Factors associated with complete immunization among children aged 12-23 months in Yaqshid District, Somalia

Abstract

Introduction: World Health Organization revealed that, immunization has been estimated to avert between 2 to 3 million deaths every year globally. In Yaqshid district, immunization coverage among children stands at 49%. Level of complete immunization among children is unknown. There is scanty literature about the factors associated complete immunization in the district. Thus this study aims to find out factors associated with complete immunization schedule among children aged 12-23 months in Yaqshid District, Somalia. Methods: This was a mixed methods study entailing a cross section study and key informant interviews for data collection. A 46 by 7 cluster random sampling strategy was used for quantitative data. Purposive sampling was used to select key informants for qualitative data. Data was collected using semi-structured questionnaire, and key informant guide. It was entered in Epi Data 3.02 software then exported to STATA version 14 software for analysis. Thematic analysis was used for qualitative data. Results: Majority of caretakers 94.4% (306/325) were female, 90.7% (294/325) were house wives and 74.1% (240/325) had no formal education. Their average age was 28 years with a standard deviation of 6. Slightly over half of the children 52.2% (169/325) were female. A total of 14 key informants were interviewed, with mean age of 39.6 years. Completion of the immunization schedule was at 27.1% (88/325), with Polio 0 vaccine showing the lowest coverage 32.0% (104/325). Odds of completing the immunization schedule were 0.73 times lower among caretakers who stayed at a distance of 2-3km from the HCF [AOR=0.27, CI=0.08-0.95, P-value=0.04] compared to those who stayed at a distance of less than 1km at a 95% confidence interval. The odds of completing the immunization schedule were 12.14 times higher among those who had heard about child immunization [AOR=12.14, CI=1.22-120.30, P-value=0.03] compared to those who never heard about immunization. The odds of completing the immunization schedule were 3.38 times higher among children of study respondents who were near health facilities which conducted outreaches in the last one year [AOR=3.38, CI=1.15-7.96, P-value=0.04] compared to those who were near HCF which did not conduct any outreach. Qualitative data corroborated the quantitative findings. For example, all key informants reported that some communities were located at very long distances to the nearest health care facilities and this required caretakers to put in a lot of money for transport in order to visit the health facility and yet vaccination outreaches were rare because of low funding for the vaccination program in addition to low levels of staffing at health facilities. Conclusions: Completion of immunization schedule among children in Yaqshid district was generally low, Somalia needs urgent attention by different actors. Interventions should focus on increasing health facility funding for community outreaches and awareness creation through political and religious leaders, managing vaccine side effects and increase on health facility staffing.