Factors contributing to immunization coverage among children less than 5 years in Nadowli-Kaleo District of Upper West Region, Ghana

Abstract

Immunization prevents deaths from diseases such as diphtheria, tetanus, whooping cough and measles in about 2.5 million children each year worldwide. Failure to vaccinate children in the required timeframe could result in disease outbreaks among them and increase costs of living among the populations directly affected. Even though Ghana has set 95% as the target for immunization coverage, the Nadowli-Kaleo district has been below this national target. This study was conducted to identify the factors influencing low immunization coverage among children under five years in the Nadowli-Kaleo district, Ghana. An analytical cross-sectional study design was adopted for this study. Systematic sampling method was used to recruit the respondents. The data was collected using KoboCollect online data collection tool and analyzed using Stata Version 17.0. Chi-square test was used to establish the association between child’s immunization status and the independent variables. Logistic regression was used to determine the degree of association. A p-value less than 0.05 was considered statistically significant. Fully immunized status among children under-five was a little above average (55.4%). Mother’s or caregiver’s age, marital status, occupation, and current child’s birth order were significantly associated with children full immunization. Also, number of ANC visits, delivery location, and distance to health facility were significantly associated with children full immunization. A child delivered at the health facility had higher chance of 2.12 times to be fully immunized than giving birth at home [AOR = 2.12, 95%CI = 1.14–3.94, and p-value = 0.017]. The health system related factors which were statistically associated with child full immunization included time spent during immunization service and being informed when to come for the next vaccination visit. Coverage for children with fully immunized status was not very encouraging at our study site. We recommend expansion of access to maternal and child health services, encouraging institutional childbirth, and timely regular antenatal visits.