacement was neither associated with vaccination completion (OR = .973, 95% CI [.748 – 1.265], p = .838) nor stunting (OR = .995, 95% CI [.902 – 1.098], p = .924). However, the odds of displaced children suffering from ARIs were unexpectedly 68.8% less than the odds of nondisplaced ones (95% CI [.610 – .777], p < .001). These findings require further investigation and consideration of factors such as length and reasons for displacement. While there has always been a special focus on displaced populations in humanitarian action, the findings of the study indicate that low vaccination completion among children aged 12 to 23 months, high rates of chronic malnutrition rates among children under 5 years of age, and higher odds of ARIs contraction among nondisplaced children were comparable to displaced ones. The close association between the dependent variables and the maternal characteristics calls for an increased investment in girls’ and boys’ education and women’s empowerment that leads to wealth creation and health improvement.

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