Barriers for Full Immunization Coverage among under Five Years Children in  Mogadishu, Somalia

Abstract

Background: Immunization is amongst the most cost effective public health interventions for reducing global childhood morbidity and mortality. However globally 9 million deaths of children occur as a result of vaccine-preventable disease, a bigger proportion occurred in sub-Saharan Africa which was 4.4 million. Therefore, this study aimed to assess barriers for complete vaccination coverage among under five years children in Mogadishu, Somalia. Methods: A community based Cross-sectional study was conducted in between April to July, 2019 in Mogadishu-Somalia. Two-stage cluster sampling with systematic random sampling was used to select a sample of 820 households. Data was collected through structured, interviewer administrator questionnaire. In case more eligible children found at single selected household, one child was randomly selected and the information related to immunization was interviewed from his/her caregiver. Results: the overall, fully vaccinated under five years children was found to be 45.2%. Immunization was found to be increased by being a younger caregiver (β = -0.019, P-value=0.042), being married caregiver, being Father with Secondary & above education (AOR=1.755, 95% CI=1.161-2.655, P-value =0.008), being a young child (β = -0.018, P-value=0.011), being children from birth order of fifth & above (AOR=1.539, 95% CI=1.011-2.343, P-value=0.044), Married caregiver (AOR=0.244, 95% CI= 0.063-0.94, P-value=0.041), increased Household monthly family income= (β = 0.003, P-value=0.000), Availability of vaccine at the time of visit (AOR =6.147, 95% CI=1.943-19.441, P-value=0.002), Cost affordability of vaccine =( AOR =1.951, 95% CI=1.238-3.076, P-value=0.004), Being born at health facility (AOR =1.517, 95% CI=1.104-2.086, P-value=0.010), having good Knowledge on immunization (AOR =1.125, 95% CI=1.070-1.181, P-value=0.001), having good Practice on immunization (AOR =2.756, 95% CI=2.233-3.402, P-value=0.001) and having good Perception on vaccine (AOR =4.976, 95% CI=2.183-11.340, P-value =0.001).Conclusion: In conclusion, the result of this study has revealed that the proportion of fully vaccinated under five children in Mogadishu is very low. Steps to promote Health education and vaccine availability should be lounged.

Barriers for full immunization coverage among under 5 years children in Mogadishu, Somalia

“…Caregivers who had positive perceptions of immunization were nearly five times more likely to immunize their children than those who had a neutral perception of immunization (AOR = 4.976, 95% CI: 2.183–11.340, P value = 0.001). This result is in line with the finding from the previous study in Somalia by[ 9 ] that showed “children's immunization status was significantly associated with caregivers’ positive perceptions on the usefulness of immunizations to children.”…”

“…[ 8 ] UNICEF, 2010 reported that the immunization coverage of under-5 children in Mogadishu was 40%. [ 9 ]…”

“…Where n = minimum sample size, Z = Standard normal deviate corresponding to 5% significant level, P = prevalence in previous studies (40%),[ 9 ] q = 1 − p, d = precision set at 0.05, DEFF is set at 2. Z =1.96, P = 0.40, q = 0.60.…”

Dropout of Vaccination Among Iraqi Children

“…Immunization is achieved by a variety of methods, the most common is vaccination (WHO/UNICEF, 2005), (Hassan, 2020), (Mohamud et al, 2020). Vaccination is regarded as one of the most successful, safe and cost-effective public health intervention for reducing child morbidity and mortality from infectious illnesses.…”

Full vaccination coverage and associated factors among children aged 12 to 23 months in remote rural area of Demba Gofa District, Southern Ethiopia

“…An estimated 2.5 million children aged less than 5 years die annually due to diseases that can be prevented by vaccination ( Tefera et al, 2018 ; Aregawi et al, 2017 ; Adokiya, Baguune & Ndago, 2017 ). About 14.8 million children who are not vaccinated with pentavalent 3 before celebrating their first year are found only in only 10 countries, including Ethiopia ( Yenit, Gelaw & Shiferaw, 2018 ; Aregawi et al, 2017 ; Mihigo et al, 2017 ; Adokiya, Baguune & Ndago, 2017 ; Mohamed et al, 2016 ). Despite the fact that most under-five deaths can be easily tackled by vaccination, about half occur in SSA ( WHO, 2015 ; Federal Ministry of Health of Ethiopia, 2012 ; Adedire et al, 2017 ; Shemwella et al, 2017 ; Kassahun, Biks & Teferra, 2015 ; Debie & Taye, 2014 ; Mohamud et al, 2014 ; Legesse & Dechasa, 2015 ; Ebrahim & Salgedo, 2015 ; Facha, 2015 ).…”