Abstract:
Childhood immunization is regarded as key to preventive and promotive health care in any community. Low immunization coverage is indicative of poor health status in children under-five years. Vitamin A supplementation is also important in strengthening the immune system as well as preventing blindness in children under-five years. In Kenya, about three quarters of children aged between 12-23 months are reported to receive all recommended vaccinations while more than half of them receive Vitamin A Supplements. However, there exist variation within provinces/Counties on the coverage of both immunization and Vitamin A Supplementation. The study was a cross-sectional study conducted at the household level to assess the immunization and vitamin A supplementation and associated factors among children aged 12-23 months in Mwaluphamba Sub-County Kwale County. The primary sampling units were households within Health Demographic Surveillance Site. A total of 285 households were sampled. A structured questionnaire was used to capture socio demographic, socio economic and health provision characteristic. Data analysis was done using SPSS software version 20 and p-value was set at < 0.05. Coverage for individual immunizations were BCG 99%, OPV3 31.6%, Pentavalent three 83.2% and Measles 67.8%. Polio vaccination coverage was significantly associated with level of education (p=0.035), type of employment (p=0.002), distance to health facility (p=0.031), time taken to health facility (p=0.008), place of last delivery (p<0.001) and facilitator during delivery (P<0.001). Pentavalent vaccination coverage had significant association with gender of the child (p=0.030), place of delivery (p=0.047), type of facilitator during delivery (p=0.034) and time (p=0.013). Measles vaccination coverage had significant association with place of last delivery (p=0.006) and type of facilitator during delivery (p=0.003). First dose of VAS coverage was significantly associated with by gender of the child (p=0.034), religion of the respondents (p=0.047), place of last delivery (p<0.001) and delivery assistant. (p=0.019). Second dose of VAS had significant association with age of the respondent (p=0.009), place of last delivery (p=0.001) and type of facilitator during delivery (p=0.036). Immunization coverage was lower than 77% reported in KDHS 2014 and the 80% recommended by WHO. The dropout rate between those who received BCG at birth and those who received measles vaccine at 9 months was high 31.2%. There was discrepancies in coverage of OPV3 and third dose of pentavalent vaccines which are given concurrently where polio vaccine (31.6%) was lower than pentavalent vaccine (83.2%). Vitamin A coverage at first dose was 45% while at second dose was 29.5%. Effective vaccination outreach services need to be put in place to target those who miss out on receiving vaccinations during immunization days. More efforts to be put in place in improving delivery rates in health facilities and with assistance by health workers, as these are positively associated with higher vaccination coverage. Health education and sensitization on the importance of child vaccinations and Vitamin A supplements should be provided in the study area.
