Determinants of Vaccination Coverage Among Refugee Children Aged 12-59 Months in Kyangwali Refugee Settlement in Uganda

Abstract

Introduction: Forced displacement is a global issue that leads to challenges like limited healthcare and low vaccination rates, particularly for children. Despite the significant impact on health outcomes, research on vaccination coverage among refugee children in Uganda is lacking. This study aimed to bridge this gap by determining factors associated with full vaccination among refugee children aged 12 to 59 months. Method: The study was conducted in Kyangwali refugee settlement. This unmatched case-control design included 140 fully vaccinated cases and 280 controls. Data was collected from 14 randomly selected villages. Analysis was performed, and summary tables with counts and percentages were used for univariate analysis. Bivariate analysis was conducted to attain odds ratios. Factors associated with full vaccination were determined in multivariable analysis using logistic regression. A p-value of 0.05 was considered significant, and collinearity was assessed using 0.4 cutoff. Results: Out of 420 participants, 58.6% were below 30 years old, 85.6% were from DR Congo, and 26.7% were not educated. Among index children, 84.8% were females, 45.5% aged 36-59 months, and 33.3% were fully vaccinated, with 39.1% being males. Factors associated with full vaccination included DR Congo origin (AOR: 2.15, CI: 1.08-4.28), high parental knowledge (AOR: 2.96, CI: 1.5-5.79), and receiving vaccine information from community health workers (AOR: 2.48, CI: 1.58-3.88). Proximity to health facilities also mattered, with those within 5 km having nearly 2 times higher odds of full vaccination (AOR: 1.94, CI: 1.2-3.09) than those beyond 5 km. Conclusion: This study highlights a substantial gap in childhood vaccination within Kyangwali refugee settlements, with only 33.3% of children below 5 fully vaccinated. Significant associations with full vaccination included Congolese origin, high parental knowledge, and receiving vaccine information from community health workers. Proximity to health facilities also played a crucial role, with those within 5 km exhibiting nearly 2 times higher odds of full vaccination.