Determinants of low immunization coverage among children aged 12-23 months in narok south narok county kenya

Abstract

Childhood immunization remains one the primary health care core component and the most effective public health interventions for controlling and eliminating life-threatening vaccine preventable diseases in the world. According to 2014 Kenya National Demographic and Health Survey (KDHS), a few children of ages 12 to 23 months in Kenya presented below average in terms of vaccination coverage of children who are fully immunized. Delayed vaccinations would increase the risk for vaccine preventable diseases in the community, therefore the information obtained from this study is to help policy makers come up with sound strategies to increase immunization coverage from 57%- 90% as recommended by World Health Organization. The broad objective of the study was to determine reasons influencing low vaccination coverage between children of ages 12 to 23 months in Narok South sub-county, Narok County in Kenya. This is to contribute to the reduction of morbidity and mortality caused by infectious diseases of public health importance related to vaccine preventable disease. Methods: This was a cross-sectional descriptive study. The study used mixed methods, both quantitative and qualitative. A structured questionnaire was used to collect data on social demographic and social cultural factors, maternal health care utilization and knowledge. Key informative Interviews and Focus Group Discussions were used to collect qualitative data on 454 mothers/caretakers with children aged between 12-23 months reached in Narok South sub county. Results: The total number of mothers/caregivers who were interviewed were 454, with a response of 100%. Results of immunization coverage; BCG 73%, OPV1 59%, OPV2 51%, OPV3 49%, Penta1 58%, Penta2 51%, Penta3 50%, Measles 54% and Fully Immunized Children 47%. Further, 47% of the children in the sub-county were fully immunized and 53% were unimmunized. The SD mean for mothers/caregivers and children 31.4 and 17.0 respectively and over 70% of the mothers/caregivers had no formal education. There were significant association predictors with immunization coverage included maternal education (X2 =11.75, df=4 p value=0.02), distance to health facility (X2 =62.30, df=2 p value=0.00), also, there was strong significant association with childbirth ranking (OR=1.218, p value=0.04). Bivariate analysis, there was an association with mothers/caregivers’ who had more than one visits with fully immunized children (χ2=13.54, df =2 and p value =0.001), source of the immunization information OR=0.75 and p value=0.02 and, ultimately, there was association between mother’s/caregiver place of delivery with non-fully immunized children (X2=74.40,df=1 p value=0.01). Predictors of non-fully immunized children in the study population were; place of delivery, family size, education level, source of income, none attendance of Antenatal clinics, distance to the health facility, source of the vaccination information was associated with incomplete fully immunized children. Conclusion: The immunization coverage for the fully immunized child in the sub county was very low 47%, compared to national 77%. Key players in the immunization sector should identify children who are at risk, deploy reach every child strategy, encourage pregnant mothers to attend ANC, expand outreach services, increase funds allocation to health sector and build more health facilities to improve immunization coverage.