Factors influencing childhood immunisation uptake in Africa: a systematic review

Abstract

Background Vaccine preventable diseases are still the most common cause of childhood mortality, with an estimated 3 million deaths every year, mainly in Africa and Asia. An estimate of 29% deaths among children aged 1–59 months were due to vaccine preventable diseases. Despite the benefits of childhood immunisation, routine vaccination coverage for all recommended Expanded Programme on Immunization vaccines has remained poor in some African countries, such as Nigeria (31%), Ethiopia (43%), Uganda (55%) and Ghana (57%). The aim of this study is to collate evidence on the factors that influence childhood immunisation uptake in Africa, as well as to provide evidence for future researchers in developing, implementing and evaluating intervention among African populations which will improve childhood immunisation uptake. Methods We conducted a systematic review of articles on the factors influencing under-five childhood immunisation uptake in Africa. This was achieved by using various keywords and searching multiple databases (Medline, PubMed, CINAHL and Psychology & Behavioral Sciences Collection) dating back from inception to 2020. Results Out of 18,708 recorded citations retrieved, 10,396 titles were filtered and 324 titles remained. These 324 abstracts were screened leading to 51 included studies. Statistically significant factors found to influence childhood immunisation uptake were classified into modifiable and non-modifiable factors and were further categorised into different groups based on relevance. The modifiable factors include obstetric factors, maternal knowledge, maternal attitude, self-efficacy and maternal outcome expectation, whereas non-modifiable factors were sociodemographic factors of parent and child, logistic and administration factors. Conclusion Different factors were found to influence under-five childhood immunisation uptake among parents in Africa. Immunisation health education intervention among pregnant women, focusing on the significant findings from this systematic review, would hopefully improve childhood immunisation uptake in African countries with poor coverage rates.

Parental Reminder Strategies and the Cost Implication for Improved Immunisation Outcomes: A Systematic Review and Meta-Analysis

“…Additionally, although it was found to have no significant heterogeneity and of high certainty, its use should also be used with caution because of the limited number of studies included in the meta-analysis. The finding corresponds to Galadima et al [ 52 ], who found in their systematic review that health education to mothers on immunisation shows a significant effect on the immunisation outcome of children. To this end, evidence reveals that understanding risk associated with health care hesitancy of recommended counsel or intervention positively impacts service utilisation or compliance with clinical advice [ 53 ].…”

Unmet need for COVID-19 vaccination coverage in Kenya

“…Vaccination coverage in urban areas was higher by 27.8% as compared to rural areas. There are several reasons for higher coverages in urban areas, including but not limited to shorter travel times also reported in other studies [54] , [55] , increased availability of vaccines, higher literacy [23] , [24] , occupation [23] , [24] , [25] , [26] , and low hesitancy rates [5] . Despite the higher rates of vaccination coverage in urban areas, it is projected to reach 73.75% in Nairobi and 44.56% in Mombasa by March 2022.…”

“…Understanding geographical access to COVID-19 vaccination sites and coverage is important for effective planning of vaccination programmes. Beyond geographical access, other factors that may affect COVID-19 vaccination coverage at population level including vaccine availability and, individual factors such as literacy, vaccination perception and acceptability, and, household level factors including location (urban or rural) [23] , [24] , [25] , [26] . To model the spatial inequalities in COVID-19 vaccination coverage, statistical approaches can be used which incorporate other geographic data.…”

Increasing the demand for vaccination through mHealth in Quetta City, Balochistan in Pakistan

“…5,7,[17][18][19] Literature shows that several supply and demand side interventions help to improve immunization coverage. 2,14,15,[20][21][22][23][24][25] Certain demand side interventions such as immunization campaigns, monetary incentives, information transfers have been successful to increase the demand for vaccines and to improve vaccination coverage among children in several LMICs 15,26,27 Various mHealth related interventions have been implemented to increase the uptake of vaccination by increasing awareness and providing relevant information about the time and places to get vaccines through reminders. 1,[3][4][5][6][7][8]17,19,24,28,29 Although mHealth interventions have potential to improve vaccination coverage by increasing demand, the evidence for such interventions is not adequate in Pakistan, and there is a lack of local robust research which could produce good evidence and inform the policy makers about the innovative solutions to improve childhood immunization uptake by the community.…”