FACTORS ASSOCIATED WITH INCOMPLETE ROUTINE IMMUNIZATION IN BAUCHI LOCAL GOVERNMENT AREA, BAUCHI STATE, NIGERIA

Abstract

Immunisation is effective only if under-five children receive the full course of recommended doses of antigens. In 2013, 14.9% of children aged 12-23months were fully immunised in Bauchi. This rate is below the 80% level required for sustained herd immunity. The low Routine Immunisation (Rl) coverage in the State has resulted in the up-surge of vaccine preventable diseases, particularly measles and poliomyelitis. The barriers to full coverage of RI have not been clearly identified. This study was conducted to examine the factors associated with incomplete childhood vaccination coverage in Bauchi State, Nigeria. This study is cross-sectional in design. Using WHO modified sampling technique; 540 mothers of children aged 12-23 months were selected from 60 clusters. Structured interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, and knowledge of RI was assessed on a 7- point scale in which ≥ 4, were graded as good knowledge. Information was also collected on symptoms of Vaccine Preventable Diseases (VPDs), attitude and perception towards RI, vaccination history of children and reasons for incomplete immunisation. Vaccination status was ascertained from RI cards. Twelve Focus Group Discussion sessions and 12 Key Informants Interviews were conducted among mothers and fathers of children aged 12-23months, health workers and community leaders respectively. Quantitative data were analyzed using descriptive statistics, Chi-square test and multinomial logistic regression at 5% level of significance. Qualitative data were analyzed thematically. Age of mothers was 2 7 ± 6.2 years, 12 .6% had no formal education while 51.5% had at least secondary education. Over one third (36. I%) did not know the importance of childhood immunisation, while 40.6% had poor knowledge of RI and VPDs. Of the 52.2% who presented RI cards at the time of the survey only 8.5% had their children fully immunised, while 91.5% were partially immunised. Reasons for incomplete vaccination included: husband disapproval (60.6%), lack of information (98.7%), child's ill health (84.4%), financial incapacitation (31.7%), unavailability of vaccine (22.8%), and poor attitude of health workers (60.9%). Out of the total sampled, one hundred and ninety-nine (36.8%) had never vaccinated their children, owing to financial incapacitation (9.6%) and husband's disapproval (96.1 %). Women who had husband disapproval (OR =3.71, Cl= 23.01 - 4639) significantly increased the likelihood of a child being partially immunized. Qualitative result showed that although there was high patronage of immunisation service, but results showed that many did not immunise their children because of unavailability of vaccine, negative attitude of some health workers and husband's disapproval. Complete routine immunization coverage in Bauchi State, Nigeria is low. Husbands have great influence on whether their children get immunized or not. Interventions that target men should be prioritized as a way of improving the immunization status of children in Bauchi State, Nigeria.