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Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Research article

Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case – control study

Authors: Abel Negussie, Wondewosen Kassahun, Sahilu Assegid, Ada K. Hagan

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rarely completed as planned and the full immunization rate is only 24 %. The objective of this study was to identify determinant factors of incomplete childhood immunization in Arbegona district, Sidama zone, southern Ethiopia.

Methods

A community based unmatched case-control study was undertaken among randomly selected children aged 12 to 23 months and with a total sample size of 548 (183 cases and 365 controls). A multi-stage sampling technique was used to get representative cases and controls. Data was collected using a structured questionnaire and analyzed using SPSS version 16 statistical software. Bivariate and multiple logistic regression analyses were done to identify independent factors for incomplete immunization status of children. Qualitative data were also generated and analyzed using thematic framework.

Results

The incomplete immunization status of children was significantly associated with young mothers (AOR = 9.54; 95 % CI = 5.03, 18.09), being born second to fourth (AOR = 3.64; 95 % CI = 1.63, 8.14) and being born fifth or later in the family (AOR = 5.27; 95 % CI = 2.20, 12.64) as compared to being born first, a mother’s lack of knowledge about immunization benefits (AOR = 5.51; 95 % CI = 1.52, 19.94) and a mother’s negative perception of vaccine side effects (AOR = 1.92; 95 % CI = 1.01, 3.70). The qualitative finding revealed that the migration of mothers and unavailability of vaccines on appointed immunization dates were the major reasons for partial immunization of children.

Conclusion

To reduce the number of children with incomplete immunization status, the Arbegona district needs to consider specific planning for mothers with these risk profiles. A focus on strengthening health communication activities to raise immunization awareness and address concerns of vaccine side effects at community level is also needed. This could be achieved through integrating the immunization service to other elements of primary health care.
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Literature
1.
go back to reference WHO. Global routine vaccination coverage 2011, The Weekly Epidemiological Record. 2012. WHO. Global routine vaccination coverage 2011, The Weekly Epidemiological Record. 2012.
2.
go back to reference WHO/UNICEF. Global Immunization Data. 2013. WHO/UNICEF. Global Immunization Data. 2013.
3.
go back to reference CDC. Morbidity and Mortality Weekly Report (MMWR), Global routine vaccination coverage. 2013. CDC. Morbidity and Mortality Weekly Report (MMWR), Global routine vaccination coverage. 2013.
4.
go back to reference Tarantola D, Hacen M, Lwanga S, Clements CJ. Is immunization coverage in Africa slipping? An evaluation of regional progress to 2013. Ann Vaccines Immun. 2014;1(2):1007. Tarantola D, Hacen M, Lwanga S, Clements CJ. Is immunization coverage in Africa slipping? An evaluation of regional progress to 2013. Ann Vaccines Immun. 2014;1(2):1007.
5.
go back to reference Nshimirimana D, Mihigo R, Clements CJ. Routine immunization services in Africa: back to basics. J Vaccines Immun. 2013;1:6–12.CrossRef Nshimirimana D, Mihigo R, Clements CJ. Routine immunization services in Africa: back to basics. J Vaccines Immun. 2013;1:6–12.CrossRef
6.
go back to reference FMOH (Ethiopia). Ethiopia National Expanded Programme on Immunization: Comprehensive Multi-Year Plan 2011-2015. FMOH (Ethiopia): Addis Ababa; 2010. FMOH (Ethiopia). Ethiopia National Expanded Programme on Immunization: Comprehensive Multi-Year Plan 2011-2015. FMOH (Ethiopia): Addis Ababa; 2010.
7.
go back to reference Federal Ministry of Health (MOH). Introduction of pneumococcal conjugate vaccine in Ethiopia. Training manual for Health workers. 2011. Federal Ministry of Health (MOH). Introduction of pneumococcal conjugate vaccine in Ethiopia. Training manual for Health workers. 2011.
8.
go back to reference Federal Ministry of Health (MOH). Introduction of Rotavirus vaccine in Ethiopia. Training Manual for Health Worker. 2013. Federal Ministry of Health (MOH). Introduction of Rotavirus vaccine in Ethiopia. Training Manual for Health Worker. 2013.
9.
go back to reference Central Statistical Agency (CSA) (Ethiopia) and ICF International, Macro ORC. Ethiopia Demographic and Health Survey 2011. Central Statistical Agency and ICF International: Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2011. Central Statistical Agency (CSA) (Ethiopia) and ICF International, Macro ORC. Ethiopia Demographic and Health Survey 2011. Central Statistical Agency and ICF International: Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2011.
10.
go back to reference Mohamud AN, Feleke A, Worku W, Kifle M, Sharma HR. Immunization coverage of 12–23 months old children and associated factors in Jigjiga District, Somali National Regional State, Ethiopia. BMC Public Health. 2014;14:865.CrossRefPubMedPubMedCentral Mohamud AN, Feleke A, Worku W, Kifle M, Sharma HR. Immunization coverage of 12–23 months old children and associated factors in Jigjiga District, Somali National Regional State, Ethiopia. BMC Public Health. 2014;14:865.CrossRefPubMedPubMedCentral
11.
go back to reference Animaw W, Taye W, Merdekios B, Tilahun M, Ayele G. Expanded program of immunization coverage and associated factors among children age 12–23 months in Arba Minch town and Zuria District, Southern Ethiopia, 2013. BMC Public Health. 2014;14:464.CrossRefPubMedPubMedCentral Animaw W, Taye W, Merdekios B, Tilahun M, Ayele G. Expanded program of immunization coverage and associated factors among children age 12–23 months in Arba Minch town and Zuria District, Southern Ethiopia, 2013. BMC Public Health. 2014;14:464.CrossRefPubMedPubMedCentral
12.
go back to reference Etana B, Deressa W. Factors associated with complete immunization coverage in children aged 12-23 months in Ambo Woreda, Central Ethiopia. BMC Public Health. 2012;12:566.CrossRefPubMedPubMedCentral Etana B, Deressa W. Factors associated with complete immunization coverage in children aged 12-23 months in Ambo Woreda, Central Ethiopia. BMC Public Health. 2012;12:566.CrossRefPubMedPubMedCentral
13.
go back to reference Debie A, Taye B. Assessment of Fully Vaccination Coverage and Associated Factors among Children Aged 12–23 Months in Mecha District, North West Ethiopia: A Cross-Sectional Study. Sci J Public Health. 2014; 2(4):342–8.CrossRef Debie A, Taye B. Assessment of Fully Vaccination Coverage and Associated Factors among Children Aged 12–23 Months in Mecha District, North West Ethiopia: A Cross-Sectional Study. Sci J Public Health. 2014; 2(4):342–8.CrossRef
14.
15.
go back to reference Roy SG. Risk Factors for Childhood Immunization Incompletion in Ethiopia [Thesis]: Georgia State University. 2010. Roy SG. Risk Factors for Childhood Immunization Incompletion in Ethiopia [Thesis]: Georgia State University. 2010.
16.
go back to reference Mutua MK, Murage EK, Ettarh RR. Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated? BMC Public Health. 2011;11:6.CrossRefPubMedPubMedCentral Mutua MK, Murage EK, Ettarh RR. Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated? BMC Public Health. 2011;11:6.CrossRefPubMedPubMedCentral
17.
go back to reference Rahman M, Obaida-Nasrin S. Factors affecting acceptance of complete immunization coverage of children under five years in rural Bangladesh. salud pública de méxico. 2010;52(2):137–9. Rahman M, Obaida-Nasrin S. Factors affecting acceptance of complete immunization coverage of children under five years in rural Bangladesh. salud pública de méxico. 2010;52(2):137–9.
18.
go back to reference Negeri EL, Heyi WD. An assessment of child immunization coverage and its determinants in Sinana District, Southeast Ethiopia. BMC Pediatrics. 2015;15(31):19–21. Negeri EL, Heyi WD. An assessment of child immunization coverage and its determinants in Sinana District, Southeast Ethiopia. BMC Pediatrics. 2015;15(31):19–21.
19.
go back to reference Juliet NB, Elizeus R, Juliet K, Henry W, Fred N, Ingunn MSE. More support for mothers: a qualitative study on factors affecting Immunisation behaviour in Kampala, Uganda. BMC Public Health. 2011;11:723.CrossRef Juliet NB, Elizeus R, Juliet K, Henry W, Fred N, Ingunn MSE. More support for mothers: a qualitative study on factors affecting Immunisation behaviour in Kampala, Uganda. BMC Public Health. 2011;11:723.CrossRef
20.
go back to reference Abdulraheem IS, Onajole AT, Jimoh AAG, Oladipo AR. Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children. Journal of Public Health and Epidemiology. 2011;3(4):194–203. Abdulraheem IS, Onajole AT, Jimoh AAG, Oladipo AR. Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children. Journal of Public Health and Epidemiology. 2011;3(4):194–203.
21.
go back to reference Bofarraj MAM. Knowledge, attitude and practices of mothers regarding immunization of infants and preschool children at Al-Beida City, Libya. Egypt J Pediatr Allergy Immunol. 2011;9(1):29–34. Bofarraj MAM. Knowledge, attitude and practices of mothers regarding immunization of infants and preschool children at Al-Beida City, Libya. Egypt J Pediatr Allergy Immunol. 2011;9(1):29–34.
22.
go back to reference GebreEgzbiabher K, Michael JW. Migration, community context, and child immunization in Ethiopia. Soc Sci Med. 2004;59:2603–16.CrossRef GebreEgzbiabher K, Michael JW. Migration, community context, and child immunization in Ethiopia. Soc Sci Med. 2004;59:2603–16.CrossRef
23.
go back to reference Diddy A. Migration and child immunization in Nigeria: individual- and community-level contexts. BMC Public Health. 2010;10:116.CrossRef Diddy A. Migration and child immunization in Nigeria: individual- and community-level contexts. BMC Public Health. 2010;10:116.CrossRef
24.
go back to reference Yadlapalli SK, Rita K, Chandrakant SP, Sanjeev KG. Migration and immunization: Determinants of childhood immunization uptake among socioeconomically disadvantaged migrants in Delhi, India. Trop Med Int Health. 2010; 15(11):1 326 -1 32. Yadlapalli SK, Rita K, Chandrakant SP, Sanjeev KG. Migration and immunization: Determinants of childhood immunization uptake among socioeconomically disadvantaged migrants in Delhi, India. Trop Med Int Health. 2010; 15(11):1 326 -1 32.
25.
go back to reference UNICEF/Armenia, WHO/Armenia. Ministry of Health Immunization coverage survey, Republic of Armenia. 2006. UNICEF/Armenia, WHO/Armenia. Ministry of Health Immunization coverage survey, Republic of Armenia. 2006.
26.
go back to reference Machingaidze S, Wiysonge CS, Hussey GD. Strengthening the Expanded Program on Immunization in Africa: Looking beyond 2015. PLoS Med. 2013;10(3).:e1001405. doi:10.1371/journal.pmed.1001405: 2-3 Machingaidze S, Wiysonge CS, Hussey GD. Strengthening the Expanded Program on Immunization in Africa: Looking beyond 2015. PLoS Med. 2013;10(3).:e1001405. doi:10.1371/journal.pmed.1001405: 2-3
Metadata
Title
Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case – control study
Authors
Abel Negussie
Wondewosen Kassahun
Sahilu Assegid
Ada K. Hagan
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2678-1

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