Coverage and Drivers to Reaching the Last Child With Vaccination in Urban Settings: A Mixed-Methods Study in Kampala, Uganda

Abstract

Access to vaccination services for children in Kampala is high; however, vaccination uptake and timeliness decrease over time, as indicated by the high percentage of partially vaccinated children (58.6%). n Parents of partially vaccinated children stated that receiving inadequate information about immunization from health workers was a barrier to vaccination. This highlights the need for tailored health education and social mobilization efforts in Kampala taking into consideration the transient and diverse populations.n Vaccine stock-outs and long waiting times prevented parents from vaccinating their children. Stronger public-private partnerships in urban areas could help address these barriers.n A primary health care model that harnesses the strengths of the private sector can help address the barrier of hidden immunization costs that deter people from seeking immunization services.n Innovative survey methods that capture data from the highly mobile nonresidents in urban settings need to be developed as this population contributes to the pool of children that need to be immunized but also to the risk of disease outbreaks.

Disparities in Vaccination Coverage and Timeliness among Children Aged 12 to 23 Months within Calabar South, Cross River State, Nigeria

“…Timeliness of vaccination in the current study indicates a relatively higher prevalence at 71.5%. However, contrasting figures are evident in previous studies conducted in Ethiopia by Dejene et al [30], Dirirsa et al [31], and in Kampala by Kamya et al [32], reporting lower rates of 33.7%, 23.9%, and 26.6% respectively. The discrepancy in timeliness rates across these studies might stem from several factors.…”

The context of urban immunization services: The case of Sodo town, Wolaita Zone, South Ethiopia

“…Notably, signi cant disparities in immunization coverage exist within urban areas, with lower coverage observed among the urban poor in numerous countries (7). This situation also elevates the risk of vaccine-preventable diseases (VPDs) due to the concentration of people in urban slums and existing disparities in health services between urban populations (4,5).…”

“…Initially, vaccination coverage in urban areas seemed higher, but there is now a reversal as urbanization progresses (8). This shift has resulted in notable disparities in vaccination services between urban and rural populations, with coverage in urban slum areas now comparable to that in remote rural communities (4,5). Globally, around 30% of children who have not received essential vaccines reside in urban areas (6).…”

“…Projections suggest a further increase to 68% by 2050, with a substantial 90% surge expected in Asian and African countries (2,3). Urbanization contributes positively to economic growth, poverty reduction, and human development (4,5). Recognizing and addressing obstacles, along with implementing effective strategies to enhance equity in urban settings, are crucial for achieving the targets outlined in the Sustainable Development Goals and Immunization Agenda 2030 (6).…”

“…A signi cant number of children in Africa remain unvaccinated or under-vaccinated, often due to limited access to effective interventions (12). It is essential to comprehend vaccine coverage and the barriers in urban slum areas (5). Despite the global impact of immunization, saving millions of lives each year, vaccine-preventable diseases still contribute to over 2 million deaths among children under ve annually, with sub-Saharan Africa being the most affected region (13).…”