Abstract
BackgroundWe aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0–23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria.MethodsThis cross-sectional study was conducted in the pre-implementation phase of a quality improvement programme. One-stage cluster sampling technique was employed. Data were collected from caregivers of children aged 0–23 months in ten randomly selected PHC facilities in Nassarawa Local Government Area of Kano State. Semi-structured, interviewer administered questionnaires were used. Frequencies and percentages were used to summarize the data. Multilevel logistic regression model with fixed effect and random effect component was fitted to obtain measures of association and variation respectively.ResultsCaregivers of 675 children responded. Among these children, the prevalence of MOV (for at least one antigen) was 36.15%. MOV (for individual antigens) was highest for inactivated polio vaccine followed by measles vaccine. The random effect model yielded an intraclass correlation coefficient of 9.60% for the empty model. The fixed effect model revealed that MOV was more likely among children that were accompanying a caregiver to the health facility (OR = 2.86, 95%CrI: 1.28 to 5.80) compared to those that were visiting the health facility for medical consultation. Failure to receive vaccination on the day of health facility visit (OR = 2.32, 95%CrI: 1.12 to 4.12) and visiting a clinic with three or more vaccinators (OR = 12.91, 95%CrI: 4.82 to 27.14) increased the likelihood of MOV.ConclusionThe study identified important local factors that are responsible for MOV which can be addressed in the QI programme.
Highlights
Vaccines can improve the health of children and increase life expectancy by reducing the burden of death and disability caused by common infectious diseases [1, 2]
missed opportunities for vaccination (MOV) was highest for inactivated polio vaccine followed by measles vaccine
The study identified important local factors that are responsible for MOV which can be addressed in the quality improvement (QI) programme
Summary
Vaccines can improve the health of children and increase life expectancy by reducing the burden of death and disability caused by common infectious diseases [1, 2]. The programme provides routine immunization with the following vaccines: Bacillus Calmette-Guerin (BCG), hepatitis B vaccine, oral polio vaccine (OPV), pentavalent vaccine (Penta), pneumococcal conjugate vaccine (PCV), inactivated polio vaccine (IPV), measles vaccine and yellow fever vaccine [4] These vaccines are provided within the first year of life according to the national immunization schedule as follows: at birth (BCG, OPV0, HEPB0), at six weeks of age (Penta, OPV 1, PCV1), at 10 weeks of age (Penta, OPV2, PCV2), at 14 weeks of age (Penta, OPV3, PCV3, IPV), and at nine months of age (measles and yellow fever) [4]. We aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0–23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria
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