The purpose of this study was to investigate rural-urban differences in the amount and causes of missed opportunities for vaccination (MOV) in Sub-Saharan Africa. This was cross-sectional research employing nationally representative household surveys performed in 35 countries throughout Sub-Saharan Africa between 2007 and 2017. The risk difference in MOV between rural and urban residents was computed. In multivariable analysis, the logistic regression technique was employed to explore urban-rural inequalities. The Blinder-Oaxaca technique was then utilized to decompose MOV differences between rural and urban people. There were 2113 children between the ages of 12 and 23 months. The extent of MOV among youngsters in rural and urban settings varied greatly throughout the 35 nations. In rural regions, the magnitude of MOV ranged from 18.0 percent in the Gambia to 85.2 percent in Gabon. Pro-rural inequality was seen in 16 of the 35 nations studied, whereas pro-urban inequality was reported in five. The compositional ‘explained’ and structural ‘unexplained’ components contributed differently among nations. The household wealth index, on the other hand, was the most commonly recognized component.

The level of missed immunization chances varies across rural and urban regions, with substantial pro-rural disparities across Africa. Although a variety of variables contribute to rural-urban inequalities in many nations, household wealth was the most commonly cited.