Factors Associated with Low Immunization Coverage in Children Under Five Years in Asuogyaman District in Eastern Region of Ghana

Abstract

Expanded Programme on Immunization is one of the most successful and cost effective programmes adopted by World Health Organization and other partners to prevent vaccine preventable diseases which are the major cause of infant morbidity and mortality worldwide. Since 2012, Africa has demonstrated unprecedented commitments in the Global Vaccine Action Plan and this has resulted in the protection of millions of children. Despite this, some infants still remained unvaccinated and at risk of vaccine preventable diseases. Even though, Ghana was among countries which achieved 95% DPT3 coverage, this was not evenly distributed across all districts and Asuogyaman District was not an exception. The study assessed the factors associated with low immunization coverage among children under five years in Asuogyaman District. A descriptive cross-sectional study was conducted among mothers/caregivers in the Asuogyaman district. A total of 401 mothers/caregivers were enrolled into the study and structured questionnaire was used to collected data from mothers/caregivers on factors associated with low immunization coverage in children under 5 years. The caregivers were mostly females, 396(98.7%) with mean age of 28.6(±6.7) years and the majority of them, 216(53.9%) were in the age group 20-29 years.  Only 250(62.3%) of the participants had good knowledge on immunization. The level of knowledge of the caregivers was significantly associated with ethnicity (χ²=9.83, p=0.043, 16?=0.05"> ), occupation (χ²=10.92, p=0.012, 16?=0.05"> ), and place of delivery (χ²=4.37, p=0.037,  16?=0.05"> ). Participants who were self-employed were 38% more likely to have good knowledge compared to those who were unemployed (AOR=0.62; 95% CI=0.40-0.95; p=0.030) and those who delivered at home were also twice more likely to have good knowledge on immunization compared to those who delivered at the health facility (AOR=2.12; 95% CI=1.19-3.77; p=0.010). Most of the caregivers, 304(75.8%) had positive attitude and good practices, 346(86.3%) on immunization. Majority of the mothers/caregivers, 353(88.0%) perceive health workers had positive attitude towards them.

Conclusion: Immunization services were largely accessible to the caregivers. Knowledge of mothers/caregivers on immunization was low, but they had positive attitude and good practices on immunization.

Keywords: Immunization, coverage, Asuogyaman district, Eastern region, Ghana

DOI: 10.7176/JHMN/81-09

Publication date:October 31^st 2020