DETERMINANTS OF FULL VACCINATION COVERAGE AMONG CHILDREN BORN IN RURAL COMMUNITIES IN ENUGU STATE

Abstract

The WHO Immunization Agenda 2030 prioritizes equitable coverage for immunization programs in various countries, aiming to ensure that vaccines reach children in remote rural areas, urban slums, and conflict-affected communities facing multiple deprivations. This study investigates the determinants of full vaccination coverage among children born in rural communities in Enugu State to understand the factors limiting vaccine coverage in this region. A descriptive cross-sectional study design was employed, utilizing interviewer-administered questionnaires to gather information on the socio-demographic, awareness and decision-making characteristics and vaccination uptake of children from their mothers or caregivers. A multistage sampling technique was utilized in the survey to select respondents. Data collected were analyzed using the descriptive statistics and the unadjusted and adjusted Logistic regression. A total of 432 children and their caregivers participated in the survey. The prevalence of zero-dose and undervaccinated children was found to be 1.6% (n=7) and 2.8% (n=15), respectively, with children in rural communities of Enugu South accounting for a significant portion of these zero-dose and under-vaccinated cases. The overall rate of full vaccination in the study population was 61.3%, with Enugu South recording the lowest percentage of fully vaccinated children. Only 61.1% of children received the BCG vaccine at birth in the rural Enugu South Local Government Area (LGA), compared to 100% coverage in other LGAs. The uptake of the measles-containing vaccine (MCV) was lowest in Oji-River LGA. Logistic regression analysis identified poor and strong determinants of full immunization in the study population. Strong determinants of full immunization coverage included having a father who is self-employed or a salary earner, obtaining information about immunization schedules from immunization cards and obtaining vaccination schedule information from health workers.