Factors affecting immunization of children (12-24 months) in Nyatike sub-county, Migori county Kenya

Abstract

Despite increasing worldwide immunization coverage, most under five children globally especially in low-income countries are not vaccinated. Poor immunization coverage remains an issue in less developed countries. In Kenya, about 8 out of 10 children (79%) aged 24 months have received all basic vaccinations (BCG, measles, and three doses each of DPT and polio vaccine, excluding polio vaccine given at birth). In 2018, Migori County immunization coverage stood at 57%. This study aimed to assess factors influencing the immunization of children aged between 12 and 24 months in Nyatike Sub–County Migori County, Kenya. Specifically, the study sought to determine immunization coverage of children, missed opportunities for immunization, and predictors of complete child immunization in Nyatike Sub-County, Migori County, Kenya. A descriptive cross-sectional study design was used while stratified random sampling was used to sample the ward. Using community unit household registers, simple random sampling was employed to select a sample size of 415 households with children (12-24 months). The target population were children aged between 12-24 months, while data was collected using a structured questionnaire. Data was pretested in Awendo Sub-County. Chi-square and Logistic regression were used to determine predictors of complete child immunization while descriptive statistics were analyzed using means, standard deviation, and confidence interval set at a p ≤0.05 level of significance. Immunization coverage stood at 281 (67.7%). On missed opportunities, measles (at 18 months) was the most defaulted (28.2%). Predictors which were found to be significant about immunization coverage were health system and socio-demographic factors. The health system factors included distance to the health facility, (p=0.001), and presence of the facility (p=0.001), There was a significant relationship between place of delivery and immunization coverage of children (p=0.000, CI=95%) with those who delivered at the health institution likely to immunize their children (OR=1.360 CI=95% [1.070-2.496]., health care providers attitude (p=0.001), availability of immunization service (p=0.001). The socio-demographic factors included cultural/religious practices (p=0.001), There was a significant relationship between level of income and immunization coverage (p=0.0001, CI=95%)., age of mother/caregiver (p=0.001 there was a strong relationship between the level of education and immunization coverage (x^2=4.113, df =1, p=0.001, CI=95%) with respondents of minimum level of education more likely to complete immunization (OR=0.693 CI=95% [1.876-1.322]. The study findings are significant and can be used to design intervention programs to improve immunization coverage, this study further recommend additional effort by community health workers to promote skills among pregnant mothers, provision of more mobile clinics to increase community reach with immunization services, there is also need for national and county department of health to scale up health education and training on maternal and child health matters while ensuring community participation to promote community ownership and sociocultural consideration which will lead to promotion of child survival and development through reduction in child morbidity and mortality.