Predictors of Immunization Defaulting among Children Age 12-23 Months in Hawassa Zuria District of Southern Ethiopia: Community Based Unmatched Case Control Study

Abstract

<p>As part of the overall package of maternal and child health services in Ethiopia, all children are provided with free immunization services and it is available in all government health facilities, both in rural and urban areas. But significant number of children was defaulted from Immunization schedule, even after the health extension program was launched. Therefore, the study was assessed predictors of immunization defaulting among children age range of 12-23 months, in Hawassa Zuria district of southern Ethiopia. Unmatched case control study was conducted in six Kebeles which were selected from 26 kebeles by simple random sampling techniques. Cases were children in the age ranges of 12 - 23 months who did not complete the recommended immunization. All cases (105) and controls (209) in the kebeles were identified by using health posts Vaccine registration book. Bivariable and multiple logistic regression model were used to identify important predictor of immunization defaulting. P-value of less than 0.05 was considered as the level of significances. The study identified educational status, place of delivery, immunization related knowledge, ANC follow up and household wealth status as significant predictors of defaulting from immunization schedules. Sustained health education on vaccination related knowledge and institutional delivery services utilization will be needed. The household literacy and economic status should also get emphasis so as to decreases defaulting of children from immunization schedule.</p>

Vaccination timeliness among newborns and infants in Ethiopia

“…This finding aligns with our current understanding of the relationship between wealth and immunizations from Uganda [15], Ghana [29], and 31 countries in sub-Saharan Africa [30]. Furthermore, though the relationship between timeliness and wealth has not been explored previously in Ethiopia, the literature does suggest that wealth is associated with other measures of vaccination, e.g., complete vaccination coverage and defaulting from the vaccination program [4,5,31–33]. The strength of the association between other socioeconomic variables and timeliness of vaccination for these birth doses differed depending on whether the child was born at home or at an institution.…”

“…We do note that there is still a rural-urban discrepancy in the expected time to vaccination, with urban children taking less time compared to rural children, even for the group of children born at an institution. This association between wealth and timeliness may be due to challenges in healthcare access faced by poorer families and possible institutional barriers that individuals from certain ethnic groups face; while the vaccines are provided for free, families still must be able to afford transportation to the health center and lost productivity from taking their child to the clinic instead of working [5,31].…”

Community engagement strategy for increased uptake of routine immunization and select perinatal services in north-west Ethiopia: A descriptive analysis

“…The appointment reminder system may have contributed to reducing defaulters by creating a forum for health workers to provide MNCH education to mothers. Studies have shown fewer defaults and higher immunization completion when caregivers discussed immunization with HEWs [ 10 ] or other families in the community [ 19 ]. In addition, caregivers who were visited at home by HEWs have been shown to have better immunization completion rates [ 20 ].…”

“…In addition, caregivers who were visited at home by HEWs have been shown to have better immunization completion rates [ 20 ]. Use of maternal health services has also been associated with completion of immunizations [ 7 , 10 ]. The FCP promoted the use of ANC with the Enat Mastawesha and supported the EPI system.…”

“…Previous studies in Ethiopia identified several barriers to immunization service utilization. Lower household income [ 7 ], low maternal education levels [ 8 , 9 ], and poor use of maternal health services, including antenatal care (ANC) and delivery [ 7 , 8 , 10 ], and distance to a health facility [ 11 ] have been shown to be negatively associated with use and completion of routine immunization. Mothers’ lack of knowledge of schedules and benefits of immunization has also been associated with default from scheduled immunizations [ 7 , 8 ].…”