Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case – control study

Abstract

BackgroundThe prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rarely completed as planned and the full immunization rate is only 24 %. The objective of this study was to identify determinant factors of incomplete childhood immunization in Arbegona district, Sidama zone, southern Ethiopia.MethodsA community based unmatched case-control study was undertaken among randomly selected children aged 12 to 23 months and with a total sample size of 548 (183 cases and 365 controls). A multi-stage sampling technique was used to get representative cases and controls. Data was collected using a structured questionnaire and analyzed using SPSS version 16 statistical software. Bivariate and multiple logistic regression analyses were done to identify independent factors for incomplete immunization status of children. Qualitative data were also generated and analyzed using thematic framework.ResultsThe incomplete immunization status of children was significantly associated with young mothers (AOR = 9.54; 95 % CI = 5.03, 18.09), being born second to fourth (AOR = 3.64; 95 % CI = 1.63, 8.14) and being born fifth or later in the family (AOR = 5.27; 95 % CI = 2.20, 12.64) as compared to being born first, a mother’s lack of knowledge about immunization benefits (AOR = 5.51; 95 % CI = 1.52, 19.94) and a mother’s negative perception of vaccine side effects (AOR = 1.92; 95 % CI = 1.01, 3.70). The qualitative finding revealed that the migration of mothers and unavailability of vaccines on appointed immunization dates were the major reasons for partial immunization of children.ConclusionTo reduce the number of children with incomplete immunization status, the Arbegona district needs to consider specific planning for mothers with these risk profiles. A focus on strengthening health communication activities to raise immunization awareness and address concerns of vaccine side effects at community level is also needed. This could be achieved through integrating the immunization service to other elements of primary health care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2678-1) contains supplementary material, which is available to authorized users.

Reasons for defaulting from childhood immunization program: a qualitative study from Hadiya zone, Southern Ethiopia

“…Thus, mothers missed out on opportunities to get help and advice regarding how their children could get missed doses and even when they tried, they didn’t get a positive response from health workers. The relationship between perception of health professionals and the health institutions in general and completing immunization is previously reported from several developing countries, including Ethiopia [13, 15, 19, 26] and findings of this study also suggest mothers hold negative views about health workers and the treatment they get from them. These problems were also compounded by problems such as long waiting time and vaccines and supplies stock-outs, which were also mentioned previously [13, 15, 26].…”

“…The reported knowledge gaps include knowledge of benefits of vaccination [26], scheduling and number of sessions [12, 27–29] and age at which vaccination is started or completed [14, 30]. In some cases, knowledge is expressed in broad terms only, such as knowledge towards immunization [19, 31–33].…”

Cakupan Imunisasi Dasar Lengkap dan Faktor yang Memengaruhi

“…Pada penelitian ini, urutan kelahiran tidak memengaruhi kelengkapan imunisasi dasar. Hasil ini tidak sesuai dengan penelitian di Distrik Arbegona, Etiopia bagian Utara tahun 2014 yang melaporkan bahwa urutan kelahiran kedua sampai keempat dan urutan kelahiran kelima serta selanjutnya memiliki imunisasi dasar tidak lengkap dibandingkan dengan anak pertama 13 karena jumlah anak pertama pada kedua kelompok tidak jauh berbeda.…”

“…1 Imunisasi merupakan salah satu usaha yang paling efektif dan banyak dilakukan untuk mencegah kematian anak. 2 Imunisasi melindungi anak terhadap beberapa penyakit yang dapat dicegah dengan imunisasi (PD3I), seperti tuberkulosis, difteri, tetanus, hepatitis B, pertusis, campak, polio, radang selaput otak, dan radang paru-paru. 1 Program imunisasi dasar lengkap menurut Peraturan Menteri Kesehatan Republik Indonesia no.…”

Vaccination Coverage and Associated Factors among Children Aged 12–23 Months in Debre Markos Town, Amhara Regional State, Ethiopia

“…It was adapted from previous researches done on similar title [4,7,9]. The questionnaire was first prepared in English and translated to Amharic and back to English to maintain the consistency of the content of the instrument.…”