Determinants of Vaccination Uptake among Children aged 12-24 Months in Afgoi Town, Somalia

Abstract

Vaccination is designed to confer to a person, immunity or resistance to an infectious disease. Vaccines stimulate the body’s own immune system to protect the individual against subsequent infection or disease. It is a proven mechanism for eradicating life-threatening infectious diseases, and averting millions of deaths each year. Vaccination is one of the most cost-effective health interventions, with proven strategies that make it accessible worldwide. Despite their public health benefits, immunization programs face obstacles of negative public perception and poor planning. The aim of the study was to determine the proportion of vaccination uptake and factors influencing uptake of vaccination including access, awareness and cultural practices among caregivers in Afgoi town. A descriptive cross-sectional study design was used to obtain a clear picture of factors influencing vaccination uptake. Structured questionnaires were administered to mothers or caregivers to evaluate vaccination uptake and factors affecting it. The study populations of this study were all children aged between 12-24 months living in eligible households in Afgoi town. The town was demarcated based on its population and section-wise distribution. Simple random sampling was used to select four villages that is Balguri, Elqode, Bandar-jadid and Bulofolyo to represent the target population of the study. Household selection, systematic random sampling was used to select the eligible households who had children aged 12-24 months. Informed consent was obtained from the respondents prior to data collection. Data was analyzed using SPSS version 20 at 95% confidence. Data was subjected to descriptive, chi square and binary regression analysis. From the results of this study, full vaccination uptake of vaccine preventable diseases was less than 4.4 %, partial vaccination uptake was 69.7% while 25.9% of children had not been vaccinated. Health facility related factor found to significantly influence vaccination uptake were Care provider friendliness [(Crude OR = 0.27, 95% CI = 0.151 – 0.499, P <0.001)] and availability of vaccines [(Crude OR = 0.482, 95% CI = 0.323 – 0.720, P <0.001)]. Cultural and religious factors reported to significantly influence vaccination uptake were; cultural perception of vaccine safety [(Crude OR = 0.285, 95% CI = 0.195 – 0.417, P <0.0001)] and religious influence [(Crude OR = 0.671, 95% CI = 0.474 – 0.951, P = 0.025)]. Therefore, the Somali government and non-governmental organization should ensure quality health services are near the reach of people by ensuring hiring of professional health care providers and provide for use of mobile clinics. In addition, religious leaders should be involved in decision making regarding vaccination in the aim of meeting the national vaccination coverage targets and by extension targets of the 3rd sustainable development goal (SDG).